Evaluation of the psychometric properties of PainChek in older general hospital patients with dementia

Abstract

Background Pain is common in people with dementia in general hospitals. This can be difficult to identify. Objectives To evaluate the psychometric properties of PainChek electronic pain assessment tool. Design Cross-sectional psychometric study. Setting Six medical care of older people wards from two general hospitals in greater London, UK. Subjects 63 people with clinical diagnosis of dementia: mean 84 years (SD 6.7), 59% female, 69% living in their own homes, 64% white British, 77% moderate/severe dementia. Method Psychometric evaluation of PainChek, a point-of-care electronic pain assessment tool combining artificial intelligence, facial analysis and smartphone technology. From a total of 216 assessments, we tested PainChek's inter-rater reliability (IRR) (Cohen's kappa), internal consistency (Cronbach's alpha) and concurrent validity (Pearson's coefficient) between PainChek and Pain Assessment in Advanced Dementia (PAINAD) scores at rest and post-movement 95% confidence interval (95% CI) where appropriate]. We assessed convergent validity with Symptom Management–End of Life in Dementia scale (SM-EOLD) (Pearson's coefficient) and discriminant validity (rest vs post-movement). Results IRR was 0.714 (95% CI 0.562 to 0.81) (rest) and 0.817 (95% CI 0.692 to 0.894) (post-movement). Internal consistency was 0.755 (rest) and 0.833 (post-movement). Concurrent validity with PAINAD was 0.528 (95% CI 0.317 to 0.690) (rest) and 0.787 (0.604 to 0.891) (post-movement). Convergent validity with SM-EOLD was -0.555 (95% CI -0.726 to -0.318) (rest) and -0.5644 (95% CI -0.733 to -0.331) (post-movement). Discriminant validity was significant. Conclusions PainChek is a valid and reliable pain assessment tool for people with dementia in general hospitals. Further consideration will be needed for implementation into this setting.