Evidence map›Paper›PMID 17668269›Full record

ArticleJournal of general internal medicine2007

Accuracy of the pain numeric rating scale as a screening test in primary care.

Erin E Krebs, Timothy S Carey, Morris Weinberger

2 registry-linked trialsAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of general internal medicine, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 192 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
192citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

NCT03465111 phase2unknown statusnot on this mapstarted 2019, after this paper: background citation

An Open Label, Multi-centered, Randomized Phase 2 Study to Evaluate the Safety, Tolerability and Bioactivity of Subcutaneous ACTH GeL in PAtients With Scleritis: The ATLAS Study

TypeinterventionalSponsorMetropolitan Eye Research & Surgery InstituteRan2019 to 2024Enrolled30ConditionsScleritisArmsACTH (adrenocorticotropic hormone) gel
NCT06906107 narecruitingnot on this mapstarted 2025, after this paper: background citation

Validation of a Clinical Prediction Rule to Identify Patients With Neck Pain Likely to Benefit From Cervical Spinal Manipulation: A Randomized Clinical Trial

TypeinterventionalSponsorBaylor UniversityRan2025 to 2026Enrolled160ConditionsNeck Pain Musculoskeletal, Neck Pain Treatment, CervicalgiaArmsCervical Manipulation, Exercise, Mobilization
3 · Its place in the literature

Who cites it

192 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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  7. D-Mannose PlusMedicina (Kaunas, Lithuania) · 2023
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  20. Computerized patient-reported symptom assessment in radiotherapy: a pilot randomized, controlled trial.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2016
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132 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Erin E KrebsCenter on Implementing Evidence-Based Practice, Roudebush Veterans Affairs Medical Center, Indianapolis, IN, USA. krebse@iupui.edu
Timothy S Carey
Morris Weinberger

Funding

Chronic Back and Neck Pain: Care Seeking and EvidenceR01AR051970 · NIAMS · UNIV OF NORTH CAROLINA CHAPEL HILL · PI CAREY, TIMOTHY S., MD, MPH. · 2005 to 2007
$787k
NIAMS NIH HHS 1R01AR051970NIAMS NIH HHS R01 AR051970
6 · The paper itself

Abstract

backgroundUniversal pain screening with a 0-10 pain intensity numeric rating scale (NRS) has been widely implemented in primary care.

objectiveTo evaluate the accuracy of the NRS as a screening test to identify primary care patients with clinically important pain.

designProspective diagnostic accuracy study

participants275 adult clinic patients were enrolled from September 2005 to March 2006. MEASUREMENTS: We operationalized clinically important pain using two alternate definitions: (1) pain that interferes with functioning (Brief Pain Inventory interference scale > or = 5) and (2) pain that motivates a physician visit (patient-reported reason for the visit).

results22% of patients reported a pain symptom as the main reason for the visit. The most common pain locations were lower extremity (21%) and back/neck (18%). The area under the receiver operator characteristic curve for the NRS as a test for pain that interferes with functioning was 0.76, indicating fair accuracy. A pain screening NRS score of 1 was 69% sensitive (95% CI 60-78) for pain that interferes with functioning. Multilevel likelihood ratios for scores of 0, 1-3, 4-6, and 7-10 were 0.39 (0.29-0.53), 0.99 (0.38-2.60), 2.67 (1.56-4.57), and 5.60 (3.06-10.26), respectively. Results were similar when NRS scores were evaluated against the alternate definition of clinically important pain (pain that motivates a physician visit).

conclusionsThe most commonly used measure for pain screening may have only modest accuracy for identifying patients with clinically important pain in primary care. Further research is needed to evaluate whether pain screening improves patient outcomes in primary care.

Indexed as

AdultAgedAge FactorsChronic DiseaseCohort StudiesConfidence IntervalsFemaleHumansMaleMass ScreeningMiddle AgedPainPain MeasurementPrimary Health CareProbabilityProspective Studies

Identifiers

PMID17668269
PMCPMC2305860

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.