Cited by 1,247Musculoskeletal pain and rehabilitationPain Management and Opioid UsePsychometric Methodologies and Testing

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Comparative reliability and validity of chronic pain intensity measures.

Jensen, Mark P, Turner, Judith A, Romano, Joan M, Fisher, Lloyd D·1999·Pain

DOI 10.1016/s0304-3959(99)00101-3

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Abstract

Reliable and valid measures of pain are essential for conducting research on chronic pain. The purpose of this longitudinal study was to compare the reliability and validity of several measures of pain intensity. One hundred twenty-three patients with chronic pain were administered telephone interview versions of 0-10 scales of current, worst, least and average pain, immediately prior to beginning a multidisciplinary treatment program. The measures were administered again to these subjects 2 weeks (n=108), 1 month (n=106) and 2 months (n=105) after the end of treatment. The validity (defined as ability to detect changes in pain intensity over the course of treatment up to the 2-month follow-up assessment) and reliability (defined as stability over time in the 2 months after treatment) of these four measures and of composite combinations of these measures were examined. Contrary to prediction, the composite measures did not show a statistically significant superiority to the individual ratings in terms of their ability to detect change in pain intensity from pre-treatment to various points after treatment. The composite scores did, however, show greater stability than did the individual ratings after treatment. The practical conclusions of this study are; (1), individual 0-10 pain intensity ratings have sufficient psychometric strengths to be used in chronic pain research, especially research that involves group comparison designs with relatively large sample sizes, but, (2), composites of 0-10 ratings may be more useful when maximal reliability is necessary, (e.g. in studies with relatively small sample sizes, or in clinical settings where monitoring of changes in pain intensity in individuals is needed).

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Fernández‐de‐las‐Peñas, C., Alonso‐Blanco, C., Cuadrado, M. L., & Pareja, J. A. (2006) · Cephalalgia · doi:10.1111/j.1468-2982.2006.01247.x · Cited by 30
Validación y fiabilidad de la versión española de la escala autoadministrada de Evaluación de Signos y Síntomas Neuropáticos de Leeds (S-LANSS)
López‐de‐Uralde‐Villanueva, I., Gil‐Martínez, A., Candelas-Fernández, P., Ares, J. D. A., Beltrán-Alacreu, H., & Touche, R. L. (2016) · Neurología · doi:10.1016/j.nrl.2016.10.009 · Cited by 30
Perceived pain and satisfaction with medical rehabilitation after hospital discharge
Bergés, I.-M., Ottenbacher, K. J., Smith, P. M., & Smith, D. R. (2006) · Clinical Rehabilitation · doi:10.1191/0269215506cre1006oa · Cited by 30
Oxidative stress is associated with characteristic features of the dysfunctional chronic pain phenotype
Bruehl, S., Milne, G., Schildcrout, J., Shi, Y., Anderson, S., Shinar, A., Polkowski, G., Mishra, P., & Billings, F. T. (2022) · Pain · doi:10.1097/j.pain.0000000000002429 · Cited by 30
Comparison of daily, weekly or monthly pain assessments in hip and knee osteoarthritis. A 29-day prospective study
Perrot, S., Rozenberg, S., Moyse, D., Legout, V., & Marty, M. (2010) · Joint Bone Spine · doi:10.1016/j.jbspin.2010.11.009 · Cited by 29
Translating Evidence for Low Back Pain Management into a Consumer-Focussed Resource for Use in Community Pharmacies: A Cluster-Randomised Controlled Trial
Slater, H., Briggs, A. M., Watkins, K., Chua, J., & Smith, A. J. (2013) · PLoS ONE · doi:10.1371/journal.pone.0071918 · Cited by 30
“Average LBP severity in the previous 24 hours and activity impairment were measured using an 11 point numerical rating scale (NRS), with anchors at 0 (no pain/no effect on activities of daily living) and 10 (worst pain/unable to perform any activities of daily living) [38,39].”
Method
Radiation Therapy Versus No Radiation Therapy to the Neo-breast Following Skin-Sparing Mastectomy and Immediate Autologous Free Flap Reconstruction for Breast Cancer: Patient-Reported and Surgical Outcomes at 1 Year—A Mastectomy Reconstruction Outcomes Consortium (MROC) Substudy
Cooke, A. L., Diaz‐Abele, J., Hayakawa, T., Buchel, E. W., Dalke, K. R., & Lambert, P. J. (2017) · International Journal of Radiation Oncology*Biology*Physics · doi:10.1016/j.ijrobp.2017.05.001 · Cited by 30
Patient and Disease Characteristics Associate With Sensory Testing Results in Chronic Pancreatitis
Kuhlmann, L., Olesen, S. S., Grønlund, D., Olesen, A. E., Phillips, A. E., Faghih, M., & Drewes, A. M. (2019) · Clinical Journal of Pain · doi:10.1097/ajp.0000000000000740 · Cited by 29
The effect of alexithymia and depressive feelings on pain perception in somatoform pain disorder
Lankes, F. N., Schiekofer, S., Eichhammer, P., & Busch, V. (2020) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2020.110101 · Cited by 29
The effects of whole-body electromyostimulation (WB-EMS) in comparison to a multimodal treatment concept in patients with non-specific chronic back pain—A prospective clinical intervention study
Konrad, K. L., Baeyens, J., Birkenmaier, C., Ranker, A. H., Widmann, J. H., Leukert, J., Wenisch, L., Kraft, E., Jansson, V., & Wegener, B. (2020) · PLoS ONE · doi:10.1371/journal.pone.0236780 · Cited by 29
“The NRS has been shown to have sufficient psychometric strengths and predictive validity as a measure of pain intensity, to be used in chronic pain research [41].”
Cervical transcutaneous vagal neuromodulation in chronic pancreatitis patients with chronic pain: A randomised sham controlled clinical trial
Muthulingam, J. A., Olesen, S. S., Hansen, T. M., Brock, C., Drewes, A. M., & Frøkjær, J. B. (2021) · PLoS ONE · doi:10.1371/journal.pone.0247653 · Cited by 29
Referred Pain Elicited by Manual Exploration of the Lateral Rectus Muscle in Chronic Tension-Type Headache
Fernández‐de‐las‐Peñas, C., Cuadrado, M. L., Gerwin, R. D., & Pareja, J. A. (2008) · Pain Medicine · doi:10.1111/j.1526-4637.2008.00416.x · Cited by 29
Factors Associated With Recovery From Early Postoperative Delirium
DeCrane, S. K., Sands, L. P., Ashland, M., Lim, E., Tsai, T. L., Paul, S., & Leung, J. M. (2011) · Journal of PeriAnesthesia Nursing · doi:10.1016/j.jopan.2011.03.001 · Cited by 29
Altered Pattern of Cervical Muscle Activation During Performance of a Functional Upper Limb Task in Breast Cancer Survivors
Galiano‐Castillo, N., Fernández‐Lao, C., Cantarero‐Villanueva, I., Fernández‐de‐las‐Peñas, C., Menjón-Beltrán, S., & Arroyo‐Morales, M. (2011) · American Journal of Physical Medicine & Rehabilitation · doi:10.1097/phm.0b013e318214e406 · Cited by 29
Predictors of Response to Physical Therapy Intervention for Plantar Heel Pain
McClinton, S. M., Cleland, J. A., & Flynn, T. W. (2014) · Foot & Ankle International · doi:10.1177/1071100714558508 · Cited by 29
“88, and an MCID of 2 points.(7,20,33,34) The GRC was a singleitem questionnaire that ranked patient-perceived improvement between –7 (a very great deal worse) to 0 (about the same) to +7 (a very great deal better).”
Background
Nerve Pressure Pain Hypersensitivity and Upper Limb Mechanosensitivity in Breast Cancer Survivors: A Case–Control Study
Caro-Morán, E., Díaz‐Rodríguez, L., Cantarero‐Villanueva, I., Galiano‐Castillo, N., Arroyo‐Morales, M., & Fernández‐Lao, C. (2014) · Pain Medicine · doi:10.1111/pme.12567 · Cited by 30
Analgesic effects of a capacitive-resistive monopolar radiofrequency in patients with myofascial chronic neck pain: a pilot randomized controlled trial
Diego, I. M. A., Fernández‐Carnero, J., Laguarta-Val, S., Cano‐de‐la‐Cuerda, R., Calvo‐Lobo, C., Martínez-Piédrola, R. M., Oliva, L. L., & Rueda, F. M. (2019) · Revista da Associação Médica Brasileira · doi:10.1590/1806-9282.65.2.156 · Cited by 29
Multiple Active Myofascial Trigger Points and Pressure Pain Sensitivity Maps in the Temporalis Muscle Are Related in Women With Chronic Tension Type Headache
Fernández‐de‐las‐Peñas, C., Caminero, A. B., Madeleine, P., Guillem-Mesado, A., Ge, H., Arendt‐Nielsen, L., & Pareja, J. A. (2009) · Clinical Journal of Pain · doi:10.1097/ajp.0b013e3181a08747 · Cited by 29
Influence of Priming on Patient-Reported Outcome Measures: A Randomized Controlled Trial.
Claessen, F., Mellema, J. J., Stoop, N., Lubberts, B., Ring, D., & Poolman, R. (2016) · Psychosomatics · doi:10.1016/j.psym.2015.09.005 · Cited by 26
Children and Adolescents With Low Back Pain: A Descriptive Study of Physical Examination and Outcome Measurement
Clifford, S. N., & Fritz, J. M. (2003) · Journal of Orthopaedic and Sports Physical Therapy · doi:10.2519/jospt.2003.33.9.513 · Cited by 28
The Effects of a Pilates-Based Exercise Rehabilitation Program on Functional Outcome and Fall Risk Reduction in an Aging Adult Status-Post Traumatic Hip Fracture due to a Fall
Stivala, A., & Hartley, G. W. (2014) · Journal of Geriatric Physical Therapy · doi:10.1519/jpt.0b013e3182abe7a9 · Cited by 28
The effects of preoperative preparation on postoperative outcomes: The moderating role of control appraisals.
Shelley, M., & Pakenham, K. I. (2007) · Health Psychology · doi:10.1037/0278-6133.26.2.183 · Cited by 28
Empirical Evidence of the Validity of the Spanish Version of the Pain Vigilance Awareness Questionnaire
Esteve, R., Ramírez‐Maestre, C., & López-Martínez, A. E. (2011) · International Journal of Behavioral Medicine · doi:10.1007/s12529-011-9216-z · Cited by 28
Short-Term Effectiveness of Precut Kinesiology Tape Versus an NSAID as Adjuvant Treatment to Exercise for Subacromial Impingement
Devereaux, M. W., Velanoski, K. Q., Pennings, A. L., & Elmaraghy, A. (2015) · Clinical Journal of Sport Medicine · doi:10.1097/jsm.0000000000000187 · Cited by 28
“3 (4-81) Devereaux et al Clin J Sport Med Volume 26, Number 1, January 2016”
Background
Effectiveness of manual therapy versus surgery in pain processing due to carpal tunnel syndrome: A randomized clinical trial
Fernández‐de‐las‐Peñas, C., Cleland, J., Palacios‐Ceña, M., Fuensalida‐Novo, S., Alonso‐Blanco, C., Pareja, J. A., & Alburquerque‐Sendín, F. (2017) · European Journal of Pain · doi:10.1002/ejp.1026 · Cited by 28
“The reliability of pressure algometry has been found to be high (ICC: 0.91, 95%CI 0.90– 0.96) (Jones et al., 2007).”
BackgroundInfluential
Topographical pressure pain sensitivity maps of the shoulder region in individuals with subacromial pain syndrome
Ribeiro, I. L., Camargo, P. R., Alburquerque‐Sendín, F., Madeleine, P., Fernández‐de‐las‐Peñas, C., & Salvini, T. F. (2015) · Manual Therapy · doi:10.1016/j.math.2015.07.002 · Cited by 28
“This scale has been shown to be a valid and reliable tool for individuals with shoulder pain (Jensen et al., 1999).”
Method
Bilateral, wide-spread, mechanical pain sensitivity in children with frequent episodic tension-type headache suggesting impairment in central nociceptive processing
Fernández‐de‐las‐Peñas, C., Fernández-Mayoralas, D. M., Ortega‐Santiago, R., Ambite‐Quesada, S., Crujera, A. G., & Fernández‐Jaén, A. (2010) · Cephalalgia · doi:10.1177/0333102410362806 · Cited by 27
“An 11-point numerical pain rate scale (19) (NPRS; range, 01⁄4 no pain to 101⁄4maximum pain) was used to assess headache intensity.”
Method
Change in Psychosocial Distress Associated With Pain and Functional Status Outcomes in Patients With Lumbar Impairments Referred to Physical Therapy Services
Werneke, M. W., Hart, D. L., George, S. Z., Deutscher, D., & Stratford, P. W. (2011) · Journal of Orthopaedic and Sports Physical Therapy · doi:10.2519/jospt.2011.3814 · Cited by 27
Efficacy of electroacupuncture for myofascial pain in the upper trapezius muscle: a case series
Aranha, M. F. M., Alves, M. C., Bérzin, F., & Gavião, M. B. D. (2011) · Brazilian Journal of Physical Therapy · doi:10.1590/s1413-35552011005000022 · Cited by 27
Multidisciplinary biopsychosocial rehabilitation in chronic neck pain: a naturalistic prospective cohort study with intraindividual control of effects and 12-month follow-up
Letzel, J., Angst, F., & Weigl, M. B. (2019) · European Journal of Physical and Rehabilitation Medicine · doi:10.23736/s1973-9087.18.05348-0 · Cited by 27
Changes in Muscle Tone, Function, and Pain in the Chronic Hemiparetic Shoulder after Dry Needling Within or Outside Trigger Points in Stroke Patients: A Crossover Randomized Clinical Trial
Hernández-Ortíz, A. R., Ponce-Luceño, R., Sáez-Sánchez, C., García-Sánchez, O., Fernández‐de‐las‐Peñas, C., & De-la-Llave-Rincón, A. I. (2020) · Pain Medicine · doi:10.1093/pm/pnaa132 · Cited by 27
Through the Lens of Movement-Evoked Pain: A Theoretical Framework of the “Pain-Movement Interface” to Guide Research and Clinical Care for Musculoskeletal Pain Conditions
Butera, K. A., Chimenti, R. L., Alsouhibani, A., Berardi, G., Booker, S. Q., Knox, P. J., Post, A. A., Merriwether, E. N., Wilson, A. T., & Simon, C. B. (2024) · Journal of Pain · doi:10.1016/j.jpain.2024.01.351 · Cited by 28
Association between ongoing pain intensity, health-related quality of life, disability and quality of sleep in elderly people with total knee arthroplasty
Herrero-Sánchez, M. D., García-Iñigo, M. D. C., Nuño-Beato-Redondo, B. S., Fernández‐de‐las‐Peñas, C., & Alburquerque‐Sendín, F. (2014) · Ciência & Saúde Coletiva · doi:10.1590/1413-81232014196.04632013 · Cited by 27
Relationship Between Pain Severity and Outcomes in Patients Presenting With Potential Acute Coronary Syndromes
Edwards, M., Chang, A. M., Matsuura, A. C., Green, M., Robey, J. M., & Hollander, J. E. (2011) · Annals of Emergency Medicine · doi:10.1016/j.annemergmed.2011.05.036 · Cited by 27
Developing an algorithm capable of discriminating depressed mood in people with spinal cord injury
Craig, A., Rodrigues, D., Tran, Y., Guest, R., Bartrop, R., & Middleton, J. W. (2014) · Spinal Cord · doi:10.1038/sc.2014.25 · Cited by 26
Depressed Mood Differentially Mediates the Relationship between Pain Intensity and Pain Disability Depending on Pain Duration: A Moderated Mediation Analysis in Chronic Pain Patients
Probst, T., Neumeier, S., Altmeppen, J., Angerer, M., Loew, T. H., & Pieh, C. (2016) · Pain Research and Management · doi:10.1155/2016/3204914 · Cited by 30
Widespread Pressure Pain Hypersensitivity in Musculoskeletal and Nerve Trunk Areas as a Sign of Altered Nociceptive Processing in Unilateral Plantar Heel Pain
Plaza‐Manzano, G., Ríos‐León, M., Martín‐Casas, P., Arendt‐Nielsen, L., Fernández‐de‐las‐Peñas, C., & Ortega‐Santiago, R. (2018) · Journal of Pain · doi:10.1016/j.jpain.2018.08.001 · Cited by 27
Efficacy of Thrust and Nonthrust Manipulation and Exercise With or Without the Addition of Myofascial Therapy for the Management of Acute Inversion Ankle Sprain: A Randomized Clinical Trial
Truyols-Domínguez, S., Salom‐Moreno, J., Abián‐Vicén, J., Cleland, J. A., & Fernández‐de‐las‐Peñas, C. (2013) · Journal of Orthopaedic and Sports Physical Therapy · doi:10.2519/jospt.2013.4467 · Cited by 27
Ecological or Recalled Assessments in Chronic Musculoskeletal Pain? A Comparative Study of Prospective and Recalled Pain Assessments in Low Back Pain and Lower Limb Painful Osteoarthritis
Perrot, S., Marty, M., Legout, V., Moyse, D., Henrotin, Y. E., & Rozenberg, S. (2011) · Pain Medicine · doi:10.1111/j.1526-4637.2011.01052.x · Cited by 26
Do recovery expectations change over time?
Kamper, S., Kongsted, A., Haanstra, T., & Hestbaek, L. (2015) · European spine journal · doi:10.1007/s00586-014-3380-1 · Cited by 29
“At all assessment points participants rated their back pain in the last week on a 0–10 Numerical rating Scale (NRS) [11], back pain-related disability on the 0–23 Roland Morris questionnaire recalculated as a percentage score 0–100 [12, 13] and an outcome expectations measure.”
Method
Progression of Structural Brain Changes in Patients With Chronic Pancreatitis and Its Association to Chronic Pain
Muthulingam, J. A., Olesen, S. S., Hansen, T. M., Seminowicz, D. A., Burrowes, S. A. B., Drewes, A. M., & Frøkjær, J. B. (2018) · Pancreas · doi:10.1097/mpa.0000000000001151 · Cited by 26

Authors: Jensen, M. P., Turner, J. A., Romano, J. M., & Fisher, L. D.
Affiliations: University of Washington (US)
Corresponding author: Jensen, Mark P
ORCID: Jensen, Mark P
Turner, Judith A
Romano, Joan M
Venue: Pain
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 1999-11
Volume: 83
Issue: 2
Pages: 157-162
ISSN: 0304-3959 (ISSN-L)
DOI: 10.1016/s0304-3959(99)00101-3
OpenAlex: W2009568727
Cited by: 1,247
References: 14
Citations by year: 2026: 38 · 2025: 39 · 2024: 52 · 2023: 49 · 2022: 55 · 2021: 75 · 2020: 92 · 2019: 77 · 2018: 64 · 2017: 64 · 2016: 68 · 2015: 60 · 2014: 66 · 2013: 52 · 2012: 52
FWCI: 6.73
Type: journal article
Language: en
Open access: closed
Locations: Pain (publishedVersion)
PubMed (publishedVersion)
Funders: National Institutes of Health
U.S. Public Health Service (R01 31683)
Topics: Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
Keywords: chronic pain, pain intensity assessment, reliability statistics, validity, multidisciplinary pain management, longitudinal change detection
MeSH terms: Adult, Aged, Analgesics, Analysis of Variance, Chronic Disease, Counseling, Female, Follow-Up Studies, Humans, Interviews as Topic, Longitudinal Studies, Male, Middle Aged, Occupational Therapy, Pain, Pain Measurement, Patient Care Team, Psychotherapy, Socioeconomic Factors, Time Factors, Reproducibility of Results, Physical Therapy Modalities, Pain Management

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Comparative reliability and validity of chronic pain intensity measures.

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