Interrater Reliability of Scoring of Pain Drawings in a Self-Report Health Survey

Abstract

Study Design. Study of interrater reliability. Objective. To assess the interrater reliability of data from pain drawings scored by multiple raters and the consistency of the subsequent classification of cases of widespread pain.Summary of Background Data. In large health surveys, pain drawings used to capture self-reported pain, and to classify cases of widespread pain, are often scored by several raters. The reliability of multiple rater scoring of pain drawings has not been investigated.Methods. As part of a postal survey sent to adults 50 years and older, subjects were asked to shade their pain on a blank body manikin. The first 50 pain drawings in which respondents had shaded pain were selected for this study. Eight nonclinical staff were trained to score pain drawings using transparent templates divided into 50 body areas. Interrater reliability was assessed by comparing the scoring of "pain" or "no pain" for all 50 areas of each pain drawing.Results. Complete scoring agreement among all raters was observed for at least 78% of pain drawings across all body areas (kappa Ͼ 0.60). The raters had complete agreement in 42 of 50 areas in 90% or more of pain drawings. From the raters' scoring of pain areas, there was complete agreement on the presence or absence of widespread pain for 49 of 50 pain drawings (98% agreement, Kappa ϭ 0.98).Conclusions. This study shows that multiple raters, with training and guidelines, can reliably score pain drawings, and high consistency in the subsequent classification of cases of widespread pain can be obtained from such data.

One-year trajectories of depression and anxiety symptoms in older patients presenting in general practice with musculoskeletal pain: A latent class growth analysis

“…In addition to age (50-59, 60-69, 70 + years) and gender, variables summarized by Lee and Mercurio-Riley [38] in their conceptual framework of factors previously found to be associated with psychosocial adjustment to chronic pain (mainly originating in musculoskeletal pain), were selected according to availability, parsimony and interpretability. Selected groups of factors included: pain condition (number of pain sites recorded on a full body manikin (range 0-44) [37]), functional dependence (pain interference with social, daily and work activities (average score, range 0-10 each) [67]) and stress processing factors (coping by catastrophizing, increased behavioral activities, self-statements, and ignoring pain (highest tertile vs. lowest tertile (range 0-6) [30]). Finally, the following socio-ecological factors were included: living arrangements (living alone vs. not living alone); marital status (married/cohabiting vs. single/divorced/widowed); availability of emotional and instrumental support (yes/no need vs. no each) and current or previous occupation grouped into socioeconomic classes based on the National Statistics Socio-Economic Classification (NS-SEC; manual/routine vs. managerial or professional/intermediate/ other [61]).…”

Older People’s Perceptions of Remaining Physically Active and Living With Chronic Pain

“…In the first phase of this study data from these questionnaires were used to formulate three pain groups: group (a) reported no pain (np); group (b) reported pain without interference (pni); and group (c) reported pain with interference (pi) at all three time points (Jordan et al, 2012). The presence of pain was based on a pain manikin on which patients were asked to shade in the location(s) of pain that had lasted for one day or more in the past four weeks (Lacey, Lewis, Jordan, Jinks, & Sim, 2005).…”

“Pain elsewhere” and the impact of knee pain in older people

“…Transparent templates were applied to the manikin to categorize responders according to the presence or absence of pain in the knee ("knee pain") and in the following regions ("pain elsewhere" than the knee): neck, hand, lower back, hip, and foot and ankle. The template scoring method has been shown to be reliable (6).…”