Clinimetric properties of the electronic Pain Assessment Tool (ePAT) for aged-care residents with moderate to severe dementia
Accurate pain assessment is critical to detect pain and facilitate effective pain management in dementia patients. The electronic Pain Assessment Tool (ePAT) is a point-of-care solution that uses automated facial analysis in conjunction with other clinical indicators to evaluate the presence and int...
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Published in | Journal of pain research Vol. 11; pp. 1037 - 1044 |
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Main Authors | , , |
Format | Journal Article |
Language | English |
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New Zealand
Dove Medical Press Limited
01.01.2018
Taylor & Francis Ltd Dove Medical Press |
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Abstract | Accurate pain assessment is critical to detect pain and facilitate effective pain management in dementia patients. The electronic Pain Assessment Tool (ePAT) is a point-of-care solution that uses automated facial analysis in conjunction with other clinical indicators to evaluate the presence and intensity of pain in patients with dementia. This study aimed to examine clini-metric properties (clinical utility and predictive validity) of the ePAT in this population group.
Data were extracted from a prospective validation (observational) study of the ePAT in dementia patients who were ≥65 years of age, living in a facility for ≥3 months, and had Psychogeriatric Assessment Scales - cognitive scores ≥10. The study was conducted in two residential aged-care facilities in Perth, Western Australia, where residents were sampled using purposive convenience strategy. Predictive validity was measured using accuracy statistics (sensitivity, specificity, positive predictive value, and negative predictive value). Positive and negative clinical utility index (CUI) scores were calculated using Mitchell's formula. Calculations were based on comparison with the Abbey Pain Scale, which was used as a criterion reference.
A total of 400 paired pain assessments for 34 residents (mean age 85.5±6.3 years, range 68.0-93.2 years) with moderate-severe dementia (Psychogeriatric Assessment Scales - cognitive score 11-21) were included in the analysis. Of those, 303 episodes were classified as pain by the ePAT based on a cutoff score of 7. Unadjusted prevalence findings were sensitivity 96.1% (95% CI 93.9%-98.3%), specificity 91.4% (95% CI 85.7%-97.1%), accuracy 95.0% (95% CI 92.9%-97.1%), positive predictive value 97.4% (95% CI 95.6%-99.2%), negative predictive value 87.6% (95% CI 81.1%-94.2%), CUI
0.936 (95% CI 0.911-0.960), CUI
0.801 (95% CI 0.748-0.854).
The clinimetric properties demonstrated were excellent, thus supporting the clinical usefulness of the ePAT when identifying pain in patients with moderate-severe dementia. |
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AbstractList | Accurate pain assessment is critical to detect pain and facilitate effective pain management in dementia patients. The electronic Pain Assessment Tool (ePAT) is a point-of-care solution that uses automated facial analysis in conjunction with other clinical indicators to evaluate the presence and intensity of pain in patients with dementia. This study aimed to examine clini-metric properties (clinical utility and predictive validity) of the ePAT in this population group.
Data were extracted from a prospective validation (observational) study of the ePAT in dementia patients who were ≥65 years of age, living in a facility for ≥3 months, and had Psychogeriatric Assessment Scales - cognitive scores ≥10. The study was conducted in two residential aged-care facilities in Perth, Western Australia, where residents were sampled using purposive convenience strategy. Predictive validity was measured using accuracy statistics (sensitivity, specificity, positive predictive value, and negative predictive value). Positive and negative clinical utility index (CUI) scores were calculated using Mitchell's formula. Calculations were based on comparison with the Abbey Pain Scale, which was used as a criterion reference.
A total of 400 paired pain assessments for 34 residents (mean age 85.5±6.3 years, range 68.0-93.2 years) with moderate-severe dementia (Psychogeriatric Assessment Scales - cognitive score 11-21) were included in the analysis. Of those, 303 episodes were classified as pain by the ePAT based on a cutoff score of 7. Unadjusted prevalence findings were sensitivity 96.1% (95% CI 93.9%-98.3%), specificity 91.4% (95% CI 85.7%-97.1%), accuracy 95.0% (95% CI 92.9%-97.1%), positive predictive value 97.4% (95% CI 95.6%-99.2%), negative predictive value 87.6% (95% CI 81.1%-94.2%), CUI
0.936 (95% CI 0.911-0.960), CUI
0.801 (95% CI 0.748-0.854).
The clinimetric properties demonstrated were excellent, thus supporting the clinical usefulness of the ePAT when identifying pain in patients with moderate-severe dementia. Purpose: Accurate pain assessment is critical to detect pain and facilitate effective pain management in dementia patients. The electronic Pain Assessment Tool (ePAT) is a point-of-care solution that uses automated facial analysis in conjunction with other clinical indicators to evaluate the presence and intensity of pain in patients with dementia. This study aimed to examine clini-metric properties (clinical utility and predictive validity) of the ePAT in this population group. Methods: Data were extracted from a prospective validation (observational) study of the ePAT in dementia patients who were [greater than or equal to]65 years of age, living in a facility for [greater than or equal to]3 months, and had Psychogeriatric Assessment Scales--cognitive scores [greater than or equal to]10. The study was conducted in two residential aged-care facilities in Perth, Western Australia, where residents were sampled using purposive convenience strategy. Predictive validity was measured using accuracy statistics (sensitivity, specificity, positive predictive value, and negative predictive value). Positive and negative clinical utility index (CUI) scores were calculated using Mitchell's formula. Calculations were based on comparison with the Abbey Pain Scale, which was used as a criterion reference. Results: A total of 400 paired pain assessments for 34 residents (mean age 85.5[+ or -]6.3 years, range 68.0-93.2 years) with moderate-severe dementia (Psychogeriatric Assessment Scales--cognitive score 11-21) were included in the analysis. Of those, 303 episodes were classified as pain by the ePAT based on a cutoff score of 7. Unadjusted prevalence findings were sensitivity 96.1% (95% CI 93.9%-98.3%), specificity 91.4% (95% CI 85.7%-97.1%), accuracy 95.0% (95% CI 92.9%-97.1%), positive predictive value 97.4% (95% CI 95.6%-99.2%), negative predictive value 87.6% (95% CI 81.1%-94.2%), [CUI.sup.+] 0.936 (95% CI 0.911-0.960), [CUI.sup.-] 0.801 (95% CI 0.748-0.854). Conclusion: The clinimetric properties demonstrated were excellent, thus supporting the clinical usefulness of the ePAT when identifying pain in patients with moderate-severe dementia. Keywords: ePAT, PainChek[TM], pain assessment, dementia, predictive validity, clinical utility, automated facial analysis PURPOSEAccurate pain assessment is critical to detect pain and facilitate effective pain management in dementia patients. The electronic Pain Assessment Tool (ePAT) is a point-of-care solution that uses automated facial analysis in conjunction with other clinical indicators to evaluate the presence and intensity of pain in patients with dementia. This study aimed to examine clini-metric properties (clinical utility and predictive validity) of the ePAT in this population group. METHODSData were extracted from a prospective validation (observational) study of the ePAT in dementia patients who were ≥65 years of age, living in a facility for ≥3 months, and had Psychogeriatric Assessment Scales - cognitive scores ≥10. The study was conducted in two residential aged-care facilities in Perth, Western Australia, where residents were sampled using purposive convenience strategy. Predictive validity was measured using accuracy statistics (sensitivity, specificity, positive predictive value, and negative predictive value). Positive and negative clinical utility index (CUI) scores were calculated using Mitchell's formula. Calculations were based on comparison with the Abbey Pain Scale, which was used as a criterion reference. RESULTSA total of 400 paired pain assessments for 34 residents (mean age 85.5±6.3 years, range 68.0-93.2 years) with moderate-severe dementia (Psychogeriatric Assessment Scales - cognitive score 11-21) were included in the analysis. Of those, 303 episodes were classified as pain by the ePAT based on a cutoff score of 7. Unadjusted prevalence findings were sensitivity 96.1% (95% CI 93.9%-98.3%), specificity 91.4% (95% CI 85.7%-97.1%), accuracy 95.0% (95% CI 92.9%-97.1%), positive predictive value 97.4% (95% CI 95.6%-99.2%), negative predictive value 87.6% (95% CI 81.1%-94.2%), CUI+ 0.936 (95% CI 0.911-0.960), CUI- 0.801 (95% CI 0.748-0.854). CONCLUSIONThe clinimetric properties demonstrated were excellent, thus supporting the clinical usefulness of the ePAT when identifying pain in patients with moderate-severe dementia. Kreshnik Hoti,1,2 Mustafa Atee,1 Jeffery D Hughes1 1School of Pharmacy, Curtin University, Perth, Australia; 2Division of Pharmacy, Faculty of Medicine, University of Prishtina, Pristina, Kosovo Purpose: Accurate pain assessment is critical to detect pain and facilitate effective pain management in dementia patients. The electronic Pain Assessment Tool (ePAT) is a point-of-care solution that uses automated facial analysis in conjunction with other clinical indicators to evaluate the presence and intensity of pain in patients with dementia. This study aimed to examine clinimetric properties (clinical utility and predictive validity) of the ePAT in this population group. Methods: Data were extracted from a prospective validation (observational) study of the ePAT in dementia patients who were ≥65 years of age, living in a facility for ≥3 months, and had Psychogeriatric Assessment Scales - cognitive scores ≥10. The study was conducted in two residential aged-care facilities in Perth, Western Australia, where residents were sampled using purposive convenience strategy. Predictive validity was measured using accuracy statistics (sensitivity, specificity, positive predictive value, and negative predictive value). Positive and negative clinical utility index (CUI) scores were calculated using Mitchell's formula. Calculations were based on comparison with the Abbey Pain Scale, which was used as a criterion reference. Results: A total of 400 paired pain assessments for 34 residents (mean age 85.5±6.3 years, range 68.0-93.2 years) with moderate-severe dementia (Psychogeriatric Assessment Scales - cognitive score 11-21) were included in the analysis. Of those, 303 episodes were classified as pain by the ePAT based on a cutoff score of 7. Unadjusted prevalence findings were sensitivity 96.1% (95% CI 93.9%-98.3%), specificity 91.4% (95% CI 85.7%-97.1%), accuracy 95.0% (95% CI 92.9%-97.1%), positive predictive value 97.4% (95% CI 95.6%-99.2%), negative predictive value 87.6% (95% CI 81.1%-94.2%), CUI+ 0.936 (95% CI 0.911-0.960), CUI- 0.801 (95% CI 0.748-0.854). Conclusion: The clinimetric properties demonstrated were excellent, thus supporting the clinical usefulness of the ePAT when identifying pain in patients with moderate-severe dementia. Keywords: ePAT, PainChekTM, pain assessment, dementia, predictive validity, clinical utility, automated facial analysis Purpose: Accurate pain assessment is critical to detect pain and facilitate effective pain management in dementia patients. The electronic Pain Assessment Tool (ePAT) is a point-of-care solution that uses automated facial analysis in conjunction with other clinical indicators to evaluate the presence and intensity of pain in patients with dementia. This study aimed to examine clinimetric properties (clinical utility and predictive validity) of the ePAT in this population group. Methods: Data were extracted from a prospective validation (observational) study of the ePAT in dementia patients who were ≥65 years of age, living in a facility for ≥3 months, and had Psychogeriatric Assessment Scales – cognitive scores ≥10. The study was conducted in two residential aged-care facilities in Perth, Western Australia, where residents were sampled using purposive convenience strategy. Predictive validity was measured using accuracy statistics (sensitivity, specificity, positive predictive value, and negative predictive value). Positive and negative clinical utility index (CUI) scores were calculated using Mitchell’s formula. Calculations were based on comparison with the Abbey Pain Scale, which was used as a criterion reference. Results: A total of 400 paired pain assessments for 34 residents (mean age 85.5±6.3 years, range 68.0–93.2 years) with moderate–severe dementia (Psychogeriatric Assessment Scales – cognitive score 11–21) were included in the analysis. Of those, 303 episodes were classified as pain by the ePAT based on a cutoff score of 7. Unadjusted prevalence findings were sensitivity 96.1% (95% CI 93.9%–98.3%), specificity 91.4% (95% CI 85.7%–97.1%), accuracy 95.0% (95% CI 92.9%–97.1%), positive predictive value 97.4% (95% CI 95.6%–99.2%), negative predictive value 87.6% (95% CI 81.1%–94.2%), CUI+ 0.936 (95% CI 0.911–0.960), CUI– 0.801 (95% CI 0.748–0.854). Conclusion: The clinimetric properties demonstrated were excellent, thus supporting the clinical usefulness of the ePAT when identifying pain in patients with moderate–severe dementia. |
Audience | Academic |
Author | Hoti, Kreshnik Atee, Mustafa Hughes, Jeffery D |
AuthorAffiliation | 1 School of Pharmacy, Curtin University, Perth, Australia 2 Division of Pharmacy, Faculty of Medicine, University of Prishtina, Pristina, Kosovo |
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BackLink | https://www.ncbi.nlm.nih.gov/pubmed/29910632$$D View this record in MEDLINE/PubMed |
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Copyright | COPYRIGHT 2018 Dove Medical Press Limited 2018. This work is licensed under https://creativecommons.org/licenses/by-nc/3.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. 2018 Hoti et al. This work is published and licensed by Dove Medical Press Limited 2018 |
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Keywords | ePAT PainChek automated facial analysis clinical utility pain assessment predictive validity dementia |
Language | English |
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Snippet | Accurate pain assessment is critical to detect pain and facilitate effective pain management in dementia patients. The electronic Pain Assessment Tool (ePAT)... Purpose: Accurate pain assessment is critical to detect pain and facilitate effective pain management in dementia patients. The electronic Pain Assessment Tool... PURPOSEAccurate pain assessment is critical to detect pain and facilitate effective pain management in dementia patients. The electronic Pain Assessment Tool... Kreshnik Hoti,1,2 Mustafa Atee,1 Jeffery D Hughes1 1School of Pharmacy, Curtin University, Perth, Australia; 2Division of Pharmacy, Faculty of Medicine,... |
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SubjectTerms | Accuracy automated facial analysis clinical utility Cognition & reasoning Cognitive ability Communication cut-off scores Dementia Diagnostic tests ePAT Family medical history Health facilities Medical research Older people Original Research pain assessment Pain management Patients Pharmacy predictive validity Quantitative psychology Studies Systematic review Validity |
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Title | Clinimetric properties of the electronic Pain Assessment Tool (ePAT) for aged-care residents with moderate to severe dementia |
URI | https://www.ncbi.nlm.nih.gov/pubmed/29910632 https://www.proquest.com/docview/2237768790 https://search.proquest.com/docview/2056759418 https://pubmed.ncbi.nlm.nih.gov/PMC5989701 https://doaj.org/article/ccf1bcf1724443b7991d5b8eaec2e6bf |
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