Evangelista Marina C, Monteiro Beatriz P, Steagall Paulo V
Department of Clinical Sciences, Faculty of Veterinary Medicine, Université de Montréal, Saint-Hyacinthe, QC, Canada.
Department of Veterinary Clinical Sciences, Centre for Animal Health and Welfare, Jockey Club College of Veterinary Medicine and Life Sciences, City University of Hong Kong, Hong Kong, S.A.R.
Pain. 2022 Jun 1;163(6):e697-e714. doi: 10.1097/j.pain.0000000000002474. Epub 2021 Sep 9.
Facial expressions of pain have been identified in several animal species. The aim of this systematic review was to provide evidence on the measurement properties of grimace scales for pain assessment. The protocol was registered (SyRF#21-November-2019), and the study is reported according to the PRISMA guidelines. Studies reporting the development, validation, and the assessment of measurement properties of grimace scales were included. Data extraction and assessment were performed by 2 investigators, following the COnsensus-based Standards for the Selection of Health Measurement INstruments guidelines. Six categories of measurement properties were assessed: internal consistency, reliability, measurement error, criterion and construct validity, and responsiveness. Overall strength of evidence (high, moderate, and low) of each instrument was based on methodological quality, number of studies, and studies' findings. Twelve scales for 9 species were included (mice, rats, rabbits, horses, piglets, sheep or lamb, ferrets, cats, and donkeys). Considerable variability regarding their development and measurement properties was observed. The Mouse, Rat, Horse and Feline Grimace Scales exhibited high level of evidence. The Rabbit, Lamb, Piglet and Ferret Grimace Scales and Sheep Pain Facial Expression Scale exhibited moderate level of evidence. The Sheep Grimace Scale, EQUUS-FAP, and EQUUS-Donkey-FAP exhibited low level of evidence for measurement properties. Construct validity was the most reported measurement property. Reliability and other forms of validity have been understudied. This systematic review identified gaps in knowledge on the measurement properties of grimace scales. Further studies should focus on improving psychometric testing, instrument refinement, and the use of grimace scales for pain assessment in nonhuman mammals.
已经在几种动物物种中识别出疼痛的面部表情。本系统评价的目的是提供有关用于疼痛评估的 grimace 量表测量属性的证据。该方案已注册（SyRF#21-2019 年 11 月），并且本研究按照 PRISMA 指南进行报告。纳入了报告 grimace 量表的开发、验证及测量属性评估的研究。由 2 名研究人员按照基于共识的健康测量工具选择标准指南进行数据提取和评估。评估了六类测量属性：内部一致性、可靠性、测量误差、标准效度和结构效度以及反应性。每种工具的总体证据强度（高、中、低）基于方法学质量、研究数量和研究结果。纳入了 9 个物种的 12 种量表（小鼠、大鼠、兔子、马、仔猪、绵羊或羔羊、雪貂、猫和驴）。观察到它们在开发和测量属性方面存在很大差异。小鼠、大鼠、马和猫 grimace 量表显示出高水平的证据。兔子、羔羊、仔猪和雪貂 grimace 量表以及绵羊疼痛面部表情量表显示出中等水平的证据。绵羊 grimace 量表、EQUUS-FAP 和 EQUUS-驴-FAP 在测量属性方面显示出低水平的证据。结构效度是报告最多的测量属性。可靠性和其他形式的效度研究不足。本系统评价确定了 grimace 量表测量属性方面的知识空白。进一步的研究应侧重于改进心理测量测试、完善工具以及在非人类哺乳动物中使用 grimace 量表进行疼痛评估。
