Pain Assessment using the NIH Toolbox.

Neurology (Impact Factor: 8.29). 03/2013; 80(11):Supplement 3 S49-S53. DOI: 10.1212/WNL.0b013e3182872e80


Objective: Pain is an important component of health and function, and chronic pain can be a problem in its own right. The purpose of this report is to review the considerations surrounding pain measurement in the NIH Toolbox, as well as to describe the measurement tools that were adopted for inclusion in the NIH Toolbox assessment battery.

Methods: Instruments to measure pain in the NIH Toolbox were selected on the basis of scholarly input from a diverse group of experts, as well as review of existing instruments, which include verbal rating scales, numerical rating scales, and graphical scales.

Results: Brief self-report measures of pain intensity and pain interference were selected for inclusion in the core NIH Toolbox for use with adults. A 0 to 10 numerical rating scale was recommended for measuring pain intensity, and a 6-item Patient Reported Outcome Measurement Information System (PROMIS) short form for measuring pain interference. The 8-item PROMIS Pediatric Pain Interference measure was recommended as a supplemental measure. No specific measure was recommended for measuring pain intensity in children.

Conclusions: Core and supplemental measures were recommended for the NIH Toolbox. Additional measures were reviewed for investigators who seek tools for measuring pain intensity in pediatric samples.

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Available from: Richard Gershon, Feb 19, 2014
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    • "Respondents were asked to rate their average pain intensity over the previous 7 days. Use of NRS has been identified as a suitable assessment of pain intensity in acute and chronic pain populations in previous studies [7]. "
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    ABSTRACT: Individuals with chronic pain show a greater vulnerability to depression or anger than those without chronic pain, and also show greater interpersonal difficulties and physical disability. The current study examined data from 675 individuals with chronic pain during their initial visits to a tertiary care pain clinic using assessments from Stanford University's Collaborative Health Outcomes Information Registry (CHOIR). Using a path modeling analysis, the mediating roles of PROMIS Physical Function and PROMIS Satisfaction with Social Roles and Activities were tested between pain intensity and PROMIS Depression and Anger. Pain intensity significantly predicted both depression and anger, and both physical function and satisfaction with social roles mediated these relationships when modeled in separate 1-mediator models. Notably, however, when modeled together, ratings of satisfaction with social roles mediated the relationship between physical function and both anger and depression. Our results suggest that the process by which chronic pain disrupts emotional well-being involves both physical function and disrupted social functioning. However, the more salient factor in determining pain-related emotional distress appears to be disruption of social relationships, rather than global physical impairment. These results highlight the particular importance of social factors to pain-related distress, and highlight social functioning as an important target for clinical intervention in chronic pain.
    Pain 07/2015; DOI:10.1097/j.pain.0000000000000313 · 5.21 Impact Factor
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    • "Sixteen Institutes, centers and offices of the NIH support this initiative for neuroscience research to accelerate discoveries and reduce the burden of nervous system disorders. General methods applied to the development of measures in all four major domains are detailed in a separate series of papers introducing the full NIHTB (Coldwell et al., 2013; Cook et al., 2013; Dalton et al., 2013; Dunn et al., 2013; Gershon, Wagster, et al., 2013; Hodes, Insel, Landis, & Research, 2013; Nowinski, Victorson, Debb, & Gershon, 2013; Reuben et al., 2013; Rine et al., 2013; Salsman et al., 2013; Varma, McKean-Cowdin, Vitale, Slotkin, & Hays, 2013; Victorson et al., 2013; Weintraub, Dikmen, et al., 2013; Zecker et al., 2013). The NIHTB Cognition Battery (NIHTB-CB) is the focus of the present series. "
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    ABSTRACT: This study introduces a special series on validity studies of the Cognition Battery (CB) from the U.S. National Institutes of Health Toolbox for the Assessment of Neurological and Behavioral Function (NIHTB) (Gershon, Wagster et al., 2013) in an adult sample. This first study in the series describes the sample, each of the seven instruments in the NIHTB-CB briefly, and the general approach to data analysis. Data are provided on test-retest reliability and practice effects, and raw scores (mean, standard deviation, range) are presented for each instrument and the gold standard instruments used to measure construct validity. Accompanying papers provide details on each instrument, including information about instrument development, psychometric properties, age and education effects on performance, and convergent and discriminant construct validity. One study in the series is devoted to a factor analysis of the NIHTB-CB in adults and another describes the psychometric properties of three composite scores derived from the individual measures representing fluid and crystallized abilities and their combination. The NIHTB-CB is designed to provide a brief, comprehensive, common set of measures to allow comparisons among disparate studies and to improve scientific communication. (JINS, 2014, 20, 1-12).
    Journal of the International Neuropsychological Society 06/2014; 20(6):1-12. DOI:10.1017/S1355617714000320 · 2.96 Impact Factor
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    ABSTRACT: Objective: The NIH Toolbox is intended to be responsive to the needs of investigators evaluating neurologic and behavioral function in diverse settings. Early phases of the project involved gathering information and input from potential end users. Methods: Information was collected through literature and instrument database reviews, requests for information, consensus meetings, and expert interviews and integrated into the NIH Toolbox development process in an iterative manner. Results: Criteria for instrument inclusion, subdomains to be assessed, and preferences regarding instrument cost and length were obtained. Existing measures suitable for inclusion in the NIH Toolbox and areas requiring new measure development were identified. Conclusion: The NIH Toolbox was developed with explicit input from potential end users regarding many of its key features.
    Neurology 03/2013; 80(Issue 11, Supplement 3):S7-S12. DOI:10.1212/WNL.0b013e3182872e4c · 8.29 Impact Factor
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