Veterans Affairs Health Services Research and Development Center of Excellence for Implementing Evidence-Based Practice, Indianapolis, Indiana, USA.
J Pain. 2012 Aug;13(8):764-72. doi: 10.1016/j.jpain.2012.05.004. Epub 2012 Jul 15.
Brief measures to assess and monitor pain in cancer patients are available, but few head-to-head psychometric comparisons of different measures have been reported. Baseline and 3-month data were analyzed from 274 patients enrolled in the Indiana Cancer Pain and Depression (INCPAD) trial. Participants completed the Brief Pain Inventory (BPI), the PEG (a 3-item abbreviated version of the BPI), the short form (SF)-36 pain scale, and a pain global rating of change measure. The global rating was used as the criterion for standardized response mean and receiver operating characteristic curve analyses. To assess responsiveness to the trial intervention, we evaluated standardized effect size statistics stratified by trial arm. All measures were responsive to global improvement, discriminated between participants with and without improvement, and detected a significant intervention treatment effect. Short and longer measures were similarly responsive. Also, composite measures that combined pain severity and interference into a single score (BPI total, PEG, SF-36 pain) performed comparably to separate measures of each domain (BPI severity and BPI interference).
Pain measures as brief as 2 or 3 items that provide a single score are responsive in patients with cancer-related pain. Ultra-brief measures offer a valid and efficient means of assessing and monitoring pain for the clinical management as well as research of cancer-related pain.
简短的评估和监测癌症患者疼痛的方法已经存在,但很少有不同方法的心理计量学比较的头对头研究报告。印第安纳州癌症疼痛和抑郁(INCPAD)试验招募的 274 名患者的基线和 3 个月的数据进行了分析。参与者完成了简短疼痛量表(BPI)、PEG(BPI 的 3 项简化版本)、简短 form(SF)-36 疼痛量表和疼痛整体变化评分。整体评分被用作标准化反应均值和接收器操作特性曲线分析的标准。为了评估对试验干预的反应能力,我们按试验臂分层评估了标准化效应量统计数据。所有的测量方法都对整体改善有反应,区分了有改善和没有改善的参与者,并且检测到了显著的干预治疗效果。短和长的测量方法同样有反应。此外,将疼痛严重程度和干扰合并成一个单一评分的综合测量方法(BPI 总分、PEG、SF-36 疼痛)与每个域的单独测量方法(BPI 严重度和 BPI 干扰)表现相当。
简短的 2 或 3 项疼痛措施,提供了一个单一的评分,对癌症相关疼痛的患者是有反应的。超短的措施为癌症相关疼痛的临床管理和研究提供了一种有效的评估和监测疼痛的方法。