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Pediatric Pain Screening Tool: rapid identification of risk in youth with pain complaints
Open accessAbstract
Moderate to severe chronic pain is a problem for 1.7 million children, costing $19.5 billion dollars annually in the United States alone. Risk-stratified care is known to improve outcomes in adults with chronic pain. However, no tool exists to stratify youth who present with pain complaints to appropriate interventions. The Pediatric Pain Screening Tool (PPST) presented here assesses prognostic factors associated with adverse outcomes among youth and defines risk groups to inform efficient treatment decision making. Youth (n = 321, ages 8-18, 90.0% Caucasian, 74.8% female) presenting for multidisciplinary pain clinic evaluation at a tertiary care center participated. Of these, 195 (61.1%) participated at 4-month follow-up. Participants completed the 9-item PPST in addition to measures of functional disability, pain catastrophizing, fear of pain, anxiety, and depressive symptoms. Sensitivity and specificity for the PPST ranged from adequate to excellent, with regard to significant disability (78%, 68%) and high emotional distress (81%, 63%). Participants were classified into low- (11%), medium- (32%), and high- (57%) risk groups. Risk groups did not significantly differ by pain diagnosis, location, or duration. Only 2% to 7% of patients who met reference standard case status for disability and emotional distress at 4-month follow-up were classified as low risk at baseline, whereas 71% to 79% of patients who met reference standard case status at follow-up were classified as high risk at baseline. A 9-item screening tool identifying factors associated with adverse outcomes among youth who present with pain complaints seems valid and provides risk stratification that can potentially guide effective pain treatment recommendations in the clinic setting.
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“PPST is a 9-item screening tool used to identify prognostic factors (e.g., sleep disturbance, depression, anxiety) associated with adverse outcomes, with allocation to the high-risk group based upon responses to psychosocial items.”
From Best-evidence for the rehabilitation of chronic pain part 1: Pediatric pain (2019) · cites this paper as [126]
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“The PPST can be easily delivered within a busy clinical setting and allows providers to quickly and effectively identify medium to high risk youth who may benefit from access to more comprehensive, multidisciplinary treatments [126].”
From Best-evidence for the rehabilitation of chronic pain part 1: Pediatric pain (2019) · cites this paper as [126]
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Delivering transformative action in paediatric pain: a Lancet Child & Adolescent Health Commission
Eccleston, C., Fisher, E., Howard, R. F., Slater, R., Forgeron, P. A., Palermo, T. M., Birnie, K. A., Anderson, B. J., Chambers, C. T., Crombez, G., et al. (2020) · The Lancet Child & Adolescent Health · doi:10.1016/s2352-4642(20)30277-7 · Cited by 361
Pediatric pain treatment and prevention for hospitalized children
Friedrichsdorf, S. J., & Goubert, L. (2019) · PAIN Reports · doi:10.1097/pr9.0000000000000804 · Cited by 203
Friedrichsdorf, S. J., Giordano, J. J., Dakoji, K. D., Warmuth, A., Daughtry, C., & Schulz, C. A. (2016) · Children · doi:10.3390/children3040042 · Cited by 211
Best-evidence for the rehabilitation of chronic pain part 1: Pediatric pain
Harrison, L. E., Pate, J. W., Richardson, P. A., Ickmans, K., Wicksell, R. K., & Simons, L. E. (2019) · Journal of Clinical Medicine · doi:10.3390/jcm8091267 · Cited by 140
“The PPST can be easily delivered within a busy clinical setting and allows providers to quickly and effectively identify medium to high risk youth who may benefit from access to more comprehensive, multidisciplinary treatments [126].”
BackgroundMethodChow, E. T., Otis, J. D., & Simons, L. E. (2016) · The Journal of Pain · doi:10.1016/j.jpain.2016.02.014 · Cited by 111
Metadata
- Authors
- Simons, L. E., Smith, A., Ibagon, C., Coakley, R., Logan, D. E., Schechter, N., Borsook, D., & Hill, J. C.
- Affiliations
- Boston Children's Hospital (US)
- ORCID
- Venue
- Pain
- Published
- 2015-08
- Volume
- 156
- Issue
- 8
- Pages
- 1511-1518
- ISSN
- 0304-3959 (ISSN-L)
- PMC
- PMC4504741
- OpenAlex
- W2005555699
- Cited by
- 89
- References
- 37
- Citations by year
- 2026: 10 · 2025: 10 · 2024: 10 · 2023: 6 · 2022: 7 · 2021: 7 · 2020: 8 · 2019: 9 · 2018: 10 · 2017: 7 · 2016: 3 · 2015: 2
- FWCI
- 7.32
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Pain (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Keele Research Repository (Keele University) (submittedVersion, cc-by)
- Funders
- U.S. Public Health Service (8ULTR000170)
- National Institute of Neurological Disorders and Stroke (K24NS064050)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (K23HD067202)
- Topics
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Keywords
- pediatric chronic pain, pain screening, risk stratification, prognostic factors, functional disability, pain catastrophizing, fear of pain, anxiety, depressive symptoms, emotional distress, multidisciplinary pain clinic, screening validity, treatment decision-making
- MeSH terms
- Adolescent, Anxiety, Child, Depression, Disability Evaluation, Fear, Female, Follow-Up Studies, Humans, Male, Pain Measurement, Risk Factors, Sensitivity and Specificity, Reproducibility of Results, Risk Assessment, Early Diagnosis, Catastrophization, Chronic Pain
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