Abstract
Background
Self-reported pain scales are commonly used in emergency departments (EDs). The 11-point
(0–10) numerical rating scale is a commonly used scale for adults visiting EDs in
the United States. Despite their widespread use, little is known about whether distribution
of pain scores has remained consistent over time.
Objectives
The objective of this study is to determine if there were upwards or downwards (monotonic)
trends in pain scores over time at a single hospital.
Methods
Retrospective chart review for the years 2003–2011. All pain scores for May 1st and 2nd of those years were collected. Multinomial logistic regression was used to model
the probability of a patient rating their pain in each of 11 categories (scores 0
to 10) as a function of the calendar year. Additional analysis was carried out with
pain scores grouped into four categories.
Results
Data were collected from 2934 patient charts. Pain scores were recorded in 2136 charts,
and 1637 of these pain scores were above zero (i.e., 1–10). The pain score distribution
differed significantly over time (p = 0.001); however, there was no monotonic (single-direction) trend.
Conclusion
Although there were significant shifts in pain scores over time, there is not a significant
monotonic trend. At this hospital, there was no “inflation” or “deflation” in pain
scores over time. Shifts in distribution, even when not in a single direction, may
be important for researchers examining pain scores in the ED.
Keywords
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References
- Pain assessment instruments for use in the emergency department.Emerg Med Clin North Am. 2005; 23 (Available at:) (Accessed August 19, 2012): 285-295
- Validation of a verbally administered numerical rating scale of acute pain for use in the emergency department.Acad Emerg Med. 2003; 10 (Available at:) (Accessed August 19, 2012): 390-392
- Studies comparing numerical rating scales, verbal rating scales, and visual analogue scales for assessment of pain intensity in adults: a systematic literature review.J Pain Symptom Manage. 2011; 41 (Available at:) (Accessed August 19, 2012): 1073-1093
- Factors associated with self-reported pain scores among ED patients.Am J Emerg Med. 2012; 30 (Available at:) (Accessed August 19, 2012): 331-337
- Chapter 7. Logit models for multinomial responses.in: Categorical Data Analysis. 2nd edn. John Wiley & Sons, Inc., New York2002
- Estimation of pain intensity in emergency medicine: a validation study.Pain. 2008; 138 (Available at:) (Accessed August 19, 2012): 565-570
- The minimum clinically significant difference in patient-assigned numeric scores for pain.Am J Emerg Med. 2005; 23 (Available at:) (Accessed August 19, 2012): 828-832
- Problems with measurement of the minimum clinically significant difference in acute pain in elders.Acad Emerg Med. 2011; 18 (Available at:) (Accessed August 19, 2012): 135-139
- Comparative study of methods of measuring acute pain intensity in an ED.Am J Emerg Med. 1998; 16 (Available at:) (Accessed August 19, 2012): 132-136
- Pain assessments and the provision of analgesia: the effects of a templated chart.Acad Emerg Med. 2007; 14 (Available at:) (Accessed August 19, 2012): 47-52
Article info
Publication history
Published online: March 21, 2014
Accepted:
November 17,
2013
Received in revised form:
October 11,
2013
Received:
December 29,
2012
Identification
Copyright
© 2014 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
