Further results about pain rating by patients and physicians: reply to Chibnall and Tait

Marquié, Laetitia; Raufaste, Éric; Lauque, D.; Mariné, Claudette; Ecoiffier, M; Sorum, Paul Clay

doi:10.1016/j.pain.2003.10.014

Cited by 3 publications

(4 citation statements)

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“…These results cohere with previous studies that showed that, both for chronic and acute pain, the higher the patient's rating, the greater the observers' disbelief. 5,12,39,40 However, it should be noted that this effect was really very small, being the Cohen's d of 0.12, which is not even a small effect according to Cohen's benchmark 50 of 0.2. The statistical significance of this effect using a weak manipulation (e.g., text-based vignettes) suggests that it is worth examining how strong the effect might be with more naturalistic paradigms.…”

Section: The Influence Of the Level Of The Patient's Rating On The Extent Of Anchoringmentioning

confidence: 89%

“…First, we hypothesized that the observers would exhibit a tendency to anchor to their initial impressions of pain judgment (Hypothesis 1). Secondly, based on previous studies that showed that both for chronic and acute pain, the higher the patient's rating, the greater the observers' discrepancy, 5,12,39,40 we tested the hypothesis of a different extent of anchoring depending on the patient's self-report. Specifically, we expected a greater extent of anchoring for the cases in which patients' ratings were higher than the participants' initial impression compared with those in which the patients' ratings were lower than the participants' initial impression (Hypothesis 2).…”

Section: Introductionmentioning

confidence: 99%

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The Influence of Anchoring on Pain Judgment

Riva

Rusconi

Montali

et al. 2011

Journal of Pain and Symptom Management

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Section: The Influence Of the Level Of The Patient's Rating On The Extent Of Anchoringmentioning

confidence: 89%

Section: Introductionmentioning

confidence: 99%

The Influence of Anchoring on Pain Judgment

Riva

Rusconi

Montali

et al. 2011

Journal of Pain and Symptom Management

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show abstract

“…Although the usual methods for estimating pain, such as numerical rating scale [1] or a visual analogue scale [2], have been validated, the clinical impact of their use is uncertain. Clinicians continue in many cases to be insufficiently aware of patients' pain [3][4][5][6][7] and to rate it at lower levels than do patients themselves, for both acute [8][9][10][11][12] and chronic [13] pain. When asked why they give lower ratings, clinicians explain that they are trained to look for behavioral signs of pain and that, accordingly, when they judge the behavioral evidence or the nature of the illness as ''discordant'' with the patients' stated level of pain, they will, consciously or unconsciously, adjust their own ratings in light of this conflicting information.…”

Section: Introductionmentioning

confidence: 99%

Emergency physicians’ pain judgments: cluster analyses on scenarios of acute abdominal pain

2007

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Physicians have been found to give lower ratings of patients' pain than do the patients themselves. We hypothesized that the physicians' rating depends not only on the patient's pain rating but also on other cues. We also hypothesized that these cues influence physicians' pain treatment and urgency level. We gave to 52 emergency room physicians in Toulouse, France, 45 scenarios describing patients with acute abdominal pain, representing all combinations of 5 levels of patient's pain rating, 3 levels of behavioral manifestations of pain, and three signs of the severity of the abdominal pathology (namely, the likelihood of appendicitis). The participants rated the patient's pain, selected the intensity of pain treatment, and judged the degree of urgency of calling in a surgeon. In rating pain, physicians took into account the patient's rating, behavioral manifestations of pain, and the signs of abdominal pathology. Clusters analyses showed two sets of individual differences. When rating pain and choosing pain treatment, physicians gave either a low or high weight to behavioral pain cues. In urgency judgments, physicians could be separated into those who gave considerable weight to the different levels of severity and those who did not.

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“…Yet they provided an insightful basis for subsequent studies. Furthermore, Marquié et al (2004) didn't find any difference in the degree of miscalibration between novices and experts. 1 The latter factor was introduced on the basis of a preliminary qualitative study in which it emerged that healthcare professionals were influenced by the patients' place of origin (Montali et al, 2009).…”

Section: Participantsmentioning

confidence: 87%

Taking into account the observers’ uncertainty: a graduated approach to the credibility of the patient’s pain evaluation

et al. 2009

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1 AcknowledgementsAuthors wish to thank John Burns and three unknown referees for their pertinent comments and suggestions. We are also grateful to Marco Marelli for his suggestions on the analyses of the properties of the graduated approach used in Experiment 2. 1 AbstractThis article presents two experiments aiming to investigate the adoption of a graduated measure to describe credibility attribution by observers who evaluate patients' pain accounts. A total of 160 medical students were required to express a credibility judgment on the pain intensity level of hypothetical patients. We used 16 vignettes based on a factorial mixed-design. Withinparticipants factors were the reported pain, the presence of a physical sign, the patient's facial expression and the patient's gender, and between-groups factors were the patient's age and the geographical distribution of the patient's name. Results confirm the well-established tendency not to believe patients' self-reports and provide information regarding the evaluators' uncertainty. The findings suggest that a graduated measure is useful for assessing the degree of uncertainty of the observers and subtle effects of different factors upon the judgment of patient's pain.

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Further results about pain rating by patients and physicians: reply to Chibnall and Tait

Cited by 3 publications

References 0 publications

The Influence of Anchoring on Pain Judgment

The Influence of Anchoring on Pain Judgment

Emergency physicians’ pain judgments: cluster analyses on scenarios of acute abdominal pain

Taking into account the observers’ uncertainty: a graduated approach to the credibility of the patient’s pain evaluation

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