· web viewtarbell, 1992. r. university of wisconsin pain scale. soetenga, 1999. r. vasobs...

Appendix A

Andersen RD, Langius-Eklöf A, Nakstad B, et al. The measurement properties of pediatric observational pain scales: A systematic review of reviews

eTable 1. Search strategies

eTable 2. Excluded records and studies

eTable 3. Evaluated and recommended observational pain measurement scales

eTable 4. Assessment of risk of bias – ROBIS sub-scores, scores and rationale for concern

eTable 5. Methodological quality of the included studies—AMSTAR scores

eReferences

1

eTable 1. Search StrategiesDatabase name

Query Number of records

PubMed "pain measurement"[MeSH Terms]AND(“behavior” [All Fields] OR “behavioral” [All Fields] OR “behaviour” [All Fields] OR “behavioural” [All Fields] OR “observational” [All Fields] OR “Observation” [All Fields] OR “assess” [All Fields] OR “assessment” [All Fields] OR “scale” [All Fields] OR “scales” [All Fields] OR ”measure” [All Fields] OR “measures” [All Fields] OR “tool” [All Fields] OR “tools” [All Fields] OR “instrument” [All Fields] OR “instruments” [All Fields] OR “test” [All Fields] OR “tests” [All Fields])AND"child"[MeSH Terms] OR "child"[All Fields] OR "children"[All Fields] OR "infant, newborn"[MeSH Terms] OR "infant"[All Fields] OR "newborn infant"[All Fields] OR "newborn"[All Fields] OR toddler [All Fields] OR "infant"[MeSH Terms] OR "neonate"[All Fields] OR neonatal [All Fields] OR premature [All Fields] OR "adolescent"[MeSH Terms] OR "adolescent"[All Fields] OR "pediatrics"[MeSH Terms] OR "pediatrics"[All Fields] OR "pediatric"[All Fields]AND"Review"[Publication Type] OR "Review Literature as Topic"[Mesh] OR "Review"[Title] OR "synthesis"[All Fields]) OR "systematic"[All Fields]) OR overview[All Fields] OR ("meta-analysis"[Publication Type] OR "meta-analysis as topic"[MeSH Terms] OR "meta-analysis"[All Fields]NOT"labour"[All Fields] OR "labor"[All Fields] OR "labor, obstetric"[MeSH Terms] OR "parturition"[MeSH Terms] OR "childbirth"[All Fields] OR "birth"[All Fields] OR "postpartum period"[MeSH Terms]Limitations: Article types=review

469

Web of Science

#1 TS=(review OR synthesi* OR systematic* OR meta-analys* OR overview)#2 TS=(pain NEAR/2 tool* OR pain NEAR/2 scale* OR pain NEAR/2 measure* OR pain NEAR/2 rat* OR pain NEAR/2 behavior* OR pain NEAR/2 behavour* OR pain NEAR/2 observation* OR pain NEAR/2 assess* OR pain NEAR/2 test*) #3 TS=(child* OR infant* OR newborn OR neonat* OR adolescent* OR toddler* OR pediatric*)#4 TS=(labour OR childbirth OR birth OR postpartum)#5 #1 AND #2 AND #3 NOT #4Limitations: Document types=review

213

CINAHL S1 MH "Pain Measurement"S2 pain AND (tool OR tools OR instrument OR instruments OR measure OR measures OR measurement OR scale OR scales OR observational OR observation OR behavioral OR behavioural OR biobehavioral OR assess OR assessment OR test OR tests)S3 (MH "Clinical Assessment Tools+") AND (MH "Pain+") OR "pain"S4 S1 OR S2 OR S3S5 (MH "Child, Preschool") OR (MH "Child") OR (MH "Adolescence") OR (MH "Infant") OR (MH "Infant, Newborn") OR child OR children OR infant OR infants OR newborn OR neonate OR neonates OR toddler OR premature OR adolesent OR adolescents OR pediatric OR paediatricS6 (MH "Systematic Review") OR (MH "Literature Review") OR synthesis OR systematic OR meta-analysis OR overviewS7 labour OR labor OR childbirth OR birth OR postpartumS8 S4 AND S5 AND S6 NOT S7

869

2

eTable 1. Search StrategiesDatabase name

Query Number of records

PsychINFO #1 (child or infant or neonate or toddler or premature or adolescent or newborn).mp.#2 (pain and (tool or tools or instrument or instruments or measure or measures or measurement or scale or scales or observational or observation or behavioral or behavioural or biobehavioral or assess or assessment or test or tests)).mp. [mp=title, abstract, heading word, table of contents, key concepts, original title, tests & measures]#3 pain measurement.mp. or exp Pain Measurement/#4 exp Psychological Assessment/#5 pain.mp. or exp Pain/#6 #4 and #5#7 #2 or #3 or #6#8 exp "Literature Review"/ or review.mp.#9 exp Meta Analysis/ or research synthesis.mp.#10 #8 or #9#11 #1 and #7 and #10limit 11 to (100 childhood <birth to age 12 yrs> or 120 neonatal <birth to age 1 mo> or 140 infancy <2 to 23 mo> or 160 preschool age <age 2 to 5 yrs> or 180 school age <age 6 to 12 yrs> or 200 adolescence <age 13 to 17 yrs>)

172

Cochrane Library

“Pain measurement” [MESH]AND(“Infant” [MESH] OR “Child” [MESH] OR “Adolescent” [MESH]

12

All primary searches performed November 5, 2015 and last updated December 2016.

3

eTable 2. Excluded Records and StudiesCause of exclusion Number of

records / references

Reference

Excluded records based of reading of title/abstract (n=1532)

Wrong population n=37

A complete reference list of excluded records can be obtained by contacting the authors.

Not a literature review

n=256

Pain not studied or not main outcome

n=558

The review did not include observational pain assessment scales

n=661

Measurement properties not evaluated or not reported

n=20

Excluded studies based on reading of full text (n=89)

Wrong population n=1 van Herk, R., M. van Dijk, F. P. Baar, D. Tibboel and R. de Wit (2007). "Observation scales for pain assessment in older adults with cognitive impairments or communication difficulties." Nurs Res 56(1): 34-43.

Not a systematic review

n=4 Cohen, L. L., Lemanek, K., Blount, R. L., Dahlquist, L. M., Lim, C. S., Palermo, T. M., . . . Weiss, K. E. (2008). Evidence-based assessment of pediatric pain. J Pediatr Psychol, 33(9), 939-955.Fuller, B. F. and M. Neu (2000). "Validity and reliability of a practice-based infant pain assessment instrument." Clin Nurs Res 9(2): 124-143.Gibbins, S., Stevens, B., & Asztalos, E. (2003). Assessment and management of acute pain in high-risk neonates. Expert Opin Pharmacother, 4(4), 475-483.Lloyd-Thomas, A. (1995). "Assessment and control of pain in children." Anaesthesia 50(9): 753-755.

The review did not include observational pain assessment scales

n=31 (1992). "Acute pain management: operative or medical procedures and trauma, Part 1. Agency for Health Care Policy and Research." Clin Pharm 11(4): 309-331.Andrews, K. and B. Wills (1992). "A systematic approach can reduce side-effects: a protocol for pain relief in neonates." Professional Nurse 7(8): 528-532 524p.Bertilsson, S. and B. Sjöström (2005). "Assessing pain in children -- a review [Swedish]." Nordic Journal of Nursing Research & Clinical Studies / Vård i Norden 25(3): 13-18.Bird, J. (2003). "Selection of pain measurement tools." Nurs Stand 18(13): 33-39.Bonham, A. (1996). "Managing procedural pain in children with burns. Part 1: Assessment of pain in

4



Reference

children." Int J Trauma Nurs 2(3): 68-73.Briggs, M. (1995). "Principles of acute pain assessment." Nurs Stand 9(19): 23-27.Chambliss, C. R., J. Heggen, D. N. Copelan and R. Pettignano (2002). "The assessment and management of chronic pain in children." Paediatr Drugs 4(11): 737-746.Chen-Lim, M. L., C. Zarnowsky, R. Green, S. Shaffer, B. Holtzer and E. Ely (2012). "Optimizing the assessment of pain in children who are cognitively impaired through the quality improvement process." J Pediatr Nurs 27(6): 750-759.Correia, L. L. and M. B. Linhares (2008). "Assessment of the behavior of children in painful situations: literature review." J Pediatr (Rio J) 84(6): 477-486.de Knegt, N. C., M. J. C. Pieper, F. Lobbezoo, C. Schuengel, H. M. Evenhuis, J. Passchier and E. J. A. Scherder (2013). "Behavioral Pain Indicators in People With Intellectual Disabilities: A Systematic Review." Journal of Pain 14(9): 885-896.Hamill, J. K., M. Lyndon, A. Liley and A. G. Hill (2014). "Where it hurts: A systematic review of pain-location tools for children." Pain 155(5): 851-858.Hatfield, L. A. and E. A. Ely (2015). "Measurement of acute pain in infants: a review of behavioral and physiological variables." Biol Res Nurs 17(1): 100-111.Hester, N. O. (1993). Assessment of pain in children with cancer. Current and emerging issues in cancer pain: Research and practice. New York, NY, Raven Press; US: 219-245.Hodges, C. (1998). "Easing children's pain." Nurs Times 94(10): 55-56, 58.Hoelscher, T. J. and K. L. Lichstein (1984). "Behavioral assessment and treatment of child migraine: Implications for clinical research and practice." Headache: The Journal of Head and Face Pain 24(2): 94-103.Huguet, A., J. N. Stinson and P. J. McGrath (2010). "Measurement of self-reported pain intensity in children and adolescents." Journal of Psychosomatic Research 68(4): 329-336.Jennings, P. A., P. Cameron and S. Bernard (2009). "Measuring acute pain in the prehospital setting." Emerg Med J 26(8): 552-555.Jonas, D. and A. Day (1997). "Assessing pain in children." Community Nurse 3(10): 23, 26-28.Joestlein, L. (2015). "Pain, pain, go away! Evidence-based review of developmentally appropriate pain assessment for children in a postoperative setting." Orthopaedic Nursing 34(5): 252-259.Johnston, C. C. (1989). "Pain assessment and management in infants." Pediatrician 16(1-2): 16-23.Kaiser, K. S. (1992). "Assessment and management of pain in the critically ill trauma patient." Crit Care Nurs Q 15(2): 14-34.Llewellyn, N. (1996). "Pain assessment and the use of morphine." Paediatr Nurs 8(3): 32-35; quiz 40-31.McArthur, E. and M. Cunliffe (1998). "Pain assessment and documentation--making a difference." J

5



Reference

Child Health Care 2(4): 164-169.Newton, J. T. and D. J. Buck (2000). "Anxiety and pain measures in dentistry: a guide to their quality and application." Journal of the American Dental Association (JADA) 131(10): 1449-1457.Savedra, M. C. and M. D. Tesler (1989). "Assessing children's and adolescents' pain." Pediatrician 16(1-2): 24-29.Stark, K. (1998). "Paediatric pain management." Aust Nurs J 6(4): suppl 1-4.Stevens, B. J. and L. Franck (1995). "Special needs of preterm infants in the management of pain and discomfort." J Obstet Gynecol Neonatal Nurs 24(9): 856-862.Stinson, J. N., T. Kavanagh, J. Yamada, N. Gill and B. Stevens (2006). "Systematic review of the psychometric properties, interpretability and feasibility of self-report pain intensity measures for use in clinical trials in children and adolescents." Pain 125(1-2): 143-157.Tomlinson, D., C. L. von Baeyer, J. N. Stinson and L. Sung (2010). "A systematic review of faces scales for the self-report of pain intensity in children." Pediatrics 126(5): e1168-1198.Twycross, A. (1998). "The management of acute pain in children." Prof Nurse 14(2): 95-98.Tyrer, S. (1992). "Psychiatric assessment of chronic pain." Br J Psychiatry 160: 733-741.

Measurement properties not evaluated or not reported

n=52 Ameringer, S. (2009). "Measuring pain in adolescents." J Pediatr Health Care 23(3): 201-204.Anderson, K. O. (2007). "Assessment tools for the evaluation of pain in the oncology patient." Curr Pain Headache Rep 11(4): 259-264.Arif-Rahu, M., D. Fisher and Y. Matsuda (2012). "Biobehavioral measures for pain in the pediatric patient." Pain Manag Nurs 13(3): 157-168.Beacham, P. S. (2004). "Behavioral and physiological indicators of procedural and postoperative pain in high-risk infants." J Obstet Gynecol Neonatal Nurs 33(2): 246-255.Bellieni, C. V. (2012). "Pain assessment in human fetus and infants." Aaps j 14(3): 456-461.Beyer, J. E. and N. Wells (1989). "The assessment of pain in children." Pediatr Clin North Am 36(4): 837-854.Blount, R. L. and K. A. Loiselle (2009). "Behavioural assessment of pediatric pain." Pain Res Manag 14(1): 47-52.Breau, L. M. and C. Burkitt (2009). "Assessing pain in children with intellectual disabilities." Pain Res Manag 14(2): 116-120.Caraceni, A., N. Cherny, R. Fainsinger, S. Kaasa, P. Poulain, L. Radbruch and F. De Conno (2002). "Pain measurement tools and methods in clinical research in palliative care: recommendations of an Expert Working Group of the European Association of Palliative Care." J Pain Symptom Manage 23(3): 239-255.Chatelle, C., A. Vanhaudenhuyse, A. N. Mergam, M. De Val, S. Majerus, M. Boly, M. A. Bruno, P. Boveroux, A. Demertzi, O. Gosseries, D. Ledoux, P. Peigneux, E. Salmon, G. Moonen, M. E.

6



Reference

Faymonville, S. Laureys and C. Schnakers (2008). "[Pain assessment in non-communicative patients]." Rev Med Liege 63(5-6): 429-437.Clifford, P. A., M. Stringer, H. Christensen and D. Mountain (2004). "Pain assessment and intervention for term newborns." J Midwifery Womens Health 49(6): 514-519.Coleman, M. M., K. Solarin and C. Smith (2002). "Assessment and management of pain and distress in the neonate." Adv Neonatal Care 2(3): 123-136; quiz 137-129.Cong, X., J. M. McGrath, R. M. Cusson and D. Zhang (2013). "Pain assessment and measurement in neonates: an updated review." Adv Neonatal Care 13(6): 379-395.Crosta, Q. R., T. M. Ward, A. J. Walker and L. M. Peters (2014). "A review of pain measures for hospitalized children with cognitive impairment." Journal for Specialists in Pediatric Nursing 19(2): 109-118.Cunha Batalha, L. M., A. M. Fernandes, C. de Campos and G. Ana Maria Pacheco Mendes Perdigão Costa (2015). "Pain assessment in children with cancer: a systematic review." Revista de Enfermagem Referência(5): 119-127 119p.de Melo, G. M., A. L. Lelis, A. F. de Moura, M. V. Cardoso and V. M. da Silva (2014). "[Pain assessment scales in newborns: integrative review]." Rev Paul Pediatr 32(4): 395-402.Dowling, M. (2004). "Pain assessment in children with neurological impairment." Paediatr Nurs 16(3): 37-38.Franck, L. S. and C. Miaskowski (1997). "Measurement of neonatal responses to painful stimuli: A research review." Journal of Pain and Symptom Management 14(6): 343-378.Garcia Roig, C., G. Caprotta, M. F. de Castro, R. M. Germ and E. Lagomarsino (2008). "[Analgesia and sedation in pediatric procedures Part 1: general aspects, sedation scales and pain assessment]." Arch Argent Pediatr 106(5): 429-434.Gregg, T. L. (1998). "Pediatric pain management in an adult critical care unit." Crit Care Nurs Q 21(2): 42-54; quiz 87-49.Hain, R. D. W. (1997). "Pain scales in children: a review." Palliative Medicine 11(5): 341-350.Hall, S. J. (1995). "Paediatric pain assessment in intensive care units." Intensive Crit Care Nurs 11(1): 20-25.Hester, N. O. (1993). "Pain in children." Annu Rev Nurs Res 11: 105-142.Hummel, P. and M. van Dijk (2006). "Pain assessment: current status and challenges." Semin Fetal Neonatal Med 11(4): 237-245.Jain, A. A., R. Yeluri and A. K. Munshi (2012). "Measurement and assessment of pain in children--a review." J Clin Pediatr Dent 37(2): 125-136.Lalloo, C. and J. N. Stinson (2014). "Assessment and treatment of pain in children and adolescents." Best Pract Res Clin Rheumatol 28(2): 315-330.

7



Reference

Lootens, C. C. and M. A. Rapoff (2011). "Measures of pediatric pain: 21-numbered circle Visual Analog Scale (VAS), E-Ouch Electronic Pain Diary, Oucher, Pain Behavior Observation Method, Pediatric Pain Assessment Tool (PPAT), and Pediatric Pain Questionnaire (PPQ)." Arthritis Care Res (Hoboken) 63 Suppl 11: S253-262.Marvin, J. A. (1995). "Pain assessment versus measurement." J Burn Care Rehabil 16(3 Pt 2): 348-357.Maxwell, L. G., C. P. Malavolta and M. V. Fraga (2013). "Assessment of pain in the neonate." Clin Perinatol 40(3): 457-469.Mazur, A., I. R. Winnicki and T. Szczepanski (2013). "Pain management in children." Annals of Agricultural and Environmental Medicine: 28-34.McGrath, P. A. (1987). "An assessment of children's pain: a review of behavioral, physiological and direct scaling techniques." Pain 31(2): 147-176.McGrath, P. A. (1989). "Evaluating a child's pain." J Pain Symptom Manage 4(4): 198-214.McKay, M. and S. Clarke (2012). "Pain assessment tools for the child with severe learning disability." Nurs Child Young People 24(2): 14-19.Messerer, B., A. Gutmann, M. Vittinghoff, A. M. Weinberg, W. Meissner and A. Sandner-Kiesling (2011). "[Postoperative pain assessment in special patient groups: part I: children without cognitive impairment]." Schmerz 25(3): 245-255.Messerer, B., J. Meschik, A. Gutmann, M. Vittinghoff and A. Sandner-Kiesling (2011). "[Postoperative pain assessment in special patient groups: part II. Children with cognitive impairment]." Schmerz 25(3): 256-265.Morton, N. S. (1997). "Pain assessment in children." Paediatr Anaesth 7(4): 267-272.Moyer, S. M. R. and C. J. Howe (1991). "Pediatric pain intervention in the PACU." Critical Care Nursing Clinics of North America 3(1): 49-57 49p.Nalin, A. and R. Montorsi (1990). "Assessment of pain in newborns and children." Funct Neurol 5(1): 7-14.Oakes, L. L. (2011). Compact clinical guide to infant and child pain management: An evidence-based approach for nurses. New York, NY, Springer Publishing Co; US.Pereira Da Silva, T. and L. Justo Da Silva (2010). "[Pain scales used in the newborn infant: a systematic review]." Acta Med Port 23(3): 437-454.Razmus, I. and D. Wilson (2006). "Current trends in the development of sedation/ analgesia scales for the pediatric critical care patient." Pediatr Nurs 32(5): 435-441.Ross, D. M. and S. A. Ross (1988). "Assessment of pediatric pain: an overview." Issues Compr Pediatr Nurs 11(2-3): 73-91.Ruskin, D. A., K. A. Amaria, F. F. Warnock and P. A. McGrath (2011). Assessment of pain in infants,

8



Reference

children, and adolescents. Handbook of pain assessment. D. C. Turk and R. Melzack. New York, NY, Guilford Press; US: 213-241.Salas Arrambide, M., O. Gabaldon Poc, J. L. Mayoral Miravete and I. Amayra Caro (2002). "[Assessment of pain and anxiety related to painful medical procedures in pediatric oncology]." An Esp Pediatr 57(1): 34-44.Schmitter, M., T. List and S. Wirz (2013). "[The assessment of pain intensity using one-dimensional scales]." Z Evid Fortbild Qual Gesundhwes 107(4-5): 279-284.Summers, S. (2001). "Evidence-based practice part 2: reliability and validity of selected acute pain instruments." J Perianesth Nurs 16(1): 35-40.Swiggum, M., M. L. Hamilton, P. Gleeson and T. Roddey (2010). "Pain in children with cerebral palsy: implications for pediatric physical therapy." Pediatr Phys Ther 22(1): 86-92.Thewissen, L. and K. Allegaert (2011). "Analgosedation in neonates: do we still need additional tools after 30 years of clinical research?" Arch Dis Child Educ Pract Ed 96(3): 112-118.Tobias, J. D. (2014). "Acute pain management in infants and children-Part 1: Pain pathways, pain assessment, and outpatient pain management." Pediatr Ann 43(7): e163-168.Trapanotto, M., F. Benini, C. Agosto, C. Pardi, P. Lazzarin and F. Zacchello (2001). "[Assessment and measurement of pain in infants and children]." Minerva Pediatr 53(2): 107-119.Valkenburg, A. J., M. van Dijk, A. de Klein, J. N. van den Anker and D. Tibboel (2010). "Pain management in intellectually disabled children: Assessment, treatment, and translational research." Dev Disabil Res Rev 16(3): 248-257.Younger, J., R. McCue and S. Mackey (2009). "Pain outcomes: A brief review of instruments and techniques." Current Pain and Headache Reports 13(1): 39-43.

Full text could not be retrieved

n=1 de Oliveira, C. D., G. Inoshita, P. Comone, R. Oliveira, D. M. Garcia, A. M. C. Sallum and J. d. S. S. Peliciote (2011). "Search for pain assessment tools to ensure comfort and safety to children and parents [Portuguese]." Revista Nursing 14(162): 596-601.

9

eTable 3. Evaluated and Recommended Observational Pain Measurement ScalesScale Acronym (Full Name) Primary

Reference(s)Review No.

I II III IV V VI VII VIII IX X XI XIIAHTPS (Alder Hey Triage Pain Scale) Steward, 2004 RBaby FACS (Baby Facial Action Coding System) Rosenstein, 1988

BOT (Behavior Observation Tool) Hester, 1979

BPS (Behavioral Pain Score) Pokela, 1994 (Behavioral Pain Score) Robieux, 1991

CAAS (Cardiac Analgesic Assessment Scale) Suominen, 2004 R CAMPIS/CAMPIS R (The Child–Adult Medical Procedure Interaction Scale)

Blount, 1989/1997

CFCS (Child Facial Coding System) Chambers, 1996

(Chedoke–McMaster Pediatric Pain Management Sheet) Stevens, 1990 RCHEOPS (Children’s Hospital of Eastern Ontario Pain Scale) McGrath, 1985 R R RCHIPPS (Children’s and Infants’ Postoperative Pain Scale) Büttner & Finke, 2000

(COMFORT/COMFORT behavioral scale) Ambuel, 1992 / van Dijk, 2000 R R R R R

CPBS (Checklist Pain Behavior Scale/Reduced Checklist Pain Behavior Scale)

Terstegen, 2003 / Duidenvoorden, 2006

CRIES (Crying Requires oxygen Increased vital signs Expression Sleep)

Kretchel & Bildner, 1995 R

CSS/POPS (Clinical Scoring System/Postoperative Pain Score for Infants)

Attia, 1987/Joyce, 1994

DAN (Douleur Aiguë du Nouveau-né) Carbajal, 1997 DEGR® (Douleur Enfant Gustave Roussy) Gauvain-Piquard, 1987

DPC (The Derbyshire Children’s Hospital Paediatric Pain Chart)

Peden, 2003

DSVNI (Distress Scale for Ventilated Newborn Infants) Sparshott, 1996 EDIN (Echelle Douleur Inconfort Nouveau-né) Debillon, 2001 RFACS (Facial Action Coding System) Ekman, 1978

FLACC/rFLACC (Face, Legs, Activity, Cry, Consolability) Merkel, 1997 / Malviya, 2006 R R R R R R RGDS (Groningen Distress Scale) Humphrey, 1992

IBCS (Infant Body Coding System) Craig, 1984 RINRS (Individualized Numeric Rating Scale) Solodiuk & Curley, 2003

10



I II III IV V VI VII VIII IX X XI XIIIPEC (The Infant Pain Evaluation Criteria) Lin & Sentinvany, 1994a

LIDS (Liverpool Infant Distress Scale) Horgan, 1996

MAX (Maximally Discriminative Facial Movement Coding System)

Izard, 1979/1995

MAPS (Multi-dimensional Assessment of Pain Scale) Ramelet, 2007 RMBPS (Modified Behavioral Pain Scale) Taddio, 1995 (Mills Infant/Toddler Pain Index) Mills, 1989a

MIPS (Modified Infant Pain Scale) Buchholz, 1998

NAPI (Nursing Assessment of Pain Intensity) Stevens, 1990 R

NCCPC/NCCPC-PV (Non-Communicating Children’s Pain Checklist)

Breau, 2000/2002 R R

NFCS (Neonatal Face Coding System) Grunau, 1987 R R NIPS (Neonatal Infant Pain Scale) Lawrence, 1993 R RNNICUPAT (Nepean Neonatal Intensive Care Unit Pain Assessment Tool)

Marceau, 2003 R

N-PASS (Neonatal Pain, Agitation and Sedation Scale) Hummel, 2008

(The Neonatal Pain Assessment Scale) Bell, 1993/1994a (The Neonatal Pain Assessment Tool) Friedrichs, 1995

OCDS (Observed Child Distress Scale) Bournaki, 1997 OPS (Objective Pain Scale) Hannallah, 1987 ROSBD/OSBD-R (Observational Scale of Behavioral Distress) Jay, 1983/Elliot, 1987

PAIN (Pain Assessment in Neonates Scale) Hudson-Barr, 2002 RPAIN (Pain Assessment Inventory for Neonates) Johnson, 1989 PASPI Liaw, 2012 RPAT (Pain Assessment Tool) Hodgkinson, 1994 R(Pain Assessment Tool) Jørgensen, 1997a

(Pain Evaluation Scale for Patients with Severe Cerebral Palsy)

Collignion & Guisiano, 2001

PBCL (Procedure Behavior Check List) LeBaron & Zeltzer, 1984 RPBRS/PBRS-R (Procedure Behavioral Rating Scale) Katz, 1980/1987

11



I II III IV V VI VII VIII IX X XI XIIPCS (Modified Postoperative Comfort Score) Guinsburg, 1998

(Pediatric Indicator for Communication Impaired Children) Stallard, 2002

PEPPS (Preverbal Early Verbal Pediatric Pain Scale) Schultz, 1999 PIPP (Premature Infant Pain Profile) Stevens, 1996 R RPMH-PAT (Princess Margaret Hospital Pain Assessment Tool)

Robertson, 1993

POCIS (Pain Observation Scale for Young Children) Boelen-van der Loo, 1999 RPPP (Paediatric Pain Profile) Hunt, 2004 R RPPPM (Parents’ Postoperative Pain Measure) Chambers, 1996 RPQL (Pediatric Observational Quality of Life Measure) Myatt & Myatt, 1998 PRS (Pain Rating Scale) Joyce, 1994 RRIPS (Riley Infant Pain Scale) Schade, 1996 SUN (Scale for Use in Newborns) Blauer & Gerstman, 1998 RTPPPS (Toddler Preschooler Post-operative Pain Scale) Tarbell, 1992 RUniversity of Wisconsin Pain Scale Soetenga, 1999 R

VASobs (Visual Analog Scale—used by an observer) McGrath, 1985

WOPP (The Wielenga Observational Scale for Pain in Neonates)

Wielenga, 1994a

Abbreviations: , scale was reviewed, but not recommended; R, scale was reviewed and recommendeda Not published/abstract only

12

eTable 4. Assessment of risk of bias – ROBIS sub-sores, scores and rationale for concernConcerns with the review process Judging risk of bias

Ref. no.

Domain 1. Study eligibility criteria

Domain 2. Identification and

selection of studies

Domain 3. Data collection and study

appraisal

Domain 4. Synthesis and findings

Risk of bias in the review

Question 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 6 A B CI Sub

scoreN PN N N N N Y NI NI NI NI PY N N N PN NI PY NI NI PY N N NI

Risk of bias

High High High Unclear High

Rationale for concern

No evidence of pre-specified objectives and eligibility criteria. Study objectives indirectly stated and eligibility criteria partly described. Population not specified and exclusion criteria not described.

Initial search not described. Supplementing searches in two databases only. Search words and strategy not described. Searched reference lists for additional studies. Study selection process not described.

Data collection methods not described. Study characteristics presented, sorted by psychometric properties under study. Risk of bias / methodological quality not assessed. Measurement properties mentioned but not defined. Criteria for adequacy not addressed.

No predefined data synthesis. Narrative synthesis described the included studies. Results grouped per measurement variable. Relationships within and between studies including heterogeneity partly explored. Robustness partly addressed.

High or unclear risk of bias across all domains. Concerns not addressed.Did not conclude, recommendations not given

II Sub score

N N N PN N PY Y PN PY N NI N N N N PN NI N NI NI N N N N

Risk of bias

High Unclear High High High


No evidence of predefined objectives and eligibility criteria. Study eligibility criteria lacking, the authors aimed to

Study identification and selection process incompletely described. Study selection process not described only selection of scales.

Data collection methods not described. Study characteristics not presented, only scale characteristics. Risk of bias/methodological

No predefined data synthesis. Data presented only on scale level, not study level. Relationships within and across studies including heterogeneity not explored. Robustness

High or unclear risk of bias across all domains. Concerns not addressed.Did not conclude, recommendations not given

13


Ref. no.





appraisal



Question 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 6 A B Cacquire and evaluate all published neonatal pain assessment tools.

quality not assessed. Measurement properties defined, but criteria for adequacy not addressed.

not addressed.

III Sub score

PN PY PY PY PY PY Y PY PN NI NI N N N N PN NI N NI NI N N N NI

Risk of bias

Unclear Unclear High High High


No evidence of predefined objectives and eligibility criteria. The eligibility criteria were probably appropriate.

Relevant databases and a wide range of additional search methods applied. Relevant keywords, but detailed search strategy not provided. Possible language bias. Study selection process incompletely described.

Data collection methods not described. Study characteristics not presented, only scale characteristics. Risk of bias/methodological quality not assessed. Measurement properties partly defined, but criteria for adequacy not addressed.

No predefined data synthesis. Data presented only on scale level, not study level. No values for psychometric properties given. Relationships within and across studies including heterogeneity not explored. Robustness not addressed.

High or unclear risk of bias across all domains. Concerns not addressed.All scales considered valid and reliable. Conclusions and recommendations not supported by the evidence.

IV Sub score

PN PN N N N N Y PN NI NI NI N N N N PN NI N NI NI N N N PY

Risk of bias

High High High High High


No evidence of predefined objectives and

Searched MEDLINE only. Primary search strategy not described,

Data collection methods not described. Study characteristics

No predefined data synthesis. Narrative synthesis limited to a

High risk of bias across all domains. Concerns partly addressed.

14


Ref. no.





appraisal



Question 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 6 A B Celigibility criteria. Included studies not limited to validation studies. Exclusion criteria only presented on scale level.

only keywords. Supplementary search (names of the selected scales) carried out. Additional methods used (reference lists and websites). Study selection process not described only selection of scales.

not presented, only scale characteristics. Risk of bias / methodological quality not assessed. Measurement properties defined, but criteria for adequacy not addressed.

description of the main features of each included study and a grouping (per scale) of these. Relationships within and across studies including heterogeneity not explored. Robustness not addressed.

Conclusions and recommendations mostly based on whether or not studies had been carried out in the ED setting and were not supported by the evidence.

V Sub score

PN N N PN PN PY Y PY PN N PN N N N N N NI N NI NI N N N NI

Risk of bias

High Unclear High High High


No evidence of predefined objectives and eligibility criteria. Eligibility criteria not specifically described, only as reasons for inclusion and exclusion during selection of studies. Included studies not limited to validation studies and a random sample of available studies

The use of a two-step search strategy reduced the risk of missing relevant articles. Limited to published studies in English. Study selection process incompletely described.

Data collection methods incompletely described. Standardized forms used but content not described. No duplicate data collection. Study characteristics not presented, only scale characteristics. Risk of bias in the included studies not assessed, only methodological quality of the included scalesa. Measurement

No predefined data synthesis. Included studies not described. Included scales, not studies, grouped per assessment context. Relationships within and across studies including heterogeneity not explored, some comparisons across scales. Robustness not addressed.

High or unclear risk of bias across all domains. Concerns not addressed. Conclusions and recommendations not supported by the evidence.

15


Ref. no.





appraisal



Question 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 6 A B Cwere included when reviewed scales had more than 50 citing articles.

properties partly defined, but criteria for adequacy not addressed

VI Sub score

PN PN N N PN PY Y PY PN N PN PY PY N N PN NI N NI NI N N N NI

Risk of bias

High Unclear Unclear High High


No evidence of predefined objectives and eligibility criteria. Insufficient details about eligibility criteria. Included studies not limited to validation studies.

An appropriate range of databases were searched. Additional methods used (key informants). Limited to published studies in English. Duplicate study selection not reported and no information regarding excluded studies.

Duplicate data extraction. The use of a data extraction form not described. Study characteristics presented.Risk of bias / methodological quality not assessed for validation studies. Measurement properties defined, but criteria for adequacy not addressed.

No predefined data synthesis. Narrative synthesis limited to a tabulation of results from each study and a grouping of results per measurement property. Relationships within and across studies, including heterogeneity not addressed. Robustness not addressed.

High or unclear risk of bias across all domains. Concerns not addressed. Conclusions not supported by the evidence.

VII Sub score

PY Y Y PY PY Y PN PY PN Y PY PY PY PY NI PN NI PN NI NI PY N PY NI

Risk of bias

Low Unclear Unclear High Unclear


Objectives and eligibility criteria predefined (updated

A wide range of databases were searched, including

Data collection methods incompletely described. Duplicate

No predefined data synthesis. Narrative synthesis limited to a

Unclear or high risk of bias in three of the four domains. Concerns

16


Ref. no.





appraisal



Question 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 6 A B Cversion of a guideline first published in 2000). Detailed inclusion and exclusion criteria presented.

grey literature. Detailed search strategy for each database described. Additional methods not mentioned. Only English language literature was searched. Partly duplicate study selection (a random sample of 25% checked) and a disagreement procedure in place.

data extraction and assessment of methodological quality not described. Study characteristics presented.Methodological quality assessedb.Measurement properties and criteria for adequacy defined.

description of the main features of each included study and a grouping of these. Relationships across studies including heterogeneity partly addressed. Robustness partly addressed. Adequacy or predefined thresholds for measurement properties used as exclusion criteria for scales.

only partly addressed. Unclear whether the conclusions are supported by the evidence.

VIII Sub score

N N N N N PN N N NI NI NI N N N N PN NI N NI NI N N N N

Risk of bias

High High High High High


No evidence of predefined objectives and eligibility criteria. Eligibility criteria not given

Databases incompletely described. Search strategy not shown. Additional methods used (reference lists). Study inclusion and selection process not described, only selection of scales.

Data collection procedure not described. Study characteristics not presented, only scale characteristics. Unclear how two of the included scales were selected. Risk of bias / methodological quality

No predefined data synthesis. Data presented only on scale level, not study level. No values for psychometric properties given. Relationships within and across studies including heterogeneity not explored. Robustness not addressed.

High risk of bias across all domains. Concerns not addressed. Conclusions not supported by the evidence

17


Ref. no.





appraisal



Question 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 6 A B Cof included studies not assessed. Measurement properties not defined and criteria for adequacy not addressed.

IX Sub score

PY Y PY Y Y Y Y PY PY Y Y PY PY Y PY PY NI N NI NI N N N NI

Risk of bias

Low Low Low High High


Refers to pre-established eligibility criteria in the abstract. Detailed and appropriate eligibility criteria.

A wide range of databases were searched, including grey literature. Complete search strategy described. Additional methods used (reference lists). Duplicate screening and selection of studies with a disagreement procedure in place. No information regarding excluded studies.

Duplicate data extraction. Study characteristics presented. Duplicate assessment of methodological qualityc, but assessments are neither sorted nor aggregated per scale under study. Disagreement procedure not specified. Measurement properties defined, but criteria for adequacy not addressed.

Data synthesis partly predefined. Narrative synthesis limited to tabulation and description of the main features of each included study. No grouping per measurement property. Relationships within and across studies including heterogeneity not explored. All discussions on scale level. Robustness not addressed.

High risk of bias in data synthesis, low in the other three domains.Concerns not addressed. Difficult to determine whether the conclusions are supported by the evidence.

18


Ref. no.





appraisal



Question 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 6 A B C

X Sub score

PN PY PY PY PN PY Y PN PN PY PY PY PY N N PY PY PN NI NI N N N NI

Risk of bias

Unclear Unclear Unclear Unclear High


No evidence of predefined objectives and eligibility criteria.

Searched English and Chinese mainland databases. Full search strategy not described. Additional methods used (reference lists). Duplicate study selection, but disagreement procedure not described.

Duplicate data extractions using standardized forms. Study characteristics presented for each of the included studies. Methodological quality / risk of bias in included studies not assessed, only methodological quality of the included scalesd. Measurement properties defined and criteria for adequacy addressed.

No predefined data synthesis. Narrative synthesis limited to tabulation and description of the main features of each included study. Data grouped per scale and per measurement property. Measurement properties described as a range of values. All discussion on scale level. Relationships within and across studies including heterogeneity not explored. Robustness not addressed.

Unclear risk of bias across all domains. Concerns not addressed. Conclusions not supported by the evidence

XI Sub score

PY PN Y PY N Y Y PY PN Y Y Y PY Y Y N PY PY Y NI PY PN N Y

Risk of bias

Unclear Unclear Low Unclear Unclear


Registered in PROSPERO during data extraction

A wide range of databases were searched, including

Duplicate data extraction using standardized forms and

Data synthesis predefined. Narrative synthesis including tabulation and

Unclear risk of bias in three of the four domains. Concerns

19


Ref. no.





appraisal



Question 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 6 A B Cstage.Included validation studies where the scale under review had been used to validate a new scale and intervention studies where the scale under review had been used as an outcome measure.

grey literature. Search terms described. Additional methods used (reference lists).Duplicate independent selection of studies, with a disagreement procedure in place. Only included studies available in full text or published in English

duplicate assessment of methodological qualityc, both with a disagreement procedure in place.Measurement properties defined, but criteria for adequacy not addressed.

description of the main features of each included study. Data grouped across studies per measurement property and separately for different patient groups and pain conditions. Relationships within and across studies including heterogeneity partly explored. Robustness partly addressed.

only partly addressed. Unclear whether conclusions were supported by the evidence.

XII Sub score

PY PY PY Y PY PY Y PY PN Y Y N PY N N PY NI N NI NI N N N NI

Risk of bias

Low Unclear Unclear High High


Registered in PROSPERO, after it was completed.

An appropriate range of databases searched. Broad search strategy described, but only shown for Medline. Additional methods used (reference lists). Limitations in search (year and age group) don’t match the inclusion criteria. Duplicate study

Uncertain whether data was extracted in duplicate, was “cross-checked”. Standardized data collection form. Study characteristics not presented, only scale characteristics. Risk of bias / methodological quality of the included studies not assessed, only

Data synthesis predefined. Data presented only on scale level, not study level. Measurement properties not presented only an overall rating of measurement properties* and clinical utility for each of the included scales. All discussion on scale level. Relationships within and across studies including

Unclear or high risk of bias across three of the four domains. Concerns not addressed. Conclusions not supported by the evidence The review does not provide a rationale for the scales selected and recommended.

20


Ref. no.





appraisal



Question 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 1 2 3 4 5 6 A B Cselection with a disagreement procedure in place. No information regarding excluded studies.

methodological quality of the included scales*. Measurement properties not defined and criteria for adequacy not addressed.

heterogeneity explored. Robustness not addressed.

Abbreviations: Y=Yes, PY=Probably yes, PN=Probably no, N= No, NI=No informationaUsing the Society of Pediatric Psychology Assessment Task Force criteria (Cohen et al., 2008)bUsing the SIGN criteria (Scottish Intercollegiate Guidelines Network (SIGN), 2015)cUsing the COSMIN checklist (Terwee et al., 2012)dUsing the Psychometric Property Coding System (Zwakhalen et al., 2006)

21

eTable 5Methodological quality of the included studies—AMSTAR scores

AMSTAR itemReview no.

I II III IV V VI VII VIII IX X XI XII

1. Was an “a priori” design provided?

L L L L L L H L L L H H

2. Was there duplicate study selection and data extraction?

L L L L L H H L H H H H

3. Was a comprehensive literature search performed?

L H H L H H H H H H H H

4. Was the status of publication (i.e., gray literature) used as an inclusion criterion?

L L H H L L H L H H L L

5. Was a list of studies (included and excluded) provided?

L L L L L L H L L L L L

6. Were the characteristics of the included studies provided?

H H L H L H H L H H H L

7. Was the scientific quality of the included studies assessed and documented?

L L L L L L H L H L H L

8. Was the scientific quality of the included studies used appropriately in formulating conclusions?

L L L L L L H L L L H L

9. Were the methods used to combine the findings of studies appropriate?

L L L L L L L L L L H L

10. Was the likelihood of publication bias assessed?

L L L L L L L L L L L L

11. Was the conflict of interest included?

L L L L L L L L L L L L

Number of items that scored a “High”

1 2 2 2 1 3 8 1 5 4 7 3

Each of the 11 items was scored on the answering categories “Yes”, “No”, “Can’t answer”, and “Not applicable”. Responses were dichotomized: Items scored “Yes” were considered as having a high methodological quality, while items scored “No” or “Can’t answer” were considered as having a low methodological quality. No items were scored “Not applicable”. The methodological quality was evaluated and reported individually for each of the 11 items and as a simple summary score (number of items that scored a “High”)Abbreviations: H, high methodological quality/items scored “Yes”; L, low methodological quality/ items scored “No” or “Can’t answer”.

22

eReferences

Cohen, L.L., La Greca, A.M., Blount, R.L., Kazak, A.E., Holmbeck, G.N., Lemanek, K.L., 2008. Introduction to special issue: Evidence-based assessment in pediatric psychology. J Pediatr Psychol 33 (9), 911-915.

Scottish Intercollegiate Guidelines Network (SIGN), 2015. SIGN 50: a guideline developer's handbook. Edinburgh. http://www.sign.ac.uk/ (accessed October 29, 2016).

Terwee, C.B., Mokkink, L.B., Knol, D.L., Ostelo, R.W., Bouter, L.M., de Vet, H.C., 2012. Rating the methodological quality in systematic reviews of studies on measurement properties: a scoring system for the COSMIN checklist.

Zwakhalen, S.M.G., Hamers, J.P.H., Abu-Saad, H.H., Berger, M.P.F., 2006. Pain in elderly people with severe dementia: a systematic review of behavioural pain assessment tools. BMC Geriatr 6, 3-3.

23

· web viewtarbell, 1992. r. university of wisconsin pain scale. soetenga, 1999. r. vasobs...

Documents