Instrumental validity and intra/inter-rater reliability of a novel low-cost digital pressure algometer

PeerJ. 2020 Oct 12:8:e10162. doi: 10.7717/peerj.10162. eCollection 2020.

Abstract

Background: Pain assessment is a key measure that accompanies treatments in a wide range of clinical settings. A low-cost valid and reliable pressure algometer would allow objective assessment of pressure pain to assist a variety of health professionals. However, the pressure algometer is often expensive, which limits its daily use in both clinical and research settings.

Objectives: This study aimed to assess the instrumental validity, and the intra- and inter-rater reliability of an inexpensive digital adapted pressure algometer.

Methods: A single rater applied 60 random compressions on a force platform. The pressure pain thresholds of 20 volunteers were collected twice (3 days apart) by two raters. The main outcome measurements were as follows: the maximal peak force (in kPa) and the pressure pain threshold (adapted pressure algometer vs. force platform). Cronbach's α test was used to assess internal consistency. The standard error of measurement provided estimates of measurement error, and the measurement bias was estimated with the Bland-Altman method, with lower and upper limits of agreement.

Results: No differences were observed when comparing the compression results (P = 0.51). The validity and internal intra-rater consistencies ranged from 0.84 to 0.99, and the standard error of measurement from 0.005 to 0.04 kPa. Very strong (r = 0.73-0.74) to near-perfect (r = 0.99) correlations were found, with a low risk of bias for all measurements. The results demonstrated the validity and intra-rater reliability of the digitally adapted pressure algometer. Inter-rater reliability results were moderate (r = 0.55-0.60; Cronbach's α = 0.71-0.75).

Conclusion: The adapted pressure algometer provide valid and reliable measurements of pressure pain threshold. The results support more widespread use of the pressure pain threshold method among clinicians.

Keywords: Inexpensive; Pain assessment; Pressure algometry; Pressure pain threshold; Reliability; Validity.

Grants and funding

This study was financed by Coordenação de Aperfeiçoamento de Pessoal de Nível Superior—Brasil (CAPES)—Finance Code 001, and by Fundação de Amparo à Pesquisa de Minas Gerais (FAPEMIG)—Finance Code APQ-02040-18. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.