The purpose of this study was to develop an instrument to assess satisfaction with treatment of chronic pain, evaluate the reliability and validity of this instrument, and then examine predictors and consequences of satisfaction. The Pain Service Satisfaction Test (PSST) is the result of this effort. Fifty adult patients receiving services for chronic pain in a university pain clinic completed the PSST as part of a survey mailed to their homes. Findings supporting the validity of the PSST included significant positive correlations with a general measure of treatment satisfaction, patient ratings of global treatment satisfaction and effects of treatment, and physician ratings of patient satisfaction with treatment. Regression analyses of predictors of satisfaction highlighted significant contributions of confidence and trust in the provider, pain reduction, and waiting in the clinic. These predictors together accounted for 60% of satisfaction with treatment. Treatment satisfaction was negatively correlated with depression, reported number of physicians consulted, and number of physician visits for pain in the past 12 months; and there was a trend toward a negative correlation with disability. Results of the present study support the importance of satisfaction with treatment as a predictor and possible determinant of later health, function, and service utilization.

BACKGROUND:The duration of training needed for hospitalists to accurately perform hand‐carried ultrasound echocardiography (HCUE) is uncertain.OBJECTIVE:To determine the diagnostic accuracy of HCUE performed by hospitalists after a 27‐hour training program.DESIGN:Prospective cohort study.SETTING:Large public teaching hospital.PATIENTS:A total of 322 inpatients referred for standard echocardiography (SE) between March and May 2007.INTERVENTION:Blinded to SE results, attending hospitalist physicians performed HCUE within hours of SE.MEASUREMENTS:Diagnostic characteristics of HCUE as a test for 6 cardiac abnormalities assessed by SE: left ventricular (LV) systolic dysfunction; severe mitral regurgitation (MR); moderate or severe left atrium (LA) enlargement; moderate or severe LV hypertrophy; medium or large pericardial effusion; and dilatation of the inferior vena cava (IVC).RESULTS:A total of 314 patients underwent both SE and HCUE within a median time of 2.8 hours (25th to 75th percentiles, 1.4 to 5.1 hours). Positive and negative likelihood ratios for HCUE increased and decreased, respectively, the prior odds by 5‐fold or more for LV systolic dysfunction, severe MR regurgitation, and moderate or large pericardial effusion. Likelihood ratios changed the prior odds by 2‐fold or more for moderate or severe LA enlargement, moderate or severe LV hypertrophy, and IVC dilatation. Indeterminate HCUE results occurred in 2% to 6% of assessments.CONCLUSIONS:The diagnostic accuracy of HCUE performed by hospitalists after a brief training program was moderate to excellent for 6 important cardiac abnormalities. Journal of Hospital Medicine 2009;4:340–349. © 2009 Society of Hospital Medicine.

A different version of this manuscript was submitted to Rush University (Chicago, IL) in partial fulfillment of the requirements for the degree of master of science. BACKGROUND:Procedure services may improve the training of bedside procedures.

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