A psychometric evaluation of the Pediatric Anesthesia Emergence Delirium scale

Ringblom, Jenny; Wåhlin, Ingrid; Proczkowska, Marie

doi:10.1111/pan.13348

Cited by 33 publications

(43 citation statements)

References 20 publications

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“…We found a high level of agreement indicating that the raters interpreted and used the PAED scale similarly. The findings of our study are consistent with the original study that developed the scale and one Swedish study indicating that the PAED scale was found reliable across countries in Scandinavia . We also found a high Cronbach alpha coefficient (0.92), which indicated a good internal consistency (higher than 0.7).…”

Section: Discussionsupporting

confidence: 91%

“…The first 3 items are scored in reverse order: 4 points equal ‘not at all’ and 0 points equal ‘extremely’. Items 4 and 5 are scored in ascending order: 4 points equal ‘extremely’ and 0 points equal ‘not at all.’ Scores from the 5 items are tallied to obtain a combined score …”

Section: Methodsmentioning

confidence: 99%

“…The PAED scale scores were dichotomized (yes/no) using a cut‐off level that was equal to or above 10 points, which was in accordance with the original study that introduced the scale . Accordingly, a score of 10 points or more indicated ED, whereas scores of 9 points or fewer indicated that the child did not have ED . Prior to the screenings with the PAED scale, the staff received a brief introduction to the screening tool and challenges were discussed and questions answered.…”

Section: Methodsmentioning

confidence: 99%

“…There are tools available for detecting ED, but only a few focus on capturing all aspects of ED . Among these is the Pediatric Anesthesia Emergence Delirium (PAED) scale . This scale is based on a 5‐item questionnaire.…”

Section: Introductionmentioning

confidence: 99%

“…The PAED scale has been tested for reliability and validity in its original language and also in different contexts, but its ability to measure changes over time has not yet been assessed . The PAED scale has been recently translated into Danish and successfully pilot tested in the Post Anesthesia Care Unit (PACU) at Aarhus University Hospital (AUH), Denmark.…”

Section: Introductionmentioning

confidence: 99%

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An evaluation of the Danish version of the Pediatric Anesthesia Emergence Delirium scale

Simonsen

Skovby²,

Lisby

2020

Acta Anaesthesiol Scand

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Background Emergence Delirium (ED) is a common complication from anesthesia. Although ED has a short duration, detection is important due to the risk that ED poses for post‐operative complications in the child. The Pediatric Anesthesia Emergence Delirium (PAED) scale has been translated into Danish, but it has not yet been validated. The aim of this study was to investigate the inter‐rater reliability, criterion validity, and responsiveness of the Danish version of the PAED scale as well as to determine the prevalence of ED. Method A sample of 100 post‐operative children were enrolled and assessed with the PAED scale at pre‐specified time intervals. Inter‐rater reliability was assessed independently by 2 raters. For criterion validity, a clinical expert was chosen as the gold standard. Sensitivity and specificity were based on a comparison between the scoring of the raters and the gold standard. Responsiveness was assessed by comparing changes in scores. Prevalence was based on the PAED scale's cut‐off level of ≥10 points. Results A high level of agreement was found, with an intraclass correlation coefficient of 0.85‐0.94. Few outliers appeared in the Bland‐Altman plot. Sensitivity ranged from 70% to 86%, and the specificity of both raters against the gold standard was 100%. Changes in scores were indicative of responsiveness. Prevalence was 13.2%. Conclusion The Danish version of the PAED scale was found reliable and demonstrated high levels of sensitivity and specificity. In addition, it was possible to identify changes in scores over time. Prevalence was in line with existing literature.

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Section: Discussionsupporting

confidence: 91%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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An evaluation of the Danish version of the Pediatric Anesthesia Emergence Delirium scale

Simonsen

Skovby²,

Lisby

2020

Acta Anaesthesiol Scand

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Facial expressions of pain in daily clinical practice to assess postoperative pain in children: Reliability and validity of the facial action summary score

Bringuier

Macioce

Boulhais

et al. 2021

European Journal of Pain

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Background: Behavioural pain scales are recommended to assess postoperative pain for children who are too young to use self-report tools. Their main limitation is underestimation of pain in the days following an intervention. Although relevant, facial expression is not used in daily clinical practice. This prospective study aimed to assess the validity and reliability of the Facial Action Summary Score (FASS), a fiveitem scale, to assess postoperative pain until hospital discharge in children <7 years. Methods: Assessments of pain and anxiety of 123 children using FASS and validated scales were used to study the psychometric validity of the FASS in clinical practice. Results: The content validity was previously investigated in a development study. The internal validity of the FASS was high with excellent reliability (intraclass coefficient = 0.94) and a high Cronbach α (0.89). Convergent validity with pain scales (FLACC [Face, Legs, Activity, Cry, Consoling] and FPS-R [Faces Pain Scale -Revised]) was high (r > 0.8). Sensitivity to change was verified by a significant decrease in the score after rescue analgesia. For a threshold of 2/5, the FASS shows excellent specificity (97%) and sensitivity (82%). The low number of false negatives is the main strength of this tool. Conclusions: This work highlights the interest in using facial expression in daily clinical practice to manage postoperative pain. The FASS is easy to use with excellent psychometric properties and is particularly sensitive to measure pain in the days following surgery. Significance: The aim of this study was to prove that facial expression of pain can be used in clinical practice to measure postoperative pain in children. The reduced number of false negatives is the main strength of this tool.

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Risk of esketamine anesthesia on the emergence delirium in preschool children after minor surgery: a prospective observational clinical study

Chen

Yang

Zhang

et al. 2023

Eur Arch Psychiatry Clin Neurosci

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A psychometric evaluation of the Pediatric Anesthesia Emergence Delirium scale

Cited by 33 publications

References 20 publications

An evaluation of the Danish version of the Pediatric Anesthesia Emergence Delirium scale

An evaluation of the Danish version of the Pediatric Anesthesia Emergence Delirium scale

Facial expressions of pain in daily clinical practice to assess postoperative pain in children: Reliability and validity of the facial action summary score

Risk of esketamine anesthesia on the emergence delirium in preschool children after minor surgery: a prospective observational clinical study

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