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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“It has been shown to be a reliable and valid tool for the assessment of pain (18).”
Method
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“1999 [35] has already confirmed that pain surveys, such as those used in our evaluation, are more suitable than questionnaires restricted to only a single time point.”
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MethodInfluential
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“This 11point rating scale has been shown to be a valid and reliable tool for evaluating pain intensity in a number of clinical studies (Dalton and McNaull, 1998; Jensen et al., 1999).”
Method
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Method
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Method
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Fleming, R. J., Forsythe, S., & Cook, C. E. (2007) · Journal of Manual & Manipulative Therapy · doi:10.1179/106698107790819846 · Cited by 16
Development of a chronic pain–specific version of the Sickness Impact Profile.
McEntee, M. L., Vowles, K. E., & McCracken, L. M. (2015) · Health Psychology · doi:10.1037/hea0000257 · Cited by 16
Topographical Pressure Pain Sensitivity Maps of the Feet Reveal Bilateral Pain Sensitivity in Patients With Unilateral Plantar Heel Pain
Ríos‐León, M., Ortega‐Santiago, R., Madeleine, P., Fernández‐de‐las‐Peñas, C., & Plaza‐Manzano, G. (2019) · Journal of Orthopaedic and Sports Physical Therapy · doi:10.2519/jospt.2019.8813 · Cited by 16
Structured literature review of patient-reported outcome (PRO) instruments in adult tonsillectomy or tonsillotomy
Seethaler, A., Rudack, C., & Spiekermann, C. (2019) · Health and Quality of Life Outcomes · doi:10.1186/s12955-019-1192-z · Cited by 16
A psychophysical study comparing massage to conditioned pain modulation: A single blind randomized controlled trial in healthy participants
Wilson, A. T., Riley, J. L., Bishop, M. D., Beneciuk, J. M., Godza, M., Cruz‐Almeida, Y., & Bialosky, J. E. (2021) · Journal of Bodywork and Movement Therapies · doi:10.1016/j.jbmt.2021.02.014 · Cited by 18
Effects of Dry Needling of Latent Trigger Points on Viscoelastic and Muscular Contractile Properties: Preliminary Results of a Randomized Within-Participant Clinical Trial
Pérez‐Bellmunt, A., Casasayas-Cos, O., López-de–Celis, C., Rodríguez‐Sanz, J., Rodríguez‐Jiménez, J., Ortiz-Miguel, S., Meca-Rivera, T., & Fernández‐de‐las‐Peñas, C. (2021) · Journal of Clinical Medicine · doi:10.3390/jcm10173848 · Cited by 16
Predictors of Pain for Patients With Early Inflammatory Polyarthritis
Dobkin, P. L., Liu, A., Abrahamowicz, M., Carrier, N., de Brum-Fernandes, A. J., Cossette, P., & Boire, G. (2012) · Arthritis Care & Research · doi:10.1002/acr.21923 · Cited by 16
“Jensen et al (25), in an examination of the reliability”
Background
Pain Following Spinal Cord Injury
Ullrich, P. M. (2007) · Physical Medicine and Rehabilitation Clinics of North America · doi:10.1016/j.pmr.2007.03.001 · Cited by 16
Functional limitations and associated psychological factors in military personnel with chronic nonspecific neck pain with higher levels of kinesiophobia
López‐de‐Uralde‐Villanueva, I., Notario-Pérez, R., del Corral, T., Ramos-Díaz, B., Acuyo-Osorio, M., & Touche, R. L. (2017) · Work · doi:10.3233/wor-172634 · Cited by 16
“The VAS has been shown to be a valid and reliable tool to measure pain intensity [49, 50].”
Gender differences in clinical and psychological variables associated with the burden of headache in tension-type headache
Fuensalida-Novo, S., Parás-Bravo, P., Jiménez-Antona, C., Castaldo, M., Wang, K.-L., Benito-González, E., Arendt-Nielsen, L., & Fernández-de-las-Peñas, C. (2019) · Women & health · doi:10.1080/03630242.2019.1696440 · Cited by 16
“Participants registered the number of days with headache (days per week), the intensity of headache attacks on a 0–10 points numerical pain rate scale (Jensen et al. 1999) (NPRS; 0: no pain, 10: the”
Background
A test of the fear avoidance model to predict chronic pain outcomes in a polytrauma sample
McGeary, C. A., Nabity, P. S., Reed, D. E., Cobos, B. A., Eapen, B. C., Pugh, M. J., Jaramillo, C. A., Potter, J. S., Houle, T. T., Young‐McCaughan, S., et al. (2020) · Neurorehabilitation · doi:10.3233/nre-203084 · Cited by 17
“…metrics like pain intensity ratings may represent different facets of pain in a single metric, some have suggested that clinical services should be guided by composite ratings that account for changes in pain over time (rather than a single rating at a single time point; Jensen et al., 1999).”
Influence of the Temporomandibular Joint on Range of Motion of the Hip Joint in Patients With Complex Regional Pain Syndrome
Fischer, M. J., Riedlinger, K., Gutenbrunner, C. M., & Bernateck, M. (2009) · Journal of Manipulative and Physiological Therapeutics · doi:10.1016/j.jmpt.2009.04.003 · Cited by 16
Measurement Properties of a New Quality of Life Measure for Patients with Work Disability Associated with Musculoskeletal Pain
Coutu, M., Durand, M., Loisel, P., Dupuis, G., & Gervais, S. (2005) · Journal of Occupational Rehabilitation · doi:10.1007/s10926-005-5938-6 · Cited by 16
“The test-retest stability coefficients for 14-day intervals ranged from .67 to .84, and for 30-day intervals, from .55 to .83 ( 59 ).”
Background
A randomised controlled trial to assess the efficacy of Laparoscopic Uterosacral Nerve Ablation (LUNA) in the treatment of chronic pelvic pain: The trial protocol [ISRCTN41196151]
The LUNA Trial Collaboration (2003) · BMC Women s Health · doi:10.1186/1472-6874-3-6 · Cited by 16
“Individual pain scores have sufficient psychometric strengths to be used in chronic pain research involving group comparison designs[30].”
Erratum to: Impact of old age on patient-report outcomes and cost utility for anterior cervical discectomy and fusion surgery for degenerative spine disease
Chotai, S., Park, P., Sielatycki, J. A., Sivaganesan, A., Kay, H. F., Wick, J. B., McGirt, M. J., & Devin, C. J. (2017) · European Spine Journal · doi:10.1007/s00586-017-4991-0 · Cited by 16
The behavioral inhibition and activation systems and function in patients with chronic pain
Serrano-Ibáñez, E. R., López-Martínez, A. E., Ramírez-Maestre, C., Esteve, R., & Jensen, M. P. (2019) · Personality and Individual Differences · doi:10.1016/j.paid.2018.09.021 · Cited by 15
Self-citation
Clinically Important Change in Insomnia Severity After Chronic Pain Rehabilitation
Wilson, K. G., Kowal, J., & Ferguson, E. J. (2016) · The Clinical Journal of Pain · doi:10.1097/ajp.0000000000000325 · Cited by 15
Patient-Centered Goals After Lumbar Spine Surgery: A Secondary Analysis of Cognitive-Behavioral–Based Physical Therapy Outcomes From a Randomized Controlled Trial
Coronado, R. A., Master, H., Bley, J. A., Robinette, P. E., Sterling, E. K., O’Brien, M. T., Henry, A. L., Pennings, J. S., Vanston, S. W., Myczkowski, B., et al. (2022) · Physical Therapy · doi:10.1093/ptj/pzac091 · Cited by 15
The Analgesic Effect of Resistance Training after Breast Cancer (ANTRAC): A Randomized Controlled Trial
Rasmussen, G. H. F., Kristiansen, M. V., Arroyo‐Morales, M., Voigt, M., & Madeleine, P. (2022) · Medicine & Science in Sports & Exercise · doi:10.1249/mss.0000000000003034 · Cited by 18
“PI was rated on an 11-point numeric rating scale (NRS), where 0 corresponded to “no pain” and 10 to “worst pain imaginable” (21).”
Method
Randomised controlled trial of referral to a telephone-based weight management and healthy lifestyle programme for patients with knee osteoarthritis who are overweight or obese: a study protocol
O’Brien, K. M., Wiggers, J., Williams, A. J., Campbell, E. M., Wolfenden, L., Yoong, S. L., Robson, E. K., McAuley, J. H., Haskins, R., Kamper, S. J., et al. (2016) · BMJ Open · doi:10.1136/bmjopen-2015-010203 · Cited by 14
Therapeutic Advantages of Frequent Physical Therapy Sessions for Patients With Lumbar Spinal Stenosis
Minetama, M., Kawakami, M., Teraguchi, M., Kagotani, R., Mera, Y., Sumiya, T., Nakagawa, M., Yamamoto, Y., Matsuo, S., Sakon, N., et al. (2019) · Spine · doi:10.1097/brs.0000000000003363 · Cited by 15
Effectiveness of a multicomponent treatment versus conventional treatment in patients with fibromyalgia
Araya‐Quintanilla, F., Gutiérrez‐Espinoza, H., Muñoz-Yánez, M. J., Cavero‐Redondo, I., Álvarez‐Bueno, C., & Martínez‐Vizcaíno, V. (2020) · Medicine · doi:10.1097/md.0000000000018833 · Cited by 15
Beyond pain intensity and catastrophizing: The association between self‐enhancing humour style and the adaptation of individuals with chronic pain
Ramírez‐Maestre, C., Esteve, R., López-Martínez, A. E., Miró, J., Jensen, M. P., & de la Vega, R. (2020) · European Journal of Pain · doi:10.1002/ejp.1583 · Cited by 17
An Objective Pain Score for Chronic Pain Clinic Patients
Pace, A., Bruceta, M., Donovan, J. F., Vaida, S. J., & Eckert, J. M. (2021) · Pain Research and Management · doi:10.1155/2021/6695741 · Cited by 15
“+e numeric rating scale (NRS) has been validated and widely implemented across the healthcare industry for evaluation of acute and chronic pain and for various pain types [17].”
Method
Short- and long-term effects of whole-body photobiomodulation on pain, functionality, tissue quality, central sensitisation and psychological factors in a population suffering from fibromyalgia: protocol for a triple-blinded randomised clinical trial
Ledesma, S. N., González-Muñoz, A., Carroll, J. D., & Burton, P. (2022) · Therapeutic Advances in Chronic Disease · doi:10.1177/20406223221078095 · Cited by 15
Effects of Meditation on Symptoms of Knee Osteoarthritis: A Pilot Study
Selfe, T. K., & Innes, K. E. (2013) · Alternative and Complementary Therapies · doi:10.1089/act.2013.19302 · Cited by 15
“This type of scale has demonstrated excellent reliability and validity for a range of populations, 35–38 is easier to use, and has a lower failure rate than the visual analog scale (VAS), particularly in older populations.”
Effect of behavioral activation treatment on chronic fibromyalgia pain: Replication and extension.
Lundervold, D. A., Talley, C., & Buermann, M. (2008) · International Journal of Behavioral Consultation and Therapy · doi:10.1037/h0100839 · Cited by 15
TNF-α concentrations in pre-operative synovial fluid for predicting early post-operative function and pain after fast-track total knee arthroplasty
Ziętek, P., Dziedziejko, V., Safranow, K., Ziętek, J., Stępień–Słodkowska, M., Białecka, M. A., Ziętek, M., Kotrych, D., Kamiński, A., & Kowalska, A. J. (2016) · The Knee · doi:10.1016/j.knee.2016.02.013 · Cited by 15
From acute to chronic back pain: Using linear mixed models to explore changes in pain intensity, disability, and depression
Bendayan, R., Ramírez‐Maestre, C., Ferrer, E. E., López-Martínez, A. E., & Esteve, R. (2017) · Scandinavian Journal of Pain · doi:10.1016/j.sjpain.2017.02.009 · Cited by 16
Mechanical neck pain
Dennison, B. S., & Leal, M. H. (2011) · Elsevier eBooks · doi:10.1016/b978-0-7020-3528-9.00007-8 · Cited by 15
Perceived Pain Extent Is Not Associated with Physical, Psychological, or Psychophysical Outcomes in Women with Carpal Tunnel Syndrome
Fernández‐de‐las‐Peñas, C., Falla, D., Palacios‐Ceña, M., De-la-Llave-Rincón, A. I., Schneebeli, A., & Barbero, M. (2018) · Pain Medicine · doi:10.1093/pm/pny248 · Cited by 15
Catechol-O-Methyltransferase Val158Met Polymorphism Is Associated with Anxiety, Depression, and Widespread Pressure Pain Sensitivity in Women with Chronic, but Not Episodic, Migraine
Fernández‐de‐las‐Peñas, C., Ambite‐Quesada, S., Florêncio, L. L., Palacios‐Ceña, M., Ordás, C., & Arendt‐Nielsen, L. (2018) · Pain Medicine · doi:10.1093/pm/pny237 · Cited by 15
Association between Physiological and Subjective Aspects of Pain and Disability in Post-Stroke Patients with Shoulder Pain: A Cross-Sectional Study
Martín-Martín, L., Membrilla-Mesa, M., Lozano-Lozano, M., Galiano-Castillo, N., Fernández-Lao, C., & Arroyo-Morales, M. (2019) · Journal of Clinical Medicine · doi:10.3390/jcm8081093 · Cited by 13
Early Changes in Pain Acceptance Predict Pain Outcomes in Interdisciplinary Treatment for Chronic Pain
Probst, T., Jank, R., Dreyer, N., Seel, S., Wagner, R., Hanshans, K., Reyersbach, R., Mühlberger, A., Lahmann, C., & Pieh, C. (2019) · Journal of Clinical Medicine · doi:10.3390/jcm8091373 · Cited by 15
Suicidal Ideation among Veterans Living with Cancer Referred to Mental Health
Johnson, C. C., Phillips, K. M., & Miller, S. N. (2019) · Clinical Gerontologist · doi:10.1080/07317115.2019.1686719 · Cited by 17
“Numeric rating scales to assess pain level intensity are reliable and valid measures (Jensen et al., 1999).”
Background
Long-term patient observation after conservative treatment of carpal tunnel syndrome: a summary of two randomised controlled trials
Wolny, T., & Linek, P. (2019) · PeerJ · doi:10.7717/peerj.8012 · Cited by 15

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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