Clinic for Anesthesiology and Intensive Care, University Hospital Jena, Germany.
Clin J Pain. 2013 Mar;29(3):224-32. doi: 10.1097/AJP.0b013e31824c5d7a.
In the postoperative setting, functional interference of pain is an important outcome parameter. It can be measured by numerical rating scales (NRS) and by binary items (yes/no). For implementation, dissemination, and practicability in clinical routine, not only psychometric characteristics but also patients' acceptance of assessment methods is important but has not been studied so far. To compare these 2 answer formats, the pain interference questions of the German initiative Quality Improvement in Postoperative Pain Management, a multicentric pain registry project, were used.
Psychometric quality, clinical significance, and patients' preferences were analyzed in NRS and binary formats of pain interference assessments. Responses from 430 patients in 3 surgical disciplines (abdominal, orthopedic/trauma, and oromaxillofacial surgery) were examined.
The results indicate a satisfactory reliability and validity of both answer formats. They achieve equal test-retest reliability (0.724 to 0.885) and construct validity (identifying significant differences between the 3 surgical disciplines). The binary "no interference" answer consistently corresponds to NRS values of 0 to 2. The means in 3 pain intensity measures differ significantly for the groups of patients with or without pain interference. Two third of the patients prefer to answer to binary items.
Binary answer format was proven to be a practical alternative to the NRS format for a screening instrument. Comparison of binary answers with NRS answers can improve our understanding of the clinical relevance of patients' statements. Most patients prefer the use of the binary answer format.
术后，功能障碍性疼痛是一个重要的结果参数。它可以通过数字评分量表（NRS）和二分类条目（是/否）来测量。为了在临床实践中实施、推广和实用，不仅要考虑心理测量学特征，还要考虑患者对评估方法的接受程度，但目前尚未对此进行研究。为了比较这两种回答格式，使用了德国术后疼痛管理质量改进倡议的疼痛干扰问题，这是一个多中心疼痛登记项目。
在 NRS 和疼痛干扰评估的二分类格式中，分析心理测量质量、临床意义和患者偏好。对来自 3 个外科科室（腹部、骨科/创伤、口腔颌面外科）的 430 名患者的反应进行了检查。
结果表明，两种回答格式均具有令人满意的可靠性和有效性。它们具有相同的重测信度（0.724 至 0.885）和结构效度（能够识别 3 个外科科室之间的显著差异）。二分类“无干扰”答案与 NRS 值 0 至 2 一致。在 3 个疼痛强度测量中，有疼痛干扰的患者组之间的平均值存在显著差异。三分之二的患者更喜欢回答二分类条目。
二分类回答格式已被证明是 NRS 格式的实用替代方案，用于筛选工具。将二分类答案与 NRS 答案进行比较，可以提高我们对患者陈述的临床相关性的理解。大多数患者更喜欢使用二分类回答格式。
