Recommended Citation
Guerra Branger A, Knezevic N, Fink A, Sumar M, Ong C, Patel N. Higher patient-reported percentage pain reduction than calculated pain score differences in chronic non-cancer pain patients. Presented at: Midwest Anesthesia Residents Conference (MARC); April 26, 2025; Indianapolis, IN.
Presentation Notes
Presented at: Midwest Anesthesia Residents Conference (MARC); April 26, 2025; Indianapolis, IN.
Abstract
Introduction: Pain relief is commonly evaluated through two derivatives of the numeric scale rating (NRS) and visual analog scale (VAS): patient-reported percentage pain reduction (PRPPR) and calculated percentage pain reduction (CPPR). A limited number of studies have examined the agreement between these two parameters in chronic pain patients and have generally focused on specific pain types or treatment methods. Methods: A retrospective analysis of 1,919 patients who sought medical attention for various pain conditions was conducted. Patients had to be seen for at least 6 months with no less than 4 clinic visits. At each visit, patients were asked to quantify both their pre and post-treatment pain scores on a numeric scale rating (NRS) as well as their subjective percentage improvement. IBM SPSS 27 software was utilized to analyze the data collected. Patients were first stratified based on the duration of their pain. To gauge the agreement between PRPPR and CPPR within each group, one-sample t-test was conducted to calculate the mean numerical values using the concordance correlation coefficient. Patients were further stratified into groups based on their treatment modality. The paired-sample t-test was used in order to calculate the mean PRPPR, mean CPPR and the correlation between them. Results: The mean PRPPR and CPPR for the entire population were 61.03 and 49.21 respectively, with a mean discrepancy of 11.81. The concordance correlation coefficient was 0.689. When grouped based on duration of treatment, the less than one year cohort had a PRPPR and CPPR of 60.87 and 56.26 respectively with a discrepancy of 4.61 and correlation coefficient of 0.822. In the 1–2-year group the PRPPR and CPPR were 61.76 and 50.29, respectively, with a discrepancy of 11.47 and correlation coefficient of 0.698. In patients treated for 2–3 years, the PRPPR and CPPR were 60.45 and 47.91, respectively, with an average difference of 12.54 and concordance correlation coefficient of 0.628. For patients treated for 2–3 years, the PRPPR and CPPR were 60.45 and 47.91, respectively. The average difference was 12.54, and the concordance correlation coefficient was calculated as 0.628. The PRPPR and CPPR for the 3–4-year cohort were 60.20 and 47.01, respectively, with a mean discrepancy of 13.19 and the concordance correlation coefficient was 0.657. Among patients treated for 4-5 years, the PRPPR and CPPR were recorded as 61.48 and 47.06, respectively. The average discrepancy among this group was 14.42, and the concordance correlation coefficient resulted as 0.675. For those that were treated for over 5 years, the PRPPR and CPPR were 61.23 and 50.23, respectively. The mean difference within this group was 11.00, while the concordance correlation coefficient was calculated to be 0.726. Conclusion: In this study, PRPPR overestimated CPPR. Due to the strong correlation between the two parameters, it can be concluded that changes in one can be predicted in the other with a high level of accuracy. However, it is unclear which one more accurately reflects an improvement in each patient's underlying pain. Further research is needed to better understand the mechanisms behind the discrepancy between PRPPR and CPPR. 1. Fink A.B. et al. (2023) Neurology International. 15(2):560-568.
Type
Poster
Affiliations
Advocate Illinois Masonic Medical Center