São Paulo University, São Paulo, Brazil.
School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada.
Pain Pract. 2019 Jul;19(6):602-608. doi: 10.1111/papr.12780. Epub 2019 Apr 11.
Computerized methods to analyze pain drawings (PDs) have been developed and may aid to measure the pain area more precisely.
The aim of this study was to verify whether examiners can reproduce the patient's PDs with acceptable reliability.
This was an intra-rater and inter-rater reliability study. The protocol consisted of 4 steps: (1) scanning of paper PDs; (2) sharing the digitalized PD images between examiners; (3) reproducing the PD images in the sketching application; and (4) calculating the pain area in pixels and percentages. We calculated intraclass correlation coefficients (ICCs; 2,1), the standard error of the measurement (SEM), and the smallest detectable difference (SDD).
Reliability was tested using 31 PDs from 17 patients in our database (11 female [64.7%], mean age: 53.23 ± 11.57 years). Intra-rater reliability varied from ICC (2,1) = 0.991 (95% confidence interval [CI] = 0.982 to 0.996; SEM = 3,432.45; SDD = 162.39 pixels; P < 0.001) to ICC (2,1) = 0.992 (95% CI = 0.978 to 0.997; SEM = 3,412.96; SDD = 161.93 pixels; P < 0.001). Inter-rater reliability for the measurement between all examiners was considered excellent (ICC [2,1] = 0.976; 95% CI = 0.956 to 0.987; SEM =8,580.75; SDD = 256.76 pixels; P < 0.001), being higher between Examiners A and C (ICC [2,1] = 0.970; 95% CI = 0.936 to 0.986; SEM = 6,453.34; SDD = 222.67 pixels; P < 0.001).
Our results show that intra- and inter-rater reliabilities were excellent when an examiner reproduced the paper PDs into digitalized PDs. This process gives clinicians and researchers the opportunity to analyze pain extent more precisely using a computerized method.
已经开发出了用于分析疼痛绘图（PD）的计算机化方法，这些方法可能有助于更精确地测量疼痛区域。
本研究的目的是验证检查者是否可以通过可接受的可靠性来重现患者的 PD。
这是一项内部和外部检查者的可靠性研究。该方案包括 4 个步骤：（1）扫描纸质 PD；（2）在检查者之间共享数字化 PD 图像；（3）在绘图应用程序中重现 PD 图像；（4）计算像素和百分比的疼痛面积。我们计算了组内相关系数（ICC；2,1）、测量的标准误差（SEM）和最小可检测差异（SDD）。
使用来自我们数据库中的 17 名患者的 31 份 PD 进行了可靠性测试（11 名女性[64.7%]，平均年龄：53.23±11.57 岁）。内部检查者的可靠性从 ICC（2,1）=0.991（95%置信区间[CI]0.982 至 0.996；SEM=3432.45；SDD=162.39 像素；P<0.001）到 ICC（2,1）=0.992（95% CI 0.978 至 0.997；SEM=3412.96；SDD=161.93 像素；P<0.001）不等。所有检查者之间的测量的外部检查者可靠性被认为是极好的（ICC[2,1]=0.976；95%CI 0.956 至 0.987；SEM=8580.75；SDD=256.76 像素；P<0.001），检查者 A 和 C 之间的可靠性更高（ICC[2,1]=0.970；95%CI 0.936 至 0.986；SEM=6453.34；SDD=222.67 像素；P<0.001）。
当检查者将纸质 PD 重现为数字化 PD 时，我们的结果表明内部和外部检查者的可靠性均非常出色。该过程使临床医生和研究人员有机会使用计算机化方法更精确地分析疼痛程度。
