Do metrics derived from self-reported and clinician-reported pain drawings agree for individuals with chronic low back pain?

Marco Barbero*, Matthew Piff, David Evans, Deborah Falla

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background
Clinicians commonly use pain drawings to define the spatial extent and location of a person's pain, but limited research has investigated who should perform the drawing.

Objectives
To establish the inter-rater reliability of pain extent and location derived from three sets of pain drawings for people with chronic low back pain: one self-reported and two clinician-reported. Additionally, convergent validity of pain extent was assessed using the same dataset.

Design
Repeated-measures cross-sectional study.

Method
Fifteen patients with chronic low back pain and a pool of eight clinicians were involved to assess the reliability of pain extent and location extracted by self-report and clinician-reported pain drawings. Inter-rater reliability of pain extent was computed using intraclass correlation coefficients (ICC) and Bland Altman analysis. Convergent validity of pain extent was assessed using Spearman's rank correlation. Inter-rater reliability of pain location was assessed using the Jaccard similarity index.

Results
The inter-reliability analysis for pain extent, derived from self-reported and clinician-reported pain drawings, revealed ICC scores ranging from 0.39 to 0.51, all with wide confidence intervals. The mean Jaccard similarity indexes computed for pain location ranged from 0.60 to 0.65. Moderate to good correlation was found for pain extent derived by the sets of pain drawings.

Conclusions
Inter-rater reliability of pain extent and pain location derived from self-reported and clinician-reported pain drawings is poor in patients with chronic low back pain. The lack of reliability is also confirmed when considering only clinician-reported PDs. The convergent validity analysis of pain extent revealed that the two pain drawing approaches measure a similar construct.
Original languageEnglish
Article number102871
Number of pages8
JournalMusculoskeletal Science and Practice
Volume68
Early online date7 Oct 2023
DOIs
Publication statusPublished - Nov 2023

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