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BACKGROUND: Persistent pain is the most reported symptom in patients with rheumatoid arthritis (RA); however, effective and brief assessment tools are lacking. We validated the Chinese version of the Global Pain Scale (C-GPS) in Chinese patients with RA and proposed a short version of the C-GPS (s-C-GPS). METHOD: The study was conducted using a face-to-face questionnaire survey with a multicenter cross-sectional design from March to December 2019. Patients aged > 18 years who met the RA diagnostic criteria were included. Based on the classical test theory (CTT) and the item response theory (IRT), we assessed the validity and reliability of the C-GPS and the adaptability of each item. An s-C-GPS was developed using IRT-based computerized adaptive testing (CAT) analytics. RESULTS: In total, 580 patients with RA (mean age, 51.04 ± 24.65 years; mean BMI, 22.36 ± 4.07 kg/m2), including 513 (88.4%) women, were included. Most participants lived in a suburb (49.3%), were employed (72.2%) and married (91.2%), reported 9-12 years of education (66.9%), and had partial medical insurance (57.8%). Approximately 88.1% smoked and 84.5% drank alcohol. Analysis of the CTT demonstrated that all items in the C-GPS were positively correlated with the total scale score, and the factor loadings of all these items were > 0.870. A significant positive relationship was found between the Visual Analog Scale (VAS) and the C-GPS. IRT analysis showed that discrimination of the C-GPS was between 2.271 and 3.312, and items 6, 8, 13, 14, and 16 provided a large amount of information. Based on the CAT and clinical practice, six items covering four dimensions were included to form the s-C-GPS, all of which had very high discrimination. The s-C-GPS positively correlated with the VAS. CONCLUSION: The C-GPS has good reliability and validity and can be used to evaluate pain in RA patients from a Chinese cultural background. The s-C-GPS, which contains six items, has good criterion validity and may be suitable for pain assessment in busy clinical practice. TRIAL REGISTRATION: This cross-sectional study was registered in the Chinese Clinical Trial Registry (ChiCTR1800020343), granted on December 25, 2018.
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Objectives: To identify patient- and disease-related characteristics that make it possible to predict higher disease severity in recent-onset PsA. Methods: We performed a multicenter observational prospective study (2-year follow-up, regular annual visits). The study population comprised patients aged ≥ 18 years who fulfilled the CASPAR criteria and less than 2 years since the onset of symptoms. Severe disease was defined at each visit as fulfillment of at least 1 of the following criteria: need for systemic treatment, Health Assessment Questionnaire (HAQ) > 0.5, polyarthritis. The dataset contained data for the independent variables from the baseline visit and follow-up visit number 1. These were matched with the outcome measures from follow-up visits 1 and 2, respectively. We trained a logistic regression model and random forest-type and XGBoost machine learning algorithms to analyze the association between the outcome measure and the variables selected in the bivariate analysis. Results: The sample comprised 158 patients. At the first follow-up visit, 78.2% of the patients who attended the clinic had severe disease. This percentage decreased to 76.4% at the second visit. The variables predicting severe disease were patient global pain, treatment with synthetic DMARDs, clinical form at diagnosis, high CRP, arterial hypertension, and psoriasis affecting the gluteal cleft and/or perianal area. The mean values of the measures of validity of the machine learning algorithms were all ≥ 80%. Conclusion: Our prediction model of severe disease advocates rigorous control of pain and inflammation, also addressing cardiometabolic comorbidities, in addition to actively searching for hidden psoriasis.
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INTRODUCTION: To investigate the validity and reliability of the "Global Pain Scale" for Turkish population . METHODS: The cross-sectional study was conducted at the Algology outpatient clinic of a university hospital in Izmir, Turkey, between March and December 2015, and comprised patients with chronic pain aged at least 18 years. Linguistic equivalence, content validity and construct validity were used for establishing the validity of the Global Pain Scale, while the Content Validity Index was used for the assessment of expert views. SPSS 16was used for data analysis. RESULTS: Of the 222 subjects, 142(64%) were females. Overall mean age of the sample was 54.22±13.79 years. Cronbach's alpha coefficient for the entire scale was 0.95. Total item correlation coefficients of the items in the scale ranged between 0.502 and 0.794, and no items were removed from the scale. CONCLUSIONS: The Global Pain Scale was found to have adequate validity and reliability indicators, and can be used with confidence in patients experiencing chronic pain.
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Activities of Daily Living , Chronic Pain/diagnosis , Pain Measurement/methods , Adult , Aged , Chronic Pain/physiopathology , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Reproducibility of Results , TurkeyABSTRACT
BACKGROUND: There is a critical necessity to identify psychometric properties of the total pain score as a measurement of pain management effectiveness in the clinic. PURPOSE: In this article, we perform the analysis of the global pain scores from a panel of patients treated by 10 pain management physicians in a single group practice. BASIC PROCEDURES: The pain measurement consists of 4 pain subscales, namely physical pain, emotions, clinical outcome, and activities. A panel of 130 patients with 4 pain measurements is available to perform longitudinal analysis of the total pain scores. The analysis includes the following: (1) confirmatory factor analysis of the global pain scores with 4 related dimensions, (2) the stability of the pain scores between 2 clinical visits, (3) the change trajectories of pain scores in 4 waves of the pain measurement, and (4) the detection of physician variability in patients' treatment outcomes measured by the reduction of total pain scores. MAIN FINDINGS: The global pain scores were relatively stable between time 1 and time 2 clinical visits. The analysis indicated that there was a decrease in pain with longitudinal advancement in treatment. It also indicated that there was no significant change in this improvement with respect to difference in physicians involved in providing treatment. PRINCIPAL CONCLUSION: While the results indicated a decrease in pain with an alleviation in treatment provided to the patient, the article delineates a well-thought scientific approach to the targeted problem.
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Objective To identify global pain and attachment in chronic pain sufferers, and explore the mediating effect of pain self-efficacy. Methods There were 193 patients recruited from Pain Department in West China Hospital of Sichuan University between February 2017 and June 2017. The Global Pain Scale, Experiences in Close Relationships Questionnaire-Revised and Chronic Pain Self-efficacy Scale were used to collect data. Results The score of global pain, attachment avoidance and attachment anxiety were(79.55±15.82),(2.98±0.81)and(3.22±0.89)points respectively.52.8%(102/193) participants were secure attachment.Mediating effect analyses revealed that self-efficacy exerted a partial mediating effect between global pain and attachment, with the mediating effect of 33.3% in total effect. Conclusions Health professionals should improve the self-efficacy in the management of chronic pain, especially in those with strong relationship needs,promote the positive pain adjustment,and improve the quality of life.
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Despite expert recognition that strong opioid analgesics are the cornerstone of treatment for moderate to severe pain, most of the world's population lacks adequate availability of opioids. Moreover, great disparities in availability of opioids continue to exist between higher- and lower-to-middle-income countries. This study examined more than 30 years of consumption data reported to the International Narcotics Control Board, from 1980 to 2011, for five opioids that are indicated for the treatment of moderate to severe pain: fentanyl, hydromorphone, morphine, oxycodone, and pethidine. As such, this study offers a regional and global perspective on opioid consumption, providing an indication of preparedness for treating moderate to severe pain. Countries are categorized according to the World Health Organization's six geographical regions. Morphine equivalence (ME) statistics were calculated for each study drug, allowing for equianalgesic comparisons between consumption of the study opioids and well as the ability to aggregate all study opioids (Total ME). The ME statistic is adjusted for country population, which allows for uniform global-, regional-, and country-level equianalgesic comparisons of consumption of morphine with other opioids. Although overall trend lines revealed general increases by region, profound inequities in opioid consumption continue to abound globally.
