Psychometric Properties of Pain Scales in Inpatient Settings: An Umbrella Review.
Fabio D'Agostino, Noemi Giannetta, Gianfranco Sanson and 5 others
PMID 40820732WHAT IT FOUND
Only three hospital pain scales had enough evidence to recommend: Breakthrough Pain Assessment Tool for cancer pain, Paediatric Pain Profile for children who cannot self-report, and Questionnaire on Pain caused by Spasticity for limb spasticity pain.
Most others still need better validation.
Key findings
01The review included 17 systematic reviews and identified 41 pain scales: 17 patient self-report, 23 observation by healthcare professionals or caregivers, and one using both.
02The Critical-Care Pain Observation Tool was used in 3220 intensive-care patients, and the included review reported sensitivity of 74.3% and specificity of 76.8%.
03The review's conclusion recommended the Paediatric Pain Profile for children unable to self-report, the Breakthrough Pain Assessment Tool for cancer patients, and the Questionnaire on Pain caused by Spasticity for limb spasticity, but said the latter two need confirmation.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The included reviews were too heterogeneous for a single meta-analysis. Some reviews did not report evidence quality using GRADE or used different appraisal tools, which can make comparisons less consistent. The search terms focused on hospitalisation, so relevant reviews or scales outside that wording may have been missed. Several recommended or promising scales were tested in only one study, or each property was tested in only one study, so confidence is limited. The review assessed measurement properties, not patient outcomes.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not read the three recommended scales as proof that they improve patient care. The review assessed how well the scales measure pain, and it said the Breakthrough Pain Assessment Tool and Questionnaire on Pain caused by Spasticity need confirmation by at least one additional study.