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| Rating Your Pain Might Not Help The Doctor |
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| SciMed - Horizons | |||
| TS-Si News Service | |||
| Friday, 21 September 2007 19:02 | |||
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Commonly pain screening measure may have limited accuracy
Indianapolis, IN, USA. The most commonly used measure for pain screening may only be modestly accurate, according to researchers from the Indiana University School of Medicine and the University of North Carolina. In a study that appears in the Journal of General Internal Medicine, they evaluate the usefulness of a scale that asks patients in primary care to rate their current pain from 0 (no pain) to 10 (worst pain).
Universal pain screening is an increasingly common practice, largely because of the Joint Commission on Accreditation of Healthcare Organizations’ requirement that accredited hospitals and clinics routinely assess all patients for pain. JCAHO is the nation’s predominant standards-setting and accrediting body in health care.
 “Our study is the first to evaluate the accuracy of the widely-used numeric rating scale [NRS] as a screening test to identify primary care patients with clinically important pain. Accurate screening is important because pain symptoms, both serious and not so serious, are among the most common complaints in primary care,” said Erin E. Krebs, M.D., M.P.H., assistant professor of medicine at the IU School of Medicine and a Regenstrief Institute research scientist. “To be helpful, a screening test needs to provide accurate information that doctors can use to improve care. If a test isn’t very accurate or useful, doctors learn to tune out the numbers.”
The authors found that, while the NRS is easy to administer, it fails to identify about a third of patients with pain serious enough to impair day-to-day functioning. Most patients in this study had long-standing pain, and many had more than one pain problem.
The researchers noted that because it focuses on current pain, the NRS may miss intermittent symptoms. They also reported that “pain” was not the preferred word for some patients. For example, one study participant indicated that he felt discomfort, but not pain.
“Universal pain screening has become widespread despite a lack of research evaluating its accuracy and effectiveness. We know that pain is a serious problem in primary care, but pain screening may not be the best way to address this problem,” said Dr. Krebs, who is also with the Center on Implementing Evidence-based Practice at the Roudebush Veterans Affairs Medical Center in Indianapolis.
The Robert Wood Johnson Foundation funded the study.  The TS-Si News Service is a collaborative effort by TS-Si.org editors, contributors, and corresponding institutions. The sources can include the cited individuals and organizations, as well as TS-Si.org staff contributions. Articles and news reports do not necessarily convey official positions of TS-Si, its partners, or affiliates.We welcome your comments. Use the form below to leave a public comment or send private correspondence via the TS-Si Contact Page. We will not divulge any personal details or place you on a mailing list without your permission. TS-Si is dedicated to the acceptance, medical treatment, and legal protection of individuals correcting the misalignment of their brains and their anatomical sex, while supporting their transition into society as hormonally reconstituted and surgically corrected citizens. 
 
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The TS-Si News Service
and the TS-Si Research Service are collaborations of TS-Si officials, staff, contributors, and corresponding institutions. The contents do not necessarily convey official positions of TS-Si or its owners, participants, partners, or affiliates.