Agostinho, Mariana

Canaipa, Rita

Hidjazi, Sondos

Shehab, Ons

Treister, Roi

English

Repositório Institucional da Universidade Católica Portuguesa

Bland Altman plots of test-retest reliability for R2 (left), ICC (center), CoV (right).Mariana Agostinho1,2, Ons Shehab 1, Sondos Hidjazi 1, Rita Canaipa 2, Roi Treister 11. The Cheryl Spencer Department of Nursing, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel2. CIIS, Centre for Interdisciplinary Health Research, Institute of Health Sciences, Universidade Católica Portuguesa, Lisbon, PortugalRELIABILITY OF THE WITHIN-SUBJECTS VARIABILITY OF PAIN REPORTS AS ASSESSED BY THE FOCUSED ANALGESIA SELECTION TEST (FAST)Correlation ICC SEMrs p. value ICC p. value (95% CI)R2 .630 <.001 .560 <.001 (.272–.756) .080ICC .560 <.001 .539 <.001 (.253–.740) .075CoV .163 .364 -.032 .570 (-.381–.317) .274Correlation ICC SEMrs p. value ICC p. value (95% CI)R2 .388 .034 .399 .10 (.068–.655) .116ICC .355 .054 .330 .032 (-.016–.609) .147CoV .764 <.001 .566 <.001 (.240–.772) .119Test-retest reliability (N=33)Inter-rater reliability (N=30)Session 1 Session 2N=33 Mean (SD)Median Mean (SD)Median p. valueR2 .62 (.12) .63 .63 (.13) .64 .432ICC .66 (.12) .70 .70 (.12) .71 .116CoV .38 (.21) .34 .36 (.16) .37 .879Session 1 Session 2N=30 Mean (SD)Median Mean (SD)Median p. valueR2 .60 (.16) .62 .65 (.12) .66 .133ICC .64 (.17) .69 .69 (.13) .67 .181CoV .34 (.15) .31 .43 (.24) .39 .016Test-retest descriptives of the FAST outcomes (N=33)Inter-rater descriptives of the FAST outcomes (N=30)In recent years there is a growing interest in the relatively new concept of within-subjects variability (or fluctuations) of pain reports. While originally assessed based on daily pain intensity reports collected via diaries, there is also an alternative method based on experimental noxious stimuli, a method called the Focused Analgesia Selection Test (FAST). While the FAST has proven as clinically relevant [1,4,5], the reliability of this construct has never been tested before. The aim of the current investigation is to assess the test-retest and inter-rater reliability of the FAST outcomes. BACKGROUND AND AIMSThe FAST shows moderate test-retest reliability after one week, and less impressive inter-rater reliability. These results are in line with the relatively lower reliability of dynamic quantitative sensory test tasks, such as temporal summation and conditioned pain modulation vs. the static tasks, such as thresholds and tolerance [2,3]. The results highlight the need to adequately train study staff, especially in tasks involving multiple stimuli. CONCLUSIONS1.Kuperman, (2020). Certainty in ascending sensory signals (…). Medical Hypotheses, 143, 110113. doi:10.1016/j.mehy.2020.110113;2.Marcuzzi, (2017). The long-term reliability of static (…). Pain, 158(7), 1217–1223. doi:10.1097/j.pain.0000000000000901;3.Middlebrook (2020). Reliability of temporal summation (…). PLOS ONE, 15(5). doi:10.1371/journal.pone.0233521;4.Treister, (2017). Development and preliminary validation of (…). Journal of Pain Research, 10, 319–326. doi:10.2147/jpr.s121455;5.Treister, (2019). A deeper look at pain variability and its (…). Pain, 160(7), 1522–1528. doi:10.1097/j.pain.0000000000001538 REFERENCESMETHODSParticipants: Healthy volunteers.FAST: 49 stimuli randomly administered 7 times, of 7 different temperatures:Participants are asked to report: “How much pain from 0-no pain, 100-worst pain imaginable”  do you feel in response to (each) stimulus.FAST main outcomes:• Correlation coefficient (R2) • Intraclass correlation (ICC) • Coefficient of variation (CoV)Reliability Assessment of the FASTThe FAST was repeated one week after with same investigator (test-retest reliability) or with a different investigator (inter-rater reliability).Time: Inter-rater:Reliability analysis:• Wilcoxon signed-rank test (difference T1 – T2).• Spearman correlation (<.40 weak, .40-.59 moderate, .60-.79 strong, >.80 very strong).• ICC (<.50 poor, .50-.74 moderate, .75–.90 good and >.90 excellent).• Standard error measurement (SEM).• Bland Altman plots.44 45 46 47 48 49 50 ºC1 week 1 weekBland Altman plots - test-retest reliability for R2 (left), ICC (center), CoV (right).Bland Altman plots - inter-rater reliability for R2 (left), ICC (center), CoV (right).RESULTSParticipants: N=63;  same investigator (test-retest reliability) N=33, different investigators (inter-rater reliability) N=30.The mean time between session was 8.40 (3.71) days, ranging 3 to 19 days.This research was funded by Fundação para a Ciência e a Tecnologia with a PhD grant awarded to the first author 2020.09061.BD (supervised by RC and RT), and ISF 1437/18 grant awarded to the last author (RT). Any questions? Curious about this topic? Scan our QR code oremail: mariana.ribolhos6@gmail.comACKNOWLEDGMENTS & CONTACT

Reliability of the within-subjects variability of pain reports as assessed by the focused analgesia selection test (fast)

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Reliability of the within-subjects variability of pain reports as assessed by the focused analgesia selection test (fast)

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