A smartphone version of the Faces Pain Scale-Revised and the Color Analog Scale for postoperative pain assessment in children

Paediatr Anaesth. 2015 Dec;25(12):1264-73. doi: 10.1111/pan.12790.

Abstract

Background: Effective pain assessment is essential during postoperative recovery. Extensive validation data are published supporting the Faces Pain Scale-Revised (FPS-R) and the Color Analog Scale (CAS) in children. Panda is a smartphone-based application containing electronic versions of these scales.

Objectives: To evaluate agreement between Panda and original paper/plastic versions of the FPS-R and CAS and to determine children's preference for either Panda or original versions of these scales.

Methods: ASA I-III children, 4-18 years, undergoing surgery were assessed using both Panda and original versions of either the FPS-R or CAS. Pain assessments were conducted within 10 min of waking from anesthesia and 30 min later.

Results: Sixty-two participants, median (range) age 7.5 (4-12) years, participated in the FPS-R trial; Panda scores correlated strongly with the original scores at both time points (Pearson's r > 0.93) with limits of agreement within clinical significance (80% CI). Sixty-six participants, age 13 (5-18) years, participated in the CAS trial. Panda scores correlated strongly with the original scores at both time points (Pearson's r > 0.87); mean pain scores were higher (up to +0.47 out of 10) with Panda than with the original tool, representing a small systematic bias, but limits of agreement were within clinical significance. Most participants who expressed a preference preferred Panda over the original tool (81% of FPS-R, 76% of CAS participants).

Conclusion: The Panda smartphone application can be used in lieu of the original FPS-R and CAS for assessment of pain in children. Children's preference for Panda may translate to improved cooperation with self-report of pain.

Keywords: adolescent; child; pain measurement/methods; pain measurement/standards; self-report/standards.

Publication types

  • Observational Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Ambulatory Surgical Procedures
  • Child
  • Child, Preschool
  • Cross-Over Studies
  • Facial Expression
  • Female
  • Humans
  • Male
  • Mobile Applications*
  • Pain Measurement / instrumentation*
  • Pain, Postoperative / diagnosis*
  • Reproducibility of Results
  • Rest
  • Smartphone*