The minimum clinically significant difference in visual analogue scale pain score does not differ with severity of pain

Kelly, AM

doi:10.1136/emj.18.3.205

Cited by 799 publications

(539 citation statements)

References 7 publications

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“…Our finding that pain treatment was equally effective in reducing pain for persons with and without PTSD questions the clinical wisdom that PTSD limits the effectiveness of pain treatment (Outcalt et al, 2015). For a change in VAS score to be clinically (and not only statistically) significant, the change has to be around 1 point, with a 2-point difference indicating a more substantial change (Dworkin et al, 2008; Kelly, 2001); therefore, most participants on average had a clinically significant reduction in pain during this treatment. Unfortunately, we had no measure of PTSD symptomatology at the end of treatment, but any effect of pain treatment on PTSD symptoms is clearly of great clinical and theoretical interest for future research.…”

Section: Discussionmentioning

confidence: 99%

Post-traumatic stress disorder moderates the relationship between trauma exposure and chronic pain

Siqveland

Ruud

Hauff

2017

European Journal of Psychotraumatology

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Background: Trauma exposure and post-traumatic stress disorder (PTSD) are risk factors for chronic pain. Objective: This study investigated how exposure to intentional and non-intentional traumatic events and PTSD are related to pain severity and outcome of treatment in chronic pain patients. Methods: We assessed exposure to potentially traumatizing events, psychiatric diagnosis with structured clinical interview, and pain severity in 63 patients at a secondary multidisciplinary pain clinic at the beginning of treatment, and assessed level of pain at follow up. Exposure to potentially traumatizing events and PTSD were regressed on pain severity at the initial session and at follow up in a set of multiple regression analysis. Results: The participants reported exposure to an average of four potentially traumatizing events, and 32% had PTSD. Exposure to intentional traumatic events and PTSD were significantly associated with more severe pain, and PTSD significantly moderated the relationship between trauma exposure and pain (all p < .05). The treatment programme reduced pain moderately, an effect that was unrelated to trauma exposure and PTSD. Conclusions: Trauma exposure is related to chronic pain in the same pattern as to mental disorders, with intentional trauma being most strongly related to pain severity. PTSD moderated the relationship between trauma exposure and pain. While pain patients with PTSD initially report more pain, they responded equally to specialist pain treatment as persons without PTSD.

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Section: Discussionmentioning

confidence: 99%

Post-traumatic stress disorder moderates the relationship between trauma exposure and chronic pain

Siqveland

Ruud

Hauff

2017

European Journal of Psychotraumatology

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“…Several studies demonstrate that a change of 9-14 mm on a 100-mm VAS is a minimal clinically important difference in perceived pain that is reproducible among patients experiencing both mild and severe forms of pain [14][15][16][17]. When designing this study, we anticipated that 266 women would be randomized to delayed IUD insertion in the main study and return for IUD insertion.…”

Section: Statistical Analysesmentioning

confidence: 99%

Prophylactic ibuprofen does not improve pain with IUD insertion: a randomized trial

et al. 2015

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TitleProphylactic ibuprofen does not improve pain with IUD insertion: a randomized trial. AbstractObjective: To evaluate if ibuprofen 800 mg reduces pain with intrauterine device (IUD) insertion among U.S. women. Study design: We conducted a randomized, double-blind, placebo-controlled trial of women undergoing IUD insertion approximately 2-6 weeks following first-trimester uterine aspiration. Subjects were randomized to receive ibuprofen 800 mg or placebo 30-45 min prior to IUD insertion. A 100-mm visual analog scale (VAS) was administered to measure pain after speculum insertion (baseline) and immediately following IUD insertion.Results: A total of 202 women were enrolled, with 101 randomized to each group (ibuprofen or placebo). Sociodemographic characteristics and baseline VAS scores were similar between groups. The median pain score with IUD insertion was 41.5 mm in the placebo group and 38.0 mm in the ibuprofen group (p=.50). Mean and median pain scores did not differ between placebo and ibuprofen when nulliparous and parous women were analyzed independently. Overall, median pain scores were 17.5 mm higher in nulliparous women than parous women (p=.004). Median pain scores did not differ by age, IUD-type, history of dysmenorrhea or time since aspiration. Conclusions: Administration of ibuprofen 800 mg prior to IUD insertion does not reduce pain associated with the procedure for U.S. women. Overall, nulliparous women report more pain with IUD insertion than multiparous women.

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“…The minimum clinically significant difference of VAS was reported to be between 9 mm and 19 mm in the medical literature. [7,[9][10][11][12][13] This minimum significant difference was reported to be 13-14 mm for the numeric rating scale. [10,14] The minimum clinically significant differences both for VAS and NRS were determined by verbal descriptions, "a little more pain" and "a little less pain", which is the same in the present study.…”

Section: Discussionmentioning

confidence: 99%

Reliability and Validity of a New Pain Measurement Tool: Pictorial Representation of Pain (PRP)

et al. 2011

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ÖZET Amaç Bu çalışmanın amacı yeni bir ağrı ölçeğinin (Ağrının Resimsel Temsili) geçerliliğini ve güvenilirliğini test etmektir. Ayrıca, yeni ölçeğin ağ-rının yoğunluğunu ve hastanın ağrıdan ne kadar muzdarip olduğu-nu ölçmedeki yeterliliğini de test etmeyi amaçladık. Gereç ve Yöntem SUMMARY ObjectivesThe aim of this study was to determine the reliability and validity of a new pain measurement tool, Pictorial Representation of Pain (PRP), in order to determine its ability to measure the intensity of pain and burden of pain for patients in Emergency Department (ED). MethodsPictorial Representation of Illness and Self Measure (PRISM) has been used as a tool in psychiatric interviews in order to determine the burden of an illness. With modification, a new software named PRP was developed for use in Akdeniz University Hospital ED (Antalya, Turkey). Patients presented to the ED with acute pain were enrolled into the study. Study patients were asked to rate their pain levels at 0, 1, 30, 31, 60 and 61 minutes with PRP and a verbal descriptive scale in order to determine the minimum clinically significant difference. ResultsA total of 246 patients were included into the study with mean age of 40.6±15.4. Eighty seven (35%) were men. The correlation coefficient between PRP scores one minute apart were 0.95 (95% CI: 0.94 to 0.96), 0.95 (95% CI: 0.93 to 0.96) and 0.98 (95% CI: 0.83 to 0.99) at the three preset time (0 min, 30 min, 60 min) respectively. And the overall correlation coefficient was 0.96 (95% CI: 0.96 to 0.97). The minimum clinically significant change in pain was 28.7 mm (95% CI: 27 to 30) with a median of 28 mm (IQR: 23-34, 95% CI: 26 to 30). ConclusionsPRP could be considered as a reliable and consistent tool for measuring the intensity of pain. However, further studies are needed to determine the use of PRP in measuring burden of pain.

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The minimum clinically significant difference in visual analogue scale pain score does not differ with severity of pain

Cited by 799 publications

References 7 publications

Post-traumatic stress disorder moderates the relationship between trauma exposure and chronic pain

Post-traumatic stress disorder moderates the relationship between trauma exposure and chronic pain

Prophylactic ibuprofen does not improve pain with IUD insertion: a randomized trial

Reliability and Validity of a New Pain Measurement Tool: Pictorial Representation of Pain (PRP)

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