ArticlePain2007
Initial validation of the Behavioral Indicators of Infant Pain (BIIP).
Article in Pain, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 48 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
48 citing papers in PubMed, 6 syntheses or guidelines pooled it, 170 citations in OpenAlex.
- Sucrose analgesia for venepuncture in neonates.The Cochrane database of systematic reviews · 2026Pooled it
- Clinical rating scales for assessing pain in newborn infants.The Cochrane database of systematic reviews · 2025Pooled it
- Methodological Issues in the Study of the Development of Pain Responsivity in Preterm Neonates: A Systematic Review.International journal of environmental research and public health · 2020Pooled it
- Paracetamol (acetaminophen) for prevention or treatment of pain in newborns.The Cochrane database of systematic reviews · 2020Pooled it
- Skin-to-skin care for procedural pain in neonates.The Cochrane database of systematic reviews · 2017Pooled it
- Paracetamol (acetaminophen) for prevention or treatment of pain in newborns.The Cochrane database of systematic reviews · 2016Pooled it
- Osteopathic manipulative treatment and pain in preterms: study protocol for a randomised controlled trial.Trials · 2015Trial
- Sucrose and warmth for analgesia in healthy newborns: an RCT.Pediatrics · 2015Trial
- Trial
- Warmth is analgesic in healthy newborns.Pain · 2012Trial
- Is it painful or not? Discriminant validity of the Behavioral Indicators of Infant Pain (BIIP) scale.The Clinical journal of pain · 2008Trial
- Quantification of Infant Distress Across Serial Clubfoot Casting Visits: A Prospective Pilot Study.Foot & ankle orthopaedics · 2026Article
- Article
- Evaluation of Pain in the Pediatric Patient Admitted to Sub-Intensive Care: What Is the Evidence? A Scoping Review.Epidemiologia (Basel, Switzerland) · 2025Review
- Seminars in Fetal & neonatal medicine: Palliative and end of life care in the NICU.Seminars in fetal & neonatal medicine · 2023Review
- Heart rate monitoring to detect acute pain in non-verbal patients: a study protocol for a randomized controlled clinical trial.BMC psychiatry · 2023Article
- Neonatal neuropalliative care.Handbook of clinical neurology · 2023Review
- Assessment and Management of Pain in Preterm Infants: A Practice Update.Children (Basel, Switzerland) · 2022Review
- A comparison of anesthetic efficacy between dorsal penile nerve block (DPNB) with lidocaine and eutectic mixture of local anesthetics (EMLA) cream during neonatal circumcision.World journal of pediatric surgery · 2022Article
- Neuropalliative Care for Neonates.Journal of child neurology · 2021Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors at 1 institution in 1 country.
Funding
Abstract
Accurate pain assessment in preterm infants in the neonatal intensive care unit (NICU) is complex. Infants who are born at early gestational ages (GA), and who have had greater early pain exposure, have dampened facial responses which may lead to under-treatment. Since behavioral and physiological responses to pain in infants are often dissociated, using multidimensional scales which combine these indicators into a single score may limit our ability to determine the effects of interventions on each system. Our aim was to design a unidimensional scale which would combine the relatively most specific, individual, behavioral indicators for assessing acute pain in this population. The Behavioral Indicators of Infant Pain (BIIP) combines sleep/wake states, 5 facial actions and 2 hand actions. Ninety-two infants born between 23 and 32 weeks GA were assessed during 3, 1 min Phases of blood collection. Outcome measures included changes in BIIP and in Neonatal Infant Pain Scale (NIPS) scores coded in real time from continuous bedside video recordings; changes in heart rate (HR) were obtained using custom physiological processing software. Scores on the BIIP changed significantly across Phases of blood collection (p<0.01). Internal consistency (0.82) and inter-rater reliability (0.80-0.92) were high. Correlations between the BIIP and NIPS were modest (r=0.64, p<0.01) as were correlations between the BIIP and mean heart rate (r=0.45, p<0.01). In this initial study, the BIIP has been shown to be a reliable, valid scale for assessing acute pain in preterm infants in the NICU.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.