Development and initial validation of the PEG, a three-item scale assessing pain intensity and interference - PubMed (original) (raw)

Comparative Study

Development and initial validation of the PEG, a three-item scale assessing pain intensity and interference

Erin E Krebs et al. J Gen Intern Med. 2009 Jun.

Abstract

Background: Inadequate pain assessment is a barrier to appropriate pain management, but single-item "pain screening" provides limited information about chronic pain. Multidimensional pain measures such as the Brief Pain Inventory (BPI) are widely used in pain specialty and research settings, but are impractical for primary care. A brief and straightforward multidimensional pain measure could potentially improve initial assessment and follow-up of chronic pain in primary care.

Objectives: To develop an ultra-brief pain measure derived from the BPI.

Design: Development of a shortened three-item pain measure and initial assessment of its reliability, validity, and responsiveness.

Participants: We used data from 1) a longitudinal study of 500 primary care patients with chronic pain and 2) a cross-sectional study of 646 veterans recruited from ambulatory care.

Results: Selected items assess average pain intensity (P), interference with enjoyment of life (E), and interference with general activity (G). Reliability of the three-item scale (PEG) was alpha = 0.73 and 0.89 in the two study samples. Overall, construct validity of the PEG was good for various pain-specific measures (r = 0.60-0.89 in Study 1 and r = 0.77-0.95 in Study 2), and comparable to that of the BPI. The PEG was sensitive to change and differentiated between patients with and without pain improvement at 6 months.

Discussion: We provide strong initial evidence for reliability, construct validity, and responsiveness of the PEG among primary care and other ambulatory clinic patients. The PEG may be a practical and useful tool to improve assessment and monitoring of chronic pain in primary care.

PubMed Disclaimer

Figures

Figure 1

Figure 1

The PEG three-item scale. *Items from the Brief Pain Inventory reproduced with permission from Dr. Charles Cleeland.

Figure 2

Figure 2

Mean change in PEG and BPI scales compared with global rating of change at 6 months ( = 210).

Similar articles

Cited by

References

    1. Improving the Quality of Pain Management Through Measurement and Action. 2003. Oakbrook Terrace, IL, Joint Commission on Accreditation of Healthcare Organizations and National Pharmaceutical Council.
    1. Carr DB, Jacox AK, Chapman CR, Fillingim RB, Heidrich G, Hester NK. Acute pain management: Operative or Medical Procedures and Trauma. Clinical Practice Guideline (AHCPR Pub. No. 92–0032). 1992. Rockville, MD, Agency for Health Care Policy and Research, Public Health Service, US Department of Health and Human Services.
    1. Jacox A, Carr DB, Payne R. Management of Cancer Pain. Clinical Practice Guideline (AHCPR Publication No. 94–0592). 1994. Rockville, MD, Agency for Health Care Policy and Research, U.S. Department of Health and Human Services, Public Health Service. 1994.
    1. Pain as the 5th vital sign toolkit, revised edition. National Pain Management Coordinating Committee, Veterans Health Administration 2000; Available at: http://www1.va.gov/pain_management/docs/TOOLKIT.pdf. Accessed March 27, 2009.
    1. Comprehensive Accreditation Manual for Ambulatory Care. Oakbrook Terrace, IL: Joint Commission on Accreditation of Healthcare Organizations, 2006. - PubMed

Publication types

MeSH terms

LinkOut - more resources