Articles: pain-measurement.
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There is currently no gold standard instrument for assessing pain in severely cognitively impaired adults who are unable to provide self-report. ⋯ The results of this study indicate that the PACSLAC may be the more reliable tool over the PAINAD; however, rater training and familiarity with the tool is critical.
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Reg Anesth Pain Med · Dec 2020
ReviewIs the minimal clinically important difference (MCID) in acute pain a good measure of analgesic efficacy in regional anesthesia?
In the field of acute pain medicine research, we believe there is an unmet need to incorporate patient related outcome measures that move beyond reporting pain scores and opioid consumption. The term "minimal clinically important difference" (MCID) defines the clinical benefit of an intervention as perceived by the patient, as opposed to a mathematically determined statistically significant difference that may not necessarily be clinically significant. The present article reviews the concept of MCID in acute postoperative pain research, addresses potential pitfalls in MCID determination and questions the clinical validity of extrapolating MCID determined from chronic pain and non-surgical pain studies to the acute postoperative pain setting. We further suggest the concepts of minimal clinically important improvement, substantial clinical benefit and patient acceptable symptom state should also represent aspirational outcomes for future research in acute postoperative pain management.
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Trajectories of Disability and Low Back Pain Impact: 2-year Follow-up of the Groningen Spine Cohort.
Prospective cohort study. ⋯ 2.
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Pediatric emergency care · Dec 2020
Diagnosis and Treatment of Headache in a Pediatric Emergency Department.
The aims of the study were (1) to analyze the etiology and clinical management of headaches in children in the emergency department and (2) to analyze the treatment used in children diagnosed with headaches and with migraines. ⋯ Secondary benign headaches were the most common and very rarely headache as a symptom was associated with life-threatening situations. Antiemetics seem to be efficient ally in the treatment of primary headaches, but it is important to consider alternative pharmacological regimes in patients who present with higher pain scores.