Pain rating by patients and physicians: evidence of systematic pain miscalibration.
This study is an investigation of the existence and potential causes of systematic differences between patients and physicians in their assessments of the intensity of patients' pain. In an emergency department in France, patients (N=200) and their physicians (N=48) rated the patients' pain using a visual analog scale, both on arrival and at discharge. Results showed, in confirmation of previous studies, that physicians gave significantly lower ratings than did patients of the patients' pain both on arrival (mean difference -1.33, standard error (SE)=0.17, on a scale of 0-10, P<0.001) and at exit (-1.38, SE=0.15, P<0.001). The extent of 'miscalibration' was greater with expert than novice physicians and depended on interactions among physician gender, patient gender, and the obviousness of the cause of pain. Thus physicians' pain ratings may have been affected by non-medical factors.
Marquié
Laetitia
L
LTC, UMR 5551 CNRS, Université Toulouse-II, 31058 Toulouse Cedex 1, France Département des Urgences, Hôpital Purpan, CHU Toulouse, France Department of Medicine, Albany Medical Center, Albany, NY, USA Department of Pediatrics, Albany Medical Center, Albany, NY, USA.
Raufaste
Eric
E
Lauque
Dominique
D
Mariné
Claudette
C
Ecoiffier
Marie
M
Sorum
Paul
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D002138:Calibration; D016009:Chi-Square Distribution; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis* / Q000523:psychology; D010147:Pain Measurement / Q000379:methods / Q000523:psychology / Q000706:statistics & numerical data*; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D010820:Physicians / Q000523:psychology / Q000706:statistics & numerical data*; D011446:Prospective Studies