From Paper to Digitalized Body Map: A Reliability Study of the Pain Area
From Paper to Digitalized Body Map: A Reliability Study of the Pain Area
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DOI：
10.1111/papr.12780
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发表时间：
2019-07-01
期刊：
影响因子：
2.6
通讯作者：
Wideman, Timothy H.
中科院分区：
文献类型：
--
作者：
Caseiro, Marilia;Woznowski-Vu, Arthur;Wideman, Timothy H.
背景分析疼痛描述图(PD)的计算机化方法已经被开发出来，并且可能有助于更精确地测量疼痛区域。目的本研究的目的是验证检查人员能否以可接受的可靠性再现患者的PD。方法这是一项评分员内和评分员间的可靠性研究。该方案包括4个步骤：(1)扫描纸质PD；(2)在检查者之间共享数字化PD图像；(3)在素描应用中再现PD图像；(4)以像素和百分比计算疼痛面积。我们计算组内相关系数(ICCs；2，1)、测量的标准误差(SEM)和最小可检测差异(SDD)。结果17例患者(女性11例，占64.7%，平均年龄：53.23+/-11.57岁)共31个PD进行了可靠性检验。评分员内部信度从ICC(2，1)=0.991(95%可信区间[CI]=0.982至0.996；SSD=3,432.45；SDD=162.39像素；P<；0.001)到ICC(2，1)=0.992(95%CI=0.978至0.997；Sm=3412.96；SDD=161.93像素；P<；0.001)。所有考官之间测量的评分员间信度被认为是极好的(ICC[2，1]=0.976；95%CI=0.956至0.987；SEM=8,580.75；SDD=256.76像素；P<；0.001)，高于A和C考官(ICC[2，1]=0.970；95%CI=0.936至0.986；SEM=6,453.34；SDD=222.67像素；P<；0.001)。结论我们的结果表明，当考官将纸质PD复制成数字化PD时，评分员内和评分员间的可靠性都很好。这一过程为临床医生和研究人员提供了使用计算机方法更准确地分析疼痛程度的机会。
Background Computerized methods to analyze pain drawings (PDs) have been developed and may aid to measure the pain area more precisely. Objective The aim of this study was to verify whether examiners can reproduce the patient's PDs with acceptable reliability. Methods This was an intra-rater and inter-rater reliability study. The protocol consisted of 4 steps: (1) scanning of paper PDs; (2) sharing the digitalized PD images between examiners; (3) reproducing the PD images in the sketching application; and (4) calculating the pain area in pixels and percentages. We calculated intraclass correlation coefficients (ICCs; 2,1), the standard error of the measurement (SEM), and the smallest detectable difference (SDD). Results Reliability was tested using 31 PDs from 17 patients in our database (11 female [64.7%], mean age: 53.23 +/- 11.57 years). Intra-rater reliability varied from ICC (2,1) = 0.991 (95% confidence interval [CI] = 0.982 to 0.996; SEM = 3,432.45; SDD = 162.39 pixels; P < 0.001) to ICC (2,1) = 0.992 (95% CI = 0.978 to 0.997; SEM = 3,412.96; SDD = 161.93 pixels; P < 0.001). Inter-rater reliability for the measurement between all examiners was considered excellent (ICC [2,1] = 0.976; 95% CI = 0.956 to 0.987; SEM =8,580.75; SDD = 256.76 pixels; P < 0.001), being higher between Examiners A and C (ICC [2,1] = 0.970; 95% CI = 0.936 to 0.986; SEM = 6,453.34; SDD = 222.67 pixels; P < 0.001). Conclusion Our results show that intra- and inter-rater reliabilities were excellent when an examiner reproduced the paper PDs into digitalized PDs. This process gives clinicians and researchers the opportunity to analyze pain extent more precisely using a computerized method.