Psychometric Properties and Diagnostic Utility of the Pain Descriptor System

描述（由申请人提供）：疼痛是一种非常普遍的体验，对身体和心理功能有重大影响，仅在美国就造成了数十亿美元的经济负担。许多科学和医疗保健组织现在呼吁改进评估，以更好地治疗疼痛。语言为评估疼痛提供了一种有价值的媒介，它鼓励了基于疼痛描述符的心理测量测试的发展。拟议研究的广泛目标是建立在以麦吉尔疼痛问卷（MPQ）开始的疼痛评估的基础上。在30多年前，MPQ最初被认为不是一个最终产品，而是一个可以修改的产品。最近的因素分析结果强调了这种需要改进的语言描述评估疼痛。这项研究的目的是对一种名为疼痛描述系统（PDS）的新工具进行心理测量学评估。该工具的项目基于三个独立的出版物（作者和同事），这些出版物指出了一套简洁的36个疼痛描述符，这些描述符高度可理解，相关且明确。本研究旨在(i)通过验证性因子分析和项目反应理论建立PDS的构效度，（ii）通过Cronbach's alpha确定PDS的内部一致性，（iii）通过时间稳定性相关性确定PDS得分的一周和一个月重测信度。（iv）通过PDQ来检验PDS对（身体和心理）残疾的预测效度，最后(v)通过将描述符选择模式与不同的疼痛状况（三种头痛和三种慢性疼痛综合征）联系起来，确定PDS的诊断价值；这将使用判别分析来完成。一个由一名疼痛学者、一名心理统计学家和三名疼痛临床医生组成的团队将在这个为期两年的项目中合作，涉及660名患者作为参与者。预期的结果是改善疼痛的量化和定性表征，从而改善疼痛和残疾的诊断和预后。该研究项目的研究结果有望通过使用称为疼痛描述系统的新的方便测试来改善疼痛的量化和定性表征。该仪器还有望提高疼痛相关残疾的预后和疼痛综合征的鉴别诊断。最终，改善疼痛的评估和诊断可以为疼痛患者的治疗选择和治疗计划提供信息和指导。

DESCRIPTION (provided by applicant): Pain is a highly prevalent experience with a significant impact on physical and psychosocial functioning and an economic burden amounting to billions of dollars within the U.S. alone. Many scientific and healthcare organizations are now calling for improved assessment as a means to better treatment of pain. Language offers one valuable medium for the assessment of pain and it has encouraged the development of psychometric tests based on pain descriptors. The broad objective of the proposed research is to build on a foundation of pain assessment that started with the McGill Pain Questionnaire (MPQ). At its inception over 30 years ago, the MPQ was viewed not as a final product but as one amenable to revision. Recent factor analytic findings underscore this need for improvements in verbal descriptor assessment of pain. The aim of the proposed research is to psychometrically evaluate a new instrument called the Pain Descriptor System (PDS). Items of this instrument are based on three separate publications (by the author and colleagues) that point to a parsimonious set of 36 pain descriptors that are highly comprehensible, relevant, and unambiguous. The proposed research is designed to (i) to establish the construct validity of the PDS through confirmatory factor analysis and item response theory, (ii) to determine the internal consistency of the PDS as indexed by Cronbach's alpha, (iii) to determine the one week and one month retest reliability of PDS scores as measured by temporal stability correlations, (iv) to check the predictive validity of the PDS in relation to (physical and psychosocial) disability as measured by an instrument called the PDQ, and finally (v) to ascertain the diagnostic value of the PDS by relating patterns of descriptor choice to different painful conditions (three types of headache and three chronic pain syndromes); this will be done using discriminant analysis. A team comprising a pain scholar, a psychometric statistician, and 3 pain clinicians will collaborate in this two-year project which involves 660 patients as participants. The expected outcomes are improved quantification and qualitative characterization of pain, and thereby improved diagnosis and prognosis of pain and disability. The findings from this program of research are expected to improve the quantification and qualitative characterization of pain through use of the new and convenient test called the Pain Descriptor System. This instrument is also expected to enhance the prognosis of pain-related disability and the differential diagnosis of pain syndromes. Ultimately, the improved assessment and diagnosis of pain can inform and guide the treatment selection and treatment planning for pain patients.