Background & Aims
Evaluating pain is challenging due to its subjective nature, and traditional pain assessment tools have inherent limitations (1-5). In a prior study, we explored the possibility of reporting pain intensity through squeezing GRASP, a novel handheld electronic device (not yet published). In this current study, our objective was to assess the potential of reporting pain intensity using an improved version of the GRASP unit, which provided instant visual feedback through colour-coded categories (green, blue, and red, denoting mild, moderate, and severe pain, respectively). We sought to compare these assessments with measurements obtained using the verbal Numeric Rating Scale (vNRS).
Methods
To conduct a comparative analysis between GRASP and vNRS, we invited healthy adult volunteers to undergo two consecutive standardised tests of cold-triggered pain using a cold pressor test (CPT) set at 3 degrees Celsius. Pain intensity was in a randomised manner reported by vNRS (scale 0-10) or by squeezing GRASP (millivolt with colour-coded feedback) during the two CPTs. To study the association of repeated measurements, two additional CPTs were conducted one to fourteen days later, reporting pain with vNRS and GRASP. Before each CPT involving GRASP, the GRASP unit was calibrated to individual squeeze strength.
Results
A total of 46 subjects completed all four tests (28 females). Due to technical issues, four GRASP reports were lost. Pain intensity association between GRASP and vNRS was moderate (mean Kendall’s ?-b (?) = 0.47, 95% confidence interval (CI) 0.40-0.55). Repeated GRASP measurements showed moderate association (? = 0.37, 95% CI 0.27-0.48), while repeated NRS measurements had strong association (? = 0.71, 95% CI 0.64-0.78). After adjusting GRASP to individual squeeze strength (aGRASP), a significant regression was found (? = 0.091, SE 0.015, p < 0.001, R2 = 0.58) with the equation aGRASP (%) = 0.018 + 0.091 x vNRS. Indicating, each 9.1% increase in mean aGRASP predicted a mean of 1-point vNRS increase. Grouping reports into mild (aGRASP green, vNRS 1-4), moderate (aGRASP blue, vNRS 5-7), and severe pain (aGRASP red, vNRS 8-10), agreement proportions across two CPTs were 69.3% for aGRASP and 78.6% for vNRS.
Conclusions
Pain intensity reported by squeezing GRASP showed a moderate association with pain intensity reported by vNRS during CPTs when analysed with the Kendall ?-b method. The association between pain intensity reported by vNRS during two CPTs on separate days was strong, however, lower than anticipated (? = 0.71). Upon adjusting GRASP reports to individual strength, a robust association with vNRS reports emerged through linear regression. Notably, proportions of participants agreeing on pain intensity categories across CPTs using GRASP were comparable to proportions of agreement with vNRS. Results indicate that the GRASP method with colour-coded feedback may be usable for categorical pain intensity assessment.
References
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Presenting Author
Elisabeth Ørskov Rotevatn
Poster Authors
Elisabeth Rotevatn
M.D.
Helse Bergen, Norway
Lead Author
Mette Engan
M.D.
Helse Bergen, Norway
Lead Author
Emilie Stensaker
Helse Bergen, Norway
Lead Author
Karl Ove Hufthammer
Biostatistician
Helse Bergen, Norway
Lead Author
Lars Jørgen Rygh
M.D.
Helse Bergen, Norway
Lead Author
Topics
- Assessment and Diagnosis