title: How reliable are 'valid and reliable' pain scores in the pediatric clinical setting?
abstract: SUMMARY Over the past decade, growing clinician skepticism and inconsistent use of self-report pain scales have raised important questions regarding the clinical meaning and interpretation of pain scores. The appropriate use of pain scores at the bedside requires an understanding of what they may mean to the child who is providing them. This article summarizes the evidence regarding pain score meaning, showing that despite the established psychometric properties of pain scales, pain score numbers mean different things to different children, complicating the clinical interpretation. The evidence suggests that it is inappropriate to use standardized pain score thresholds for treatment or evaluation, and suggests an individualized approach to the interpretation and use of pain scores is needed.
authors.affiliation: Department of Anesthesiology, Section of Pediatrics, Room 4917 CS Mott Children's Hospital, University of Michigan, Box 4245, 1540 E Hospital Drive, Ann Arbor, MI 48109 4245, USA. terriv@umich.edu.
authors.forename: Terri
authors.initials: T
authors.lastname: Voepel-Lewis