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The reliability of pain drawing in the assessment of pain distribution and location in patients with musculoskeletal disorders

(2017)

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Abstract
Objective: The aim was to investigate the reliability of measuring pain distribution and location using paper or digital pain drawings (PD) in various musculoskeletal disorders. Method: This systematic review (SR) was carried out by two independent authors. The searches were conducted in various electronic databases such as CINAHL, Cochrane Library Embase, Pubmed, Science direct and Scopus. The PRISMA statement allowed to structure this SR with methodology. The methodological quality of the selected articles was determined using a modified version of the QUADAS instrument. Results: A total of 303 studies were identified in electronic databases. However, only 20 of them were included in this SR after the selection of studies. Paper PD: The test-retest reliability for measuring pain distribution was k of 0,32 and ranged from ICC of 0,58 to 0,94. The test-retest reliability for measuring pain location ranged from k of 0,29 to 0,73. The intra-rater reliability for measuring pain distribution ranged from ICC of 0,990 to 0,999. The intra-rater reliability for measuring pain location ranged from k of 0,68 to 1. The inter-rater reliability for measuring pain distribution ranged from ICC of 0,960 to 0,996. The inter-rater reliability for measuring pain location ranged from k of 0,61 to 1. Digital PD: The test-retest reliability for measuring pain distribution ranged from ICC of 0,84 to 0,99. The test-retest reliability for measuring pain location was a Jaccard Index of 0,46 and 0,49 (+/- 0,21). The intra-rater reliability for measuring pain distribution ranged from ICC of 0,992 to 0,998. The inter-rater reliability for measuring pain distribution ranged from ICC of 0,925 to 0,997. The test-retest reliability for measuring pain location between paper and digital 2D-PD ranged from k of 0,23 to 0,90. The test-retest reliability for measuring pain distribution between paper and digital 2D-PD ranged from ICC of 0,63 to 0,93, between paper PD and tablet was ICC of 0,924 and between digital 2D and 3D-PD was ICC of 0,996. Conclusion: Concerning paper PD, the results suggest good to excellent reliability for all measurements except for the test-retest reliability for the measurement of pain location and pain distribution which is poor to good. Concerning digital PD, the results suggest high to excellent reliability for all measurements except for the test-retest reliability for the measurement of pain location which is rather poor to moderate. Test-retest reliability for the measurement of pain location and distribution between paper and digital 2D-PD proved to be moderate to excellent. It proved to be excellent reliability between paper PD and tablet and between digital 2D and 3D-PD.