Abstract
The article by Fanciullo et al. [1], entitled “Development of a new computer method to assess children's pain,” raises many important issues regarding measurement and implementation problems associated with various self-report faces scales designed to assess pain in children. The authors introduce a computer-based faces scale that enables children to rate their pain on a continuous scale by adjusting the facial expression (shape of mouth and eyes) to indicate their pain intensity. We agree with the authors' statements concerning the potential advantages of a computer-based, continuous faces scale, namely sensitivity, patient preference, and computer data acquisition and display. Our experience with such a scale developed in 1997 [2–4] largely supports these assertions. The authors emphasized a presumed direct correspondence between pain intensity and the amount of curvature of the mouth and diameter of the eyes. However, in doing so, they seem to have ignored a basic rule of psychophysics. They assumed that physically equal changes (intervals) in facial expression are perceptually equal intervals. If that were the case, then Mona Lisa's smile would be nothing special. Subtle changes in …
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