Pain Measurement: Present Concerns and Future Directions

Abstract

Over the past 15 years, researchers have worked to establish reliability and validity of several pain measures used to assess pain in older adults. A recent state of the science consensus statement cited slightly more than 400 references focusing on the various aspects of pain assessment in older adults [1] that identify some of the unique concerns of this population. Accurate, valid, reliable pain measures are essential in assisting clinicians as they quantify, track, and evaluate treatments to reduce pain. Although some researchers have focused on development of comprehensive pain measures for older adults, many researchers have been testing instruments that focus on the single characteristic of pain severity. This issue of Pain Medicine reports two articles on instruments that measure pain severity. Herr, Spratt, Garand, and Li report their work evaluating the sensitivity and utility of the Iowa Pain Thermometer (IPT) and four other pain severity measures [2]. This article is another in a series of the works by Herr, whose career focus has been to establish sensitivity, reliability, validity, ease of use, and preference of pain severity instruments in older adult populations. In early work, Herr and Mobily established that older adults most preferred the Verbal Descriptor Scale (VDS) when compared with other pain measures [3]. In recent years, Herr et al. have modified the VDS into the IPT, which gives a visual image of a pain thermometer and allows subjects to select levels of severity that fall between the words offered. Herr et al. confirm relatively higher failure rates in both younger and older populations of the visual analogue scale (VAS), a scale preferred by …