title: Reproducibility of pain manikins: a comparison of paper versus online questionnaires.
abstract: BACKGROUND
  In epidemiological studies, pain location is often collected by paper questionnaire using blank body manikins, onto which participants shade the location of their pain(s). However, it is unknown how reliable these will transfer to online questionnaires. The aim of the current study was to determine agreement between online- and paper-based completion of pain manikins.
  
  
  METHODS
  A total of 264 children, aged 15-18 years, completed both an online and a paper questionnaire. Participants were asked to identify the location of their pain by highlighting predefined body areas on a manikin (online) or by shading a blank version of the manikin (paper). The difference in the prevalence of 12 regional/widespread pain conditions was determined, and agreement between online and paper questionnaires was assessed using prevalence- and bias-adjusted kappa (PABAK).
  
  
  RESULTS
  For the majority of pain conditions, prevalence was higher when ascertained by paper questionnaire. However, for the most part, the difference in prevalence was modest (range: -1.1 to 5.7%) the exceptions being hip/thigh pain (difference: 10.6%) and upper back pain (difference: 14.8%). For most pain locations, there was good or very good agreement between paper and online manikins (PABAK range: 0.61 to 0.88). However, identification of pain in the hip/thigh and in the upper back had poorer agreement (PABAK: 0.49 and 0.29, respectively).
  
  
  CONCLUSIONS
  This is the first study to examine the reproducibility of body manikins on different media, in a population-based survey. We have shown that online manikins can be used to capture data on pain location in a manner satisfactorily comparable to paper questionnaires.
authors.affiliation: Aberdeen Pain Research Collaboration (Epidemiology Group), Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK.
authors.forename: Gareth T
authors.initials: GT
authors.lastname: Jones
authors.affiliation: Aberdeen Pain Research Collaboration (Epidemiology Group), Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK.
authors.forename: Ramona
authors.initials: R
authors.lastname: Kyabaggu
authors.affiliation: Public Health Nutrition Research Group, Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK.
authors.forename: Debbi
authors.initials: D
authors.lastname: Marais
authors.affiliation: Aberdeen Pain Research Collaboration (Epidemiology Group), Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK.
authors.forename: Gary J
authors.initials: GJ
authors.lastname: Macfarlane
keywords: Epidemiology; Internet; musculoskeletal pain; pain measurement; questionnaires