Reproducibility of pain measurement and pain perception
Reproducibility of pain measurement and pain perception
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DOI：
10.1016/s0304-3959(02)00048-9
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发表时间：
2002-07-01
期刊：
影响因子：
7.4
通讯作者：
Coghill, RC
中科院分区：
文献类型：
--
作者：
Rosier, EM;Iadarola, MJ;Coghill, RC
疼痛的意识体验的可重复性和疼痛的心理物理评估的可重复性仍然是关键，但在疼痛研究和治疗中缺乏表征的因素。为了评估疼痛体验和两种疼痛评估方法的可重复性，15名受试者在每周4次的会议中评估实验性热痛。在每次实验中，分别采用短时间（5 s）和长时间（90 s）热刺激来确定刺激时间对再现性的影响。在每次会议中，多次简短的热刺激被用来评估反应平均的效果。采用视觉模拟量表（VAS）和随机语言描述量表（VDS）来更好地区分疼痛体验的变化和疼痛量表使用的变化。受试者还评估了视觉刺激的强度，以便在使用两种类型的量表时提供一个独立的评估。受试者内部分析显示，视觉刺激评分在不同时段的差异明显小于热痛评分。因此，在控制了量表使用的每次会话变化后，疼痛感知比视觉刺激感知更可变。量表之间的比较表明，尽管VDS评分分布在更大的范围内，但VAS获得的强度评分在会话间的变化明显小于VDS获得的强度评分。对于这两个量表，对刺激平均和刺激持续时间的分析表明，对同一刺激的多次平均评估大大减少了会话间的差异，对短暂刺激的多次评估产生的反应比一次长时间刺激产生的反应更具有可重复性。然而，VAS对感知疼痛强度和疼痛不愉快的微小差异明显更敏感，并且没有表现出VDS存在的一些顺序效应。综上所述，这些结果表明，疼痛心理物理评分的可重复性可以最大化：(1)通过对多个简短刺激的平均反应；(2)为受试者提供与研究期不同的训练期；(3)确保尺度参数的解释随时间保持不变。因此，尽管实验和临床疼痛的经历都是高度可变的，但疼痛评估程序可以结构化，以尽量减少会话之间的可变性。(C) 2002国际疼痛研究协会。Elsevier Science B.V.版权所有。
The reproducibility of both the conscious experience of pain and the reproducibility of psychophysical assessments of pain remain critical, yet poorly characterized factors in pain research and treatment. To assess the reproducibility of both the pain experience and two methods of pain assessment, 15 subjects evaluated experimental heat pain during four weekly sessions. In each session, both brief (5 s) and prolonged (90 s) heat stimuli were utilized to determine effects of stimulus duration on reproducibility. Multiple presentations of the brief heat stimuli in each session were used to evaluate effects of response averaging. Both visual analog scales (VAS) and randomized verbal descriptor scales (VDS) were employed to better distinguish variations in the pain experience from variations in pain scale usage. Subjects also rated the intensity of visual stimuli in order to provide an independent assessment of the session-to-session variation in the use of both types of scales. Within-subjects analyses revealed that ratings of visual stimuli exhibited significantly less session-to-session variation than ratings of heat pain. Thus, pain perceptions were more variable than perceptions of visual stimuli after controlling for session-to-session variations in scale usage. Comparisons between scales indicated that intensity ratings acquired with the VAS had significantly smaller session-to-session variation than those acquired with the VDS, although VDS ratings were spread across a larger range of the scale. For both scales, analyses of the effects of stimulus averaging and stimulus duration revealed that averaging multiple assessments of the same stimulus substantially reduces session-to-session variation and that multiple assessments of brief stimuli produce responses which are more reproducible than a single presentation of a prolonged stimulus. However, the VAS was significantly more sensitive to small differences in perceived pain intensity and pain unpleasantness, and did not exhibit some of the order effects present with the VDS. Taken together, these results indicate that the reproducibility of psychophysical ratings of pain can be maximized: (1) by averaging responses to multiple, brief stimuli; (2) by providing subjects with a training period distinct from the study period; and (3) by ensuring that interpretation of scale parameters remains constant over time. Thus, although the experiences of both experimental and clinical pain are highly variable, pain assessment procedures can be structured to minimize session-to-session variability. (C) 2002 International Association for the Study of Pain. Published by Elsevier Science B.V. All rights reserved.