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Pain Scale may Not Produce a Perfect Picture of Patients' Pain

by VR Sreeraman on Sep 18 2007 6:56 PM

According to researchers in the Indiana University School of Medicine and the University of North Carolina, the most commonly used measure for screening of pain may only be moderately accurate.

In the study the evaluation of the usefulness of a scale that questions patients in primary care to rate their current pain from 0 (no pain) to 10 (worst pain) was done.

“Our study is the first to evaluate the accuracy of the widely-used numeric rating scale [NRS] as a screening test to identify primary care patients with clinically important pain. Accurate screening is important because pain symptoms, both serious and not so serious, are among the most common complaints in primary care,” said Erin E. Krebs, M.D., M.P.H., assistant professor of medicine at the IU School of Medicine and a Regenstrief Institute research scientist.

“To be helpful, a screening test needs to provide accurate information that doctors can use to improve care. If a test isn’t very accurate or useful, doctors learn to tune out the numbers,” he said.

The researchers discovered that, the NRS was easy to administer, but it failed to identify about a third of patients with serious pain enough to impair day-to-day functioning.

Most of the patients in this study had more than one pain problem, and many had long-standing pain.

They did not evaluate the accuracy of pain ratings in settings where short-term pain was more common, such as after surgery. The researchers noted that the NRS might miss intermittent symptoms because it focussed on current pain.

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“Universal pain screening has become widespread despite a lack of research evaluating its accuracy and effectiveness. We know that pain is a serious problem in primary care, but pain screening may not be the best way to address this problem,” said Dr. Krebs, who is also with the Center on Implementing Evidence-based Practice at the Roudebush Veterans Affairs Medical Center in Indianapolis.

The study would be issued in the Journal of General Internal Medicine.

Source-ANI
LIN/J


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