title: The reliability of measuring pain distribution and location using body pain diagrams in patients with acute whiplash-associated disorders.
abstract: OBJECTIVE
  The objective of this study was to measure the interexaminer reliability of scoring pain distribution using paper and electronic body pain diagrams in patients with acute whiplash-associated disorder and to assess the intermethod reliability of measuring pain distribution and location using paper and electronic diagrams.
  
  
  METHODS
  We conducted an interexaminer reliability study on 80 participants recruited from a randomized controlled trial on the conservative management of acute grade I/II whiplash-associated disorder. Participants were assessed for inclusion/exclusion criteria by an experienced clinician. As part of the baseline assessment, participants independently completed paper and electronic pain diagrams. Diagrams were scored independently by 2 examiners using the body region method. Interexaminer and intermethod reliability was computed using intraclass correlation coefficients (ICCs) for pain distribution and κ coefficient for pain location. We used Bland-Altman plots to compute limits of agreement.
  
  
  RESULTS
  The interexaminer reliability was ICC = 0.925 for paper and ICC = 0.997 for the electronic body pain diagram. The intermethod reliability for measuring pain distribution ranged from ICC = 0.63 to ICC = 0.93. For pain location, the intermethod reliability varied from κ = 0.23 (posterior neck) to κ = 0.90 (right side of the face).
  
  
  CONCLUSIONS
  We found good to excellent interexaminer reliability for scoring 2 versions of the body pain diagram. Pain distribution and pain location were reliably and consistently measured on body pain diagrams using paper and electronic methods; therefore, clinicians and researchers may choose either medium when using body pain diagrams.
authors.affiliation: Research Associate, UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, Faculty of Health Sciences, University of Ontario Institute of Technology, Toronto, ON, Canada. dsoutherst@cmcc.ca
authors.forename: Danielle
authors.initials: D
authors.lastname: Southerst
authors.forename: Maja
authors.initials: M
authors.lastname: Stupar
authors.forename: Pierre
authors.initials: P
authors.lastname: Côté
authors.forename: Silvano
authors.initials: S
authors.lastname: Mior
authors.forename: Paula
authors.initials: P
authors.lastname: Stern
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D001830:Body Surface Area; D015331:Cohort Studies; D016001:Confidence Intervals; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010146:Pain / Q000175:diagnosis* / Q000209:etiology; D010147:Pain Measurement / Q000379:methods*; D015203:Reproducibility of Results; D014911:Whiplash Injuries / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D055815:Young Adult
keywords: Neck Pain; Pain; Pain Measurement; Reproducibility of Results; Whiplash Injuries