Improve Quality of Pain Measurement

Abstract

Objectives: To review limitations of various single-item and multi-items scales of pain measurement and suggest remedial actions for better use of them leading to meaningful comparison of patients and group of patients in terms of pain scores across time and space. Method: Stages to obtain proposed score of a single item scale are: (1) Item Raw scores (2) Equidistant scores (3) Normalized equidistant scores (4) Conversion to a desired score range. For multi-item scale, further stages are (5) Summation of normalized equidistant scores with a desired score range. For transition from a stage to the next stage, method described along with empirical verification of transformation for an item to help clinicians to understand the main features of the proposed methods of scoring and to use them effectively. Results: The proposed method resulted in continuous, monotonic scores satisfying equidistant and normality conditions with a desired score range. Normalized equidistant scores help to compare patients’ scores from different distributions and facilitate application of statistical techniques in parametric set up. Conclusions: Proposed scores reflecting intensity of pain by continuous variable satisfying equidistant property. Normality, help meaningful comparison in terms of pain intensity, change in pain intensity and drawing path of progress for better prognostication. It is possible to compute split-half reliability and theoretical reliability as ratio of true score variance and observed score variance. Future studies suggested.