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Pediatric Pain Screening Tool: rapid identification of risk in youth with pain complaints.

Simons, LE; Smith, A; Ibagon, C; Coakley, R; Logan, DE; Schechter, N; Borsook, D; Hill, JC

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Authors

LE Simons

A Smith

C Ibagon

R Coakley

DE Logan

N Schechter

D Borsook



Abstract

Moderate to severe chronic pain is a problem for 1.7 million children, costing $19.5 billion annually in the United States alone. Risk-stratified care is known to improve outcomes in adults with chronic pain. However, no tool exists to stratify youth who present with pain complaints to appropriate interventions. The Pediatric Pain Screening Tool (PPST) presented here assesses prognostic factors associated with adverse outcomes among youth and defines risk groups to inform efficient treatment decision-making. Youth (n=321, ages 8-18, 90.0% Caucasian, 74.8% female) presenting for multidisciplinary pain clinic evaluation at a tertiary care center participated. Of these, 195 (61.1%) participated at 4-month follow-up. Participants completed the 9-item PPST in addition to measures of functional disability, pain catastrophizing, fear of pain, anxiety, and depressive symptoms. Sensitivity and specificity for the PPST ranged from adequate to excellent, with regard to significant disability (78%, 68%) and high emotional distress (81%, 63%). Participants were classified into low (11%), medium (32%), and high (57%) risk groups. Risk groups did not significantly differ by pain diagnosis, location, or duration. Only 2-7% of patients who met reference standard case status for disability and emotional distress at 4-month follow-up were classified as low-risk at baseline, whereas 71-79% of patients who met reference standard case status at follow-up were classified as high risk at baseline. A 9-item screening tool identifying factors associated with adverse outcomes among youth who present with pain complaints appears valid and provides risk stratification that can potentially guide effective pain treatment recommendations in the clinic setting.

Journal Article Type Article
Acceptance Date Apr 10, 2015
Publication Date Aug 1, 2015
Publicly Available Date May 26, 2023
Journal Pain
Print ISSN 0304-3959
Publisher Lippincott, Williams & Wilkins
Peer Reviewed Peer Reviewed
Volume 156
Issue 8
Pages 1511-1518
DOI https://doi.org/10.1097/j.pain.0000000000000199
Publisher URL http://dx.doi.org/10.1097/j.pain.0000000000000199

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