Verification of reliability and validity of pain scale based on quantification of facial expression movement of premature infants

本研究的目的是检验申请人开发的基于面部表情运动的三维行为分析量化疼痛量表的信度和效度，以促进临床环境中早产儿疼痛的评估。2005财年的计划是1)收集和分析数据以评估评估者内部信度2)总结评估者内部信度/评估者间信度/同时效度的结果并评估申请人开发的量表3)准备一份报告。调查在3个三级新生儿重症监护病房进行，收集了16名早产儿的61张现场记录图像和34名护士的观察数据。评价者内信度的一致性为0.761，k系数为0.626（基本一致）；评价者间信度的一致性为0.809（基本一致），k系数为0.707（基本一致）。依赖效度与PIPP比较呈强相关，相关系数(p)为0.766 （p<0.001）。评估员内信度低于评估员间信度（高）的原因被认为是由于NICU照明强度低，用于再现场景的记录图像质量较差。然而，由于良好的评估者间信度和与研究中使用的PIPP的良好相关性，申请人开发的量表被认为在临床环境中很方便。

The purpose of this study is to examine reliability and validity of pain scale developed by the applicant based on quantification of facial expression movement by 3-D behavioral analysis in order to facilitate evaluation of pain of preterm infants inclinical settings. The plan for fiscal 2005 was 1)to collect and analyze data to evaluate intra-evaluator reliability 2)to summarize results on intra-evaluator reliability/inter-evaluators reliability/concurrent validity and evaluate the scale developed by the applicant and 3)to prepare a report.The investigation was conducted at three tertiary-level NICU facilities, with 61 recorded images of scenes from 16 preterm infants and observational data of 34 nurses. As for intra-evaluator reliability, agreement was 0.761, kcoefficient 0.626 (pretty much agree), where as for inter-evaluator reliability, agreement was 0.809 (agreement with reliability) and kcoefficient 0.707 (pretty much agree). Dependence validity was compared with PIPP and was strongly correlated, with correlation coefficient (p) of 0.766 (p<0.001).The reason why intra-evaluator reliability was lower than inter-evaluator reliability, which was high, was considered to be because of the poor quality of recorded images which were used for reproducing the scenes, due to low intensity of illumination at NICU. However, because of the good inter-evaluator reliability and good correlation to PIPP used for research, the scale developed by the applicant was considered to be convenient in clinical settings.