Development and initial validation of the PEG, a three-item scale assessing pain intensity and interference.
BACKGROUND
Inadequate pain assessment is a barrier to appropriate pain management, but single-item "pain screening" provides limited information about chronic pain. Multidimensional pain measures such as the Brief Pain Inventory (BPI) are widely used in pain specialty and research settings, but are impractical for primary care. A brief and straightforward multidimensional pain measure could potentially improve initial assessment and follow-up of chronic pain in primary care.


OBJECTIVE
To develop an ultra-brief pain measure derived from the BPI.


METHODS
Development of a shortened three-item pain measure and initial assessment of its reliability, validity, and responsiveness.


METHODS
We used data from 1) a longitudinal study of 500 primary care patients with chronic pain and 2) a cross-sectional study of 646 veterans recruited from ambulatory care.


RESULTS
Selected items assess average pain intensity (P), interference with enjoyment of life (E), and interference with general activity (G). Reliability of the three-item scale (PEG) was alpha = 0.73 and 0.89 in the two study samples. Overall, construct validity of the PEG was good for various pain-specific measures (r = 0.60-0.89 in Study 1 and r = 0.77-0.95 in Study 2), and comparable to that of the BPI. The PEG was sensitive to change and differentiated between patients with and without pain improvement at 6 months.


CONCLUSIONS
We provide strong initial evidence for reliability, construct validity, and responsiveness of the PEG among primary care and other ambulatory clinic patients. The PEG may be a practical and useful tool to improve assessment and monitoring of chronic pain in primary care.
Center on Implementing Evidence-Based Practice, Roudebush VA Medical Center, Indianapolis, IN, USA. krebse@iupui.edu
Erin E
EE
Krebs
Karl A
KA
Lorenz
Matthew J
MJ
Bair
Teresa M
TM
Damush
Jingwei
J
Wu
Jason M
JM
Sutherland
Steven M
SM
Asch
Kurt
K
Kroenke
D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis* / Q000523:psychology; D010147:Pain Measurement / Q000379:methods* / Q000592:standards*; D015203:Reproducibility of Results; D012720:Severity of Illness Index