The reliability of end of day and ecological momentary assessments of pain and pain interference in individuals with spinal cord injury

Qual Life Res, 2018 · DOI: 10.1007/s11136-018-1952-y · Published: November 1, 2018

Spinal Cord Injury Pain Management Research Methodology & Design

Simple Explanation

This study compares two methods for measuring pain: Ecological Momentary Assessment (EMA), which captures immediate experiences in real-world settings, and End of Day (EOD) diaries, which require recall of same-day experiences. The goal was to determine the most efficient way to measure pain intensity and pain interference with high reliability in people with spinal cord injury. The study found that the number of assessments needed for excellent reliability differed depending on whether EMA or EOD was used, and whether pain intensity or pain interference was being measured.

Study Duration

7-day period

Participants

131 individuals with spinal cord injury

Evidence Level

Not specified

Key Findings

1
Five days of EOD assessments are needed for excellent reliability in measuring pain intensity, while three days are sufficient for pain interference.
2
For EMA, excellent reliability in pain intensity requires at least one observation over six days, two over four, or three over three days.
3
For EMA of pain interference, excellent reliability needs one observation over five days, two over three, or three over two days.

Research Summary

This study compares Ecological Momentary Assessment (EMA) and End-of-Day (EOD) diaries for measuring pain intensity and pain interference in individuals with spinal cord injury (SCI). The results indicate that the number of assessments required to achieve excellent reliability varies depending on the assessment method (EMA or EOD) and the specific measure (pain intensity or pain interference). The findings provide researchers and clinicians with specific cutoffs for the number of assessments needed to achieve excellent reliability, helping to balance cost-benefit tradeoffs.

Practical Implications

Optimize Pain Assessment

Researchers and clinicians can use the data to choose the most efficient method (EMA or EOD) and number of assessments needed to achieve desired reliability for pain intensity and interference measures.

Reduce Respondent Burden

By understanding the minimum number of assessments needed, study designs can minimize the burden on participants while maintaining acceptable reliability.

Enhance Understanding of Pain in SCI

The study highlights the importance of considering both pain intensity and interference, as they capture different aspects of the pain experience in individuals with SCI.

Study Limitations

1
The sample is predominantly male, limiting generalizability to females with SCI.
2
The study did not include the same measures during in-person assessments, precluding comparison with solitary assessments typical in many study designs.
3
Relatively high rates of missing data for both EMA and EOD assessments raise a potential concern.

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