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Objective. To evaluate the concurrent validity of the short form of an interactive computerized quality of life (ICQOL-SF) measure for patients with chronic pain. Methods. The ICQOL-SF, consisting of one global and four separate domains of quality of life, was administered to 300 chronic pain patients in two pain centers. Participants also completed the full 21-item interactive computerized quality of life (ICQOL) program, a computerized version of the World Health Organization Quality of Life Scale (WHOQOL-BREF), and a computerized assessment of pain (CAP) program. In a second study, an independent group of 336 chronic pain patients completed the ICQOL-SF, the WHOQOL-BREF, and the CAP. Results. The ICQOL-SF in both studies demonstrated adequate concurrent validity with the WHOQOL-BREF ( r = 0.75) and the CAP ( r = 0.84). The five-item ICQOL-SF was also highly correlated with the full ICQOL ( r = 0.90). Surprisingly, older individuals with more formal education and longer pain duration reported better quality of life. Number of past surgeries was negatively correlated with quality of life. Conclusions. The five-item short-form interactive computerized method to assess quality of life demonstrates adequate concurrent validity and would be a useful, brief software measure in the assessment of persons with chronic pain. Additional studies are needed to determine the reliability and sensitivity to change of the ICQOL-SF. [ABSTRACT FROM AUTHOR]

Objective. To investigate whether grouping of patients with back pain into similar behavioral patient profiles using SF-36 scores is predictive of outcome following 1-year treatment in a multidisciplinary spine center beginning with referral for epidural steroid injection. Design. A prospective observational study was conducted on 81 consecutive patients selected for epidural steroid injections by independent physicians following common institutional criteria. Each patient completed a baseline SF-36 questionnaire as well as a numerical response pain scale. The initial SF-36 data were used to place each patient into one of three subgroups (Highly Functional, Emotional Adapters, and Dysfunctional). Follow-up SF-36 and numerical response pain scale questionnaires were completed by the patients at 1 month and 12 months following the initial epidural steroid injection. Results. Results revealed significant improvement among all three patient subgroups following multidisciplinary treatment at both 1 month and 12 months. Few differences in outcome occurred among the subgroups. Conclusion. The SF-36-determined subgroups did not predict response to a multidisciplinary pain clinic. All three subgroups showed similar improvement following treatment. [ABSTRACT FROM AUTHOR]

We come from the perspective that opioids are efficacious in the management of nonterminal chronic pain. Responsible care within such a model requires that pain management physicians are adequately familiar with the broad ordering and interpretation of urine toxicology specimens, and especially with interpretation specific to issues of opiate use, addiction, and diversion as commonly seen in the course of clinical care, including risk assessment. This article provides an overview of these and related concerns. [Copyright &y& Elsevier]

. Computerized software holds the potential for the novel assessment of the pain experience of patients with chronic pain not available through traditional paper-and-pencil methods. The aim of this study was to test the feasibility and discriminant validity of a dynamic computer-administered program for the assessment of pain. . Three computer-administered programs were created to assess the intensity (dynamic visual analog scale DVAS]), character (dynamic verbal ratings), and location (dynamic pain drawings) of pain. The programs were administered to 115 chronic pain patients recruited from a hospital-based pain management program and 115 age- and gender-matched healthy individuals without pain. The healthy controls were instructed to respond as if they had chronic pain. . Analyses showed pain patient DVAS pain intensity ratings to be significantly higher than ratings by the healthy group. Patients selected more words in describing their pain, rated those words higher, and marked significantly more pain locations than the comparison group. However, no differences were found in the DVAS ratings of emotional impact between patients and healthy individuals. . Chronic pain patients were shown to differ from healthy individuals in their assessments of degree of pain intensity and pain location with the use of a novel computerized pain assessment program. Although further investigations are needed, these initial findings support the use of computer methods for the effective assessment of pain. [ABSTRACT FROM AUTHOR]

ABSTRACT objective. The purpose of this study was to describe the reliability and validity of an interac- tive computer method that assesses the quality of life of patients in chronic pain and healthy individuals. methods. A software program to assess 21 aspects of quality of life was administered to 88 pain patients on two occasions separated by an average of 30 days. Comparison data were obtained from 105 healthy individuals retested after an average of 16 days. results. For both groups, moderate test-retest correlations occurred for mean ratings based on an aggregation of data for all variables, single global ratings, and single ratings of individual variables. Patients in chronic pain scored significantly lower on all quality of life variables than did healthy individuals. High correlations were obtained between mean ratings from the present study and those from an earlier investigation using the same method. conclusions. The interactive computer method is both reliable and valid as a means to assess quality of life for patients in chronic pain as well as for healthy individuals. [ABSTRACT FROM AUTHOR]

The article discusses various reports published within the issue including one by Arthur Stone Joan Broaderic on the real time data collection for pain and another by Gilbert Fanciullo about a computerized method to assess paint in children.

Objective. The primary objective of this study was to determine initial psychometric properties and feasibility of a new Computer Face Scale for measuring pediatric pain. Drawbacks to current measurement tools include a lack of continuous variables, suboptimal mode of implementation, and difficulty interpreting results. A computer method of pediatric pain measurement is presented that addresses these problems. Basic psychometric properties, feasibility, and children’s preference when compared with Wong-Baker Faces Scale were determined. Methods. Fifty-four hospitalized, pediatric inpatients were tested using both the Computer Face Scale and the Wong-Baker Faces Scale. An additional 30 children (not hospitalized) were tested using only the Computer Face Scale. Results. Both hospitalized and nonhospitalized children between the ages of 3 and 17 years of age are able to use the Computer Face Scale to express relative amounts of pain/hurt and happiness. The Computer Face Scale shows acceptable psychometric properties and is preferred by most children. Conclusions. The Computer Face Scale offers advantages over traditional pediatric pain measurement tools. The opportunity for real time review, electronic and time-stamped recording, electronic display, and temporal comparisons of reports affords the potential for improvement in pediatric pain assessment and treatment. [ABSTRACT FROM AUTHOR]

Objective. In order to establish a diagnosis of chronic pain, emphasis is placed on a patient’s report of the pain’s intensity, location, and character. The aim of this study was to evaluate the feasibility of a computer assessment method to collect self-reports of pain that were then used in discriminant analyses to distinguish among chronic pain diagnoses. Methods. A convenience sample of 511 patients from two university-based pain clinics completed a computer pain assessment battery that elicited demographic information, pain drawings, pain and emotion intensity ratings, and intensity ratings of verbal descriptors. Patients classified themselves into one of six chronic pain diagnoses. Discriminant analyses were performed in an attempt to identify the unique features of patients’ pain experience associated with each of the diagnostic categories. Results. Pain drawings successfully classified patients into three of the diagnostic categories (back, head, and neck pain). In a second analysis, two pain descriptors (cramping and stabbing) separated rheumatoid arthritis patients from those with either fibromyalgia or neural pain. One descriptor of pain (cramping) and one descriptor of emotion (frustration) together distinguished between fibromyalgia and neural pain. Conclusions. 1) Computer assessment of a range of patient symptoms is feasible in the pain clinic. 2) Discriminant analysis based on pain drawings can distinguish among patient-reported diagnoses of back pain, headache, and neck pain. 3) Discriminant analysis based on three verbal descriptors can help to distinguish among diagnoses of fibromyalgia, neuralgia, and rheumatoid arthritis. 4) However, in general, most computerized descriptive information is not useful in distinguishing differences among pain patient diagnostic groups. [ABSTRACT FROM AUTHOR]

Pain is a complex phenomenon lacking a well-defined paradigm for diagnosis and management across medical disciplines. This is due in part to inconsistencies in the assessment of pain as well as in the measurement of related social and psychological states. Efforts to evaluate and measure pain through objective tests have been hindered by challenges such as methodological differences in data acquisition, and the lack of common, universally accepted information systems. Physicians and hospital administrators have expressed mixed reactions to the costs that inevitably accompany advances in medical technology. Nonetheless, computer systems are currently being developed for use in the quantitative assessment and management of pain, which can advance our understanding of the public health impact of pain, improve the care individual patients receive, and educate providers. The description of an interdisciplinary, integrated, health survey system illustrates the approach and highlights the advantages of using information technology in pain evaluation and management. [ABSTRACT FROM AUTHOR]