The comparison of sensitivity and specificity of the critical care pain observation tool (CPOT) and behavioral pain scale (BPS): a scoping review
Abstract
Background: Assessing pain in critically ill patients receiving mechanical ventilatory support remains a challenge in the intensive care unit. Due to mechanical ventilation and a reduced level of consciousness, the patient was unable to verbally report perceived pain. Highly sensitive pain assessment tools are critical for pain detection in critically ill patients in the intensive care unit. The Critical Care Pain Observation Tool (CPOT) and the Behavioral Pain Scale (BPS) are two pain assessment tools recommended for use in the critical care setting
Objective: The purpose of this study was to compare the sensitivity and specificity of CPOT and BPS in the assessment of pain in patients receiving mechanical ventilation.
Methods: This study was a systematic review conducted using the Scopus, PubMed, ProQuest, and ScienceDirect databases and followed established guidelines for conducting systematic reviews or scoping reviews
Results: CPOT was found to be more sensitive at 95% with a cut-off score >2, whereas BPS exhibited higher specificity at 91.5% with a cut-off score >6
Conclusion: Both CPOT and BPS demonstrate sensitivity to painful situations and are capable of detecting pain in critically ill patients.
References
Bosch-Alcaraz A, Tamame-San Antonio M, Luna-Castaño P, Garcia-Soler P, Falcó Pegueroles A, Alcolea-Monge S, et al. Specificity and sensibility of the Spanish version of the COMFORT Behaviour Scale for assessing pain, grade of sedation and withdrawal syndrome in the critically ill paediatric patient. Multicentre COSAIP study (Phase 1). Enfermería Intensiva (English ed). 2022;33(2):58–66.
Wiegand DL, Wilson T, Pannullo D, Russo MM, Kaiser KS, Soeken K, et al. Measuring Acute Pain Over Time in the Critically Ill Using the Multidimensional Objective Pain Assessment Tool (MOPAT). Pain Manag Nurs. 2018;19(3):277–87.
Hamdan KM. Nurses’ Assessment Practices of Pain Among Critically Ill Patients. Pain Manag Nurs. 2019;20(5):489–96.
Nazari R, Froelicher ES, Nia HS, Hajihosseini F, Mousazadeh N. Diagnostic Values of the Critical Care Pain Observation Tool and the Behavioral Pain Scale for Pain Assessment among Unconscious Patients: A Comparative Study. Indian J Crit care Med peer-reviewed, Off Publ Indian Soc Crit Care Med. 2022;26(4):472–6.
Yamada S, Ikematsu Y. A Pilot Study on Pain Assessment Using the Japanese Version of the Critical-Care Pain Observation Tool. Pain Manag Nurs. 2021;22(6):769–74.
Aktaş YY, Karabulut N. A Turkish Version of the Critical-Care Pain Observation Tool: Reliability and Validity Assessment. J PeriAnesthesia Nurs. 2017;32(4):341–51.
Alotni M, Guilhermino M, Duff J, Sim J. Barriers to nurse-led pain management for adult patients in intensive care units: An integrative review. Aust Crit Care. 2022;(xxxx).
Chookalayia H, Heidarzadeh M, Hassanpour-Darghah M, Aghamohammadi-Kalkhoran M, Karimollahi M. The Critical Care Pain Observation Tool is reliable in non-agitated but not in agitated intubated patients. Intensive Crit Care Nurs. 2018;44:123–8.
Liu YT, Lee CC, Chen CC, Chiu YH, Liu ZH, Wang YC. Verification of the critical-care pain observation tool in conscious patients with hemiparesis or cognitive dysfunction. J Crit Care. 2021;65:91–7.
Björn A, Pudas-Tähkä SM, Salanterä S, Axelin A. Video education for critical care nurses to assess pain with a behavioural pain assessment tool: A descriptive comparative study. Intensive Crit Care Nurs. 2017;42:68–74.
Gutysz-Wojnicka A, Ozga D, Mayzner-Zawadzka E, Dyk D, Majewski M, Doboszyńska A. Psychometric Assessment of Physiologic and Behavioral Pain Indicators in Polish Versions of the Pain Assessment Scales. Pain Manag Nurs. 2019;20(3):292–301.
Tricco AC, Lillie E, Zarin W, O’Brien KK, Colquhoun H, Levac D, et al. PRISMA extension for scoping reviews (PRISMA-ScR): Checklist and explanation. Ann Intern Med. 2018;169(7):467–73.
Cheng LH, Tsai YF, Wang CH, Tsay PK. Validation of two Chinese-version pain observation tools in conscious and unconscious critically ill patients. Intensive Crit Care Nurs. 2018;44:115–22.
Severgnini P, Pelosi P, Contino E, Serafinelli E, Novario R, Chiaranda M. Accuracy of Critical Care Pain Observation Tool and Behavioral Pain Scale to assess pain in critically ill conscious and unconscious patients: prospective, observational study. J Intensive Care. 2016;4.
Gomarverdi S, Sedighie L, Seifrabiei M, Nikooseresht M. Comparison of two pain scales: Behavioral pain scale and critical-care pain observation tool during invasive and noninvasive procedures in intensive care unit-admitted patients. Iran J Nurs Midwifery Res. 2019;24(2):151–5.
Klein C, Caumo W, Gélinas C, Patines V, Pilger T, Lopes A, et al. Validation of Two Pain Assessment Tools Using a Standardized Nociceptive Stimulation in Critically Ill Adults. J Pain Symptom Manage. 2018;56(4):594–601.
Birkedal HC, Larsen MH, Steindal SA, Solberg MT. Comparison of two behavioural pain scales for the assessment of procedural pain: A systematic review. Nurs Open. 2021 Sep;8(5):2050–60.
Emsden C, Schäfer UB, Denhaerynck K, Grossmann F, Frei IA, Kirsch M. Validating a pain assessment tool in heterogeneous ICU patients: Is it possible? Nurs Crit Care. 2020;25(1):8–15.
Marques R, Araújo F, Fernandes M, Freitas J, Dixe MA, Gélinas C. Validation Testing of the European Portuguese Critical-Care Pain Observation Tool. Healthcare. 2022;10(6):1075.
Hylén M, Alm-Roijer C, Idvall E, Akerman E. To assess patients pain in intensive care: developing and testing the Swedish version of the Behavioural Pain Scale. Intensive Crit Care Nurs. 2019;52:28–34.
Pudas-Tähkä SM, Salanterä S. Reliability of three linguistically and culturally validated pain assessment tools for sedated ICU patients by ICU nurses in Finland. Scand J Pain. 2018;18(2):165–73.
Sastroasmoro S. Dasar-dasar Metodologi Penelitian Klinis. Edisi ke-5. Handarto Aryono, editor. Jakarta: Sagung seto; 2014. 219–243 p.
Kotfis K, Zegan-Barańska M, Strzelbicka M, Safranow K, Żukowski M, Ely EW. Validation of the Polish version of the Critical Care Pain Observation Tool (CPOT) to assess pain intensity in adult, intubated intensive care unit patients: the POL-CPOT study. Arch Med Sci. 2018;14(4):880–9.
Kiesewetter I, Bartels U, Bauer A, Schneider G, Pilge S. The German version of the Critical-Care Pain Observation Tool for critically ill adults: A prospective validation study. Anaesthesist. 2019;68(12):836–42.
Ito Y, Teruya K, Nakajima E. Evaluation of pain severity in critically ill patients on mechanical ventilation. Intensive Crit Care Nurs. 2022;68:103118.
Copyright (c) 2024 MEDIA ILMU KESEHATAN
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Articles received and published by the Media Ilmu Kesehatan are by the publication, the copyright of the article is fully transferred to the Media Ilmu Kesehatan. All operational forms such as printing, publication, and distribution of hard file journals are carried out by the Media Ilmu Kesehatan. Articles that have finished the review process and have been declared accepted by the journal manager or editor will be asked to fill out a statement of submission of copyright by the journal secretary to the main author or correspondent author. The statement of transfer of copyright is signed with a seal and sent via email to journalmik2018@gmail.com and contacted the admin of the journal to be followed up on archiving. Journal managers and editors have the right to edit the manuscript according to the provisions of the writing rules in the Media Ilmu Kesehatan.
Articles that have been declared accepted either online through the author's account on the OJS website https://ejournal.unjaya.ac.id/index.php/mik or a letter of receipt of the article (LOA), as well as those that have been published on OJS are not allowed to be published in other journals, or proceedings. The number of authors with more than one and as the main author or designated as the correspondent writer must have coordinated with members of the research team. The order of the authors submitted in the article as the author of one, two, three and so on cannot be changed when the article is published unless an error occurs in the technical operation of the journal.
