Test–retest Reliability in Reporting the Pain Induced by a Pain Provocation Test: Further Validation of a Novel Approach for Pain Drawing Acquisition and Analysis

• Published in: Pain practice Vol. 17; no. 2; pp. 176 - 184
• Main Authors: Leoni, Diego, Falla, Deborah, Heitz, Carolin, Capra, Gianpiero, Clijsen, Ron, Egloff, Michele, Cescon, Corrado, Baeyens, Jean‐Pierre, Barbero, Marco
• Format: Journal Article
• Language: English
• Published: United States 01.02.2017
• Subjects: Adult; electronic acquisition; Female; Humans; Male; Pain - diagnosis; Pain - psychology; pain drawing; pain extent; pain location; Pain Measurement - instrumentation; Pain Measurement - methods; Pain Measurement - standards; reliability; Reproducibility of Results; Upper Extremity; Young Adult; pain extent; pain location; electronic acquisition; pain drawing; reliability
• ISSN: 1530-7085; 1533-2500
• DOI: 10.1111/papr.12429

Background Pain drawings (PD) are frequently used in research to illustrate the pain response to pain provocation tests. However, there is a lack of data on the reliability in defining the extent and location of pain. We investigated the test–retest reliability in reporting an acute painful sensation induced by a pain provocation test using a novel approach for PD acquisition and analysis in healthy volunteers. Methods Forty healthy volunteers participated. Each participant underwent 2 upper limb neurodynamic tests 1 (ULNT1), once to the point of pain onset (PO) and once until the point of submaximal pain (SP). After each ULNT1, participants completed 2 consecutive PD with an interval of 1 minute. Custom software was used to quantify the pain extent and analyze the pain overlap. The test–retest reliability of pain extent was examined using Intraclass Correlation Coefficient (ICC 2,1) and Bland–Altman plots. Pain location reliability was examined using the Jaccard similarity coefficient (JSC). Results The ICC values for PO and SP were 0.98 (95% CI: 0.96–0.99) and 0.97 (95% CI: 0.95–0.98), respectively. The mean difference and 95% limits of agreement (± 1.96 SD) in the Bland–Altman plots were 14 pixels (−1080;1110) for PO, and 145 (−1610;1900) for SP. The median JSCs (Q1;Q3) were 0.73 (0.64;0.80) for PO and 0.76 (0.65;0.79) for SP. Conclusions Pain drawings is a reliable instrument to investigate pain extent and pain location in healthy individuals experiencing an acute painful sensation induced by a pain provocation test.