Evidence map›Paper›PMID 35264356›Full record

ArticleBMJ open2022

What is the definition of acute episodic and chronic pain in critically ill neonates and infants? A global, four-stage consensus and validation study.

Emre Ilhan, Verity Pacey, Laura Brown, Kaye Spence, Christ-Jan van Ganzewinkel, Rebecca Pillai Riddell, Marsha Campbell-Yeo, Bonnie J Stevens, Mats Eriksson, Vibhuti Shah and 5 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
4.6field-weighted citation impact, top 6% of its field
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.

  1. Clinical rating scales for assessing pain in newborn infants.The Cochrane database of systematic reviews · 2025
    Pooled it
  2. Neonatal Pain Management: Is There An Endocrinal Response?Endocrine, metabolic & immune disorders drug targets · 2025
    Review
  3. Review
  4. Article
  5. COMFORTneo scale: a reliable and valid instrument to measure prolonged pain in neonates?Journal of perinatology : official journal of the California Perinatal Association · 2023
    Observational
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

15 authors at 11 institutions in 6 countries.

Emre IlhanDepartment of Health Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia emre.ilhan@mq.edu.au.ORCID 0000-0002-4075-0733
Verity PaceyDepartment of Health Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia.
Laura BrownDepartment of Health Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia.
Kaye SpenceGrace Centre for Newborn Intensive Care, Children's Hospital at Westmead, Westmead, New South Wales, Australia.
Christ-Jan van GanzewinkelMaxima Medical Centre, Veldhoven, The Netherlands.
Rebecca Pillai RiddellDepartment of Psychology, Faculty of Health Sciences, York University, Toronto, Ontario, Canada.ORCID 0000-0003-3990-3680
Marsha Campbell-YeoSchool of Nursing, Faculty of Health, Dalhousie University, Halifax, Nova Scotia, Canada.
Bonnie J StevensLawrence S Bloomberg Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada.
Mats ErikssonFaculty of Medicine and Health, School of Health Sciences, Örebro University, Sweden, Örebro, Sweden.ORCID 0000-0002-5996-2584
Vibhuti ShahDepartment of Paediatrics, Mount Sinai Hospital, Toronto, Ontario, Canada.
Kanwaljeet J S AnandDepartment of Pediatrics, School of Medicine, Stanford University, Stanford, California, USA.
Carlo BellieniDepartment of Pediatrics, University of Siena, Siena, Italy.
Mandy DalyIrish Neonatal Health Alliance, Wicklow, Ireland.
Celeste JohnstonIngram School of Nursing, McGill University, Montreal, Québec, Canada.
Julia HushDepartment of Health Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia.
Macquarie University · AUChildren's Hospital at Westmead · AUDalhousie University · CAIzaak Walton Killam Health Centre · CAMount Sinai Hospital · CAÖrebro University · SERadboud University Nijmegen · NLStanford University · USUniversity of Siena · ITUniversity of Toronto · CAYork University · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo define and validate types of pain in critically ill neonates and infants by researchers and clinicians working in the neonatal intensive care unit (NICU) and high dependency unit (HDU).

designA qualitative descriptive mixed-methods design. PROCEDURE/S: Each stage of the study was built on and confirmed the previous stages. Stage 1 was an expert panel to develop definitions; stage 2 was a different expert panel made up of neonatal clinicians to propose clinical characteristics associated with the definitions from stage 1; stage 3 was a focus group of neonatal clinicians to provide clinical case scenarios associated with each definition and clinical characteristics; and stage 4 was a survey administered to neonatal clinicians internationally to test the validity of the definitions using the clinical case scenarios.

resultsIn stage 1, the panel (n=10) developed consensus definitions for acute episodic pain and chronic pain in neonates and infants. In stage 2, a panel (n=8) established clinical characteristics that may be associated with each definition. In stage 3, a focus group (n=11) created clinical case scenarios of neonates and infants with acute episodic pain, chronic pain and no pain using the definitions and clinical characteristics. In stage 4, the survey (n=182) revealed that the definitions allowed an excellent level of discrimination between case scenarios that described neonates and infants with acute episodic pain and chronic pain (area under the receiver operating characteristic=0.87 and 0.89, respectively).

conclusionsThis four-stage study enabled the development of consensus-based and clinically valid definitions of acute episodic pain and chronic pain. There is a need to define and validate other pain types to inform a taxonomy of pain experienced by neonates and infants in the NICU and HDU.

Indexed as

Chronic PainCritical IllnessConsensus Statements as TopicHumansInfantInfant, NewbornIntensive Care Units, NeonatalROC Curveneonatal intensive & critical careneonatologypain management

Identifiers

PMID35264356
PMCPMC8915348
OpenAlexW4221030327

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.