Standardization of chronic pain assessment: a multiperspective approach.
OBJECTIVE
this study reports the results of reliability and validity analyses on the Multiperspective Multidimensional Pain Assessment Protocol (MMPAP). When pain becomes chronic it intertwines with the many dimensions of a patient's life, increasing the complexity of the patient's perception of the pain and, subsequently, the prescribed treatment. Both the patient's perspective and the physician's perspective are crucial in the assessment of these multiple dimensions, creating a fundamental need for a valid and reliable, multiperspective, multidimensional pain assessment tool.


METHODS
A randomized regional sample of outpatients complaining of chronic pain. Each MMPAP consisted of physical examinations by two physicians and the participant's subjective self-report. Primary criterion standards were the Multidimensional Pain Instrument and the McGill Pain Questionnaire.


METHODS
Ambulatory referral centers, both public and private.


METHODS
A population-based random sample of 651 outpatients claiming chronic pain. Thirty-six patients who were originally recruited refused participation, and four patients did not complete the entire assessment.


METHODS
No interventions were continued or initiated by the research team.


METHODS
As this was a validation of the instruments used, no patient outcomes were influenced or assessed. The MMPAP is a recently developed pain assessment protocol, which uses both subjective information and objective medical evidence.


RESULTS
The MMPAP proved to be a reliable and valid tool that may assist in the assessment of chronic pain when two physicians independently assess the patient and this information is combined with the patient's self-reported pain perceptions. Test-retest and interrater reliability analyses confirmed that the data collected with the MMPAP were repeatable. A combination of concurrent comparisons with previously validated instruments, construct corroboration with factor analysis, and internal consistency analyses ascertained the validity of the MMPAP.


CONCLUSIONS
The introduction of this standardized protocol will assist in standardizing assessments of patients with chronic pain. The MMPAP has potential as a diagnostic tool, a measure of treatment effectiveness, and a tool to compare various pain treatment center outcomes.
Rucker
K S
KS
Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University/Medical College of Virginia, Richmond 23298, USA.
Metzler
H M
HM
Kregel
J
J
D000293:Adolescent; D000328:Adult; D002908:Chronic Disease; D003625:Data Collection; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis* / Q000523:psychology; D018710:Pain Clinics; D010147:Pain Measurement / Q000592:standards*; D010361:Patients; D010820:Physicians; D015203:Reproducibility of Results; D012944:Social Support