Computerized dynamic assessment of pain: comparison of chronic pain patients and healthy controls.

OBJECTIVE Computerized software holds the potential for the novel assessment of the pain experience of patients with chronic pain not available through traditional paper-and-pencil methods. The aim of this study was to test the feasibility and discriminant validity of a dynamic computer-administered program for the assessment of pain. DESIGN Three computer-administered programs were created to assess the intensity (dynamic visual analog scale DVAS]), character (dynamic verbal ratings), and location (dynamic pain drawings) of pain. The programs were administered to 115 chronic pain patients recruited from a hospital-based pain management program and 115 age- and gender-matched healthy individuals without pain. The healthy controls were instructed to respond as if they had chronic pain. RESULTS Analyses showed pain patient DVAS pain intensity ratings to be significantly higher than ratings by the healthy group. Patients selected more words in describing their pain, rated those words higher, and marked significantly more pain locations than the comparison group. However, no differences were found in the DVAS ratings of emotional impact between patients and healthy individuals. CONCLUSIONS Chronic pain patients were shown to differ from healthy individuals in their assessments of degree of pain intensity and pain location with the use of a novel computerized pain assessment program. Although further investigations are needed, these initial findings support the use of computer methods for the effective assessment of pain.

[1]  R. Melzack.  The McGill Pain Questionnaire: Major properties and scoring methods , 1975, PAIN.

[2]  Laura Porter,et al.  Reactive effects of diary self-assessment in chronic pain patients , 1996, Pain.

[3]  Use of sensory descriptors in assessing chronic pain patients. , 1987, Journal of psychosomatic research.

[4]  Donna L Berry,et al.  Usability of a computerized PAINReportIt in the general public with pain and people with cancer pain. , 2003, Journal of pain and symptom management.

[5]  Ronald Melzack,et al.  The McGill Pain Questionnaire: Appraisal and current status. , 2001 .

[6]  A. Stone,et al.  The science of self-report. Implications for research and practice , 1999 .

[7]  R. L. Collins,et al.  Ecological momentary assessment in a behavioral drinking moderation training program. , 1998, Experimental and clinical psychopharmacology.

[8]  R. Jamison.  Mastering Chronic Pain: A Professional's Guide to Behavioral Treatment , 1996 .

[9]  John L. Reeves,et al.  Memory for pain: Relation between past and present pain intensity , 1985, Pain.

[10]  J. Rohay,et al.  Compliance with inhaled medications: The relationship between diary and electronic monitor , 1998, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[11]  S. Shiffman,et al.  Capturing momentary, self-report data: A proposal for reporting guidelines , 2002, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[12]  D. Forman,et al.  Automated collection of quality-of-life data: a comparison of paper and computer touch-screen questionnaires. , 1999, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[13]  S. Shiffman,et al.  Introduction to the special section: Ecological momentary assessment in health psychology. , 1998 .

[14]  M P Smith,et al.  The anesthesiologist's guide to Palm Computing. , 1999, Regional anesthesia and pain medicine.

[15]  R. Hamer,et al.  An emotional component analysis of chronic pain , 1990, Pain.

[16]  J. Baird.  Sensation and Judgment: Complementarity Theory of Psychophysics , 1996 .

[17]  Ronald Melzack,et al.  Pain Measurement and Assessment , 1983 .

[18]  J. Bensing,et al.  Electronic diary assessment of pain, disability and psychological adaptation in patients differing in duration of pain , 2000, PAIN®.

[19]  S. Shiffman,et al.  A comparison of coping assessed by ecological momentary assessment and retrospective recall. , 1998, Journal of personality and social psychology.

[20]  R. Jamison,et al.  Electronic diaries for monitoring chronic pain: 1-year validation study , 2001, Pain.

[21]  Paul Karoly,et al.  Self-report scales and procedures for assessing pain in adults , 1992 .

[22]  Robert N. Jamison,et al.  The influence of physical and psychosocial factors on accuracy of memory for pain in chronic pain patients , 1989, Pain.

[23]  R. Gatchel,et al.  Psychological approaches to pain management : a practitioner's handbook , 1996 .

[24]  S. Shiffman,et al.  Patient compliance with paper and electronic diaries. , 2003, Controlled clinical trials.

[25]  B. Tiplady,et al.  Use of Pen-Based Electronic Diaries in An International Clinical Trial of Asthma , 2000 .

[26]  R. Jamison.  Learning to Master Your Chronic Pain , 1996 .

[27]  John C. Baird,et al.  Fundamentals of scaling and psychophysics , 1978 .

[28]  S Shiffman,et al.  Coping in real time: using Ecological Momentary Assessment techniques to assess coping with the urge to smoke. , 1998, Research in nursing & health.

[29]  Nathaniel P. Katz,et al.  Comparative study of electronic vs. paper VAS ratings: a randomized, crossover trial using healthy volunteers , 2002, PAIN.

[30]  A. Stone,et al.  The experience of rheumatoid arthritis pain and fatigue: examining momentary reports and correlates over one week. , 1997, Arthritis care and research : the official journal of the Arthritis Health Professions Association.

[31]  R. Straka,et al.  Patient Self‐Reporting of Compliance Does Not Correspond with Electronic Monitoring: An Evaluation Using Isosorbide Dinitrate as a Model Drug , 1997, Pharmacotherapy.

[32]  Ronald Melzack,et al.  The short-form McGill pain questionnaire , 1987, Pain.

[33]  M. Litt,et al.  Ecological momentary assessment (EMA) with treated alcoholics: methodological problems and potential solutions. , 1998, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.