Barbero Marco, Piff Matthew, Evans David, Falla Deborah
Rehabilitation Research Laboratory 2rLab, Department of Business Economics Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno, Switzerland.
Nuffield Health, Epsom, United Kingdom; Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, United Kingdom.
Musculoskelet Sci Pract. 2023 Nov;68:102871. doi: 10.1016/j.msksp.2023.102871. Epub 2023 Oct 7.
Clinicians commonly use pain drawings to define the spatial extent and location of a person's pain, but limited research has investigated who should perform the drawing.
To establish the inter-rater reliability of pain extent and location derived from three sets of pain drawings for people with chronic low back pain: one self-reported and two clinician-reported. Additionally, convergent validity of pain extent was assessed using the same dataset.
Repeated-measures cross-sectional study.
Fifteen patients with chronic low back pain and a pool of eight clinicians were involved to assess the reliability of pain extent and location extracted by self-report and clinician-reported pain drawings. Inter-rater reliability of pain extent was computed using intraclass correlation coefficients (ICC) and Bland Altman analysis. Convergent validity of pain extent was assessed using Spearman's rank correlation. Inter-rater reliability of pain location was assessed using the Jaccard similarity index.
The inter-reliability analysis for pain extent, derived from self-reported and clinician-reported pain drawings, revealed ICC scores ranging from 0.39 to 0.51, all with wide confidence intervals. The mean Jaccard similarity indexes computed for pain location ranged from 0.60 to 0.65. Moderate to good correlation was found for pain extent derived by the sets of pain drawings.
Inter-rater reliability of pain extent and pain location derived from self-reported and clinician-reported pain drawings is poor in patients with chronic low back pain. The lack of reliability is also confirmed when considering only clinician-reported PDs. The convergent validity analysis of pain extent revealed that the two pain drawing approaches measure a similar construct.
临床医生通常使用疼痛图来界定个人疼痛的空间范围和位置，但针对应由谁来绘制疼痛图的研究较少。
确定三组慢性下腰痛患者疼痛图所反映的疼痛范围和位置的评分者间信度：一组为自我报告，两组为临床医生报告。此外，使用同一数据集评估疼痛范围的收敛效度。
重复测量横断面研究。
纳入15名慢性下腰痛患者和8名临床医生，以评估自我报告和临床医生报告的疼痛图所提取的疼痛范围和位置的信度。使用组内相关系数（ICC）和布兰德-奥特曼分析计算疼痛范围的评分者间信度。使用斯皮尔曼等级相关评估疼痛范围的收敛效度。使用杰卡德相似性指数评估疼痛位置的评分者间信度。
自我报告和临床医生报告的疼痛图所反映的疼痛范围的信度分析显示，ICC分数在0.39至0.51之间，所有置信区间均较宽。计算得出的疼痛位置的平均杰卡德相似性指数在0.60至0.65之间。各套疼痛图得出的疼痛范围之间存在中度至良好的相关性。
慢性下腰痛患者自我报告和临床医生报告的疼痛图所反映的疼痛范围和疼痛位置的评分者间信度较差。仅考虑临床医生报告的疼痛图时，信度不足也得到了证实。疼痛范围的收敛效度分析表明，两种疼痛图方法测量的是相似的结构。
