Reliability of pressure pain threshold testing in healthy pain free young adults

Background and aims: Investigation of the multidimensional correlates of pressure pain threshold (PPT) requires the study of large cohorts, and thus the use of multiple raters, for sufficient statistical power. Although PPT testing has previously been shown to be reliable, the reliability of multipl...

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Main Authors: Waller, R., Straker, Leon, O'Sullivan, Peter, Sterling, M., Smith, A.
Format: Journal Article
Published: 2015
Online Access:http://hdl.handle.net/20.500.11937/17476
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author Waller, R.
Straker, Leon
O'Sullivan, Peter
Sterling, M.
Smith, A.
author_facet Waller, R.
Straker, Leon
O'Sullivan, Peter
Sterling, M.
Smith, A.
author_sort Waller, R.
building Curtin Institutional Repository
collection Online Access
description Background and aims: Investigation of the multidimensional correlates of pressure pain threshold (PPT) requires the study of large cohorts, and thus the use of multiple raters, for sufficient statistical power. Although PPT testing has previously been shown to be reliable, the reliability of multiple raters and investigation for systematic bias between raters has not been reported. The aim of this study was to evaluate the intrarater and interrater reliability of PPT measurement by handheld algometer at the wrist, leg, cervical spine and lumbar spine. Additionally the study aimed to calculate sample sizes required for parallel and cross-over studies for various effect sizes accounting for measurement error. Methods: Five research assistants (RAs) each tested 20 pain free subjects at the wrist, leg, cervical and lumbar spine. Intraclass correlation coefficient (ICC), standard error of measurement (SEM) and systematic bias were calculated. Results: Both intrarater reliability (ICC = 0.81–0.99) and interrater reliability (ICC = 0.92–0.95) were excellent and intrarater SEM ranged from 79 to 100 kPa. There was systematic bias detected at three sites with no single rater tending to consistently rate higher or lower than others across all sites. Conclusion: The excellent ICCs observed in this study support the utility of using multiple RAs in large cohort studies using standardised protocols, with the caveat that an absence of any confounding of study estimates by rater is checked, due to systematic rater bias identified in this study.
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spelling curtin-20.500.11937-174762019-02-19T05:34:59Z Reliability of pressure pain threshold testing in healthy pain free young adults Waller, R. Straker, Leon O'Sullivan, Peter Sterling, M. Smith, A. Background and aims: Investigation of the multidimensional correlates of pressure pain threshold (PPT) requires the study of large cohorts, and thus the use of multiple raters, for sufficient statistical power. Although PPT testing has previously been shown to be reliable, the reliability of multiple raters and investigation for systematic bias between raters has not been reported. The aim of this study was to evaluate the intrarater and interrater reliability of PPT measurement by handheld algometer at the wrist, leg, cervical spine and lumbar spine. Additionally the study aimed to calculate sample sizes required for parallel and cross-over studies for various effect sizes accounting for measurement error. Methods: Five research assistants (RAs) each tested 20 pain free subjects at the wrist, leg, cervical and lumbar spine. Intraclass correlation coefficient (ICC), standard error of measurement (SEM) and systematic bias were calculated. Results: Both intrarater reliability (ICC = 0.81–0.99) and interrater reliability (ICC = 0.92–0.95) were excellent and intrarater SEM ranged from 79 to 100 kPa. There was systematic bias detected at three sites with no single rater tending to consistently rate higher or lower than others across all sites. Conclusion: The excellent ICCs observed in this study support the utility of using multiple RAs in large cohort studies using standardised protocols, with the caveat that an absence of any confounding of study estimates by rater is checked, due to systematic rater bias identified in this study. 2015 Journal Article http://hdl.handle.net/20.500.11937/17476 10.1016/j.sjpain.2015.05.004 restricted
spellingShingle Waller, R.
Straker, Leon
O'Sullivan, Peter
Sterling, M.
Smith, A.
Reliability of pressure pain threshold testing in healthy pain free young adults
title Reliability of pressure pain threshold testing in healthy pain free young adults
title_full Reliability of pressure pain threshold testing in healthy pain free young adults
title_fullStr Reliability of pressure pain threshold testing in healthy pain free young adults
title_full_unstemmed Reliability of pressure pain threshold testing in healthy pain free young adults
title_short Reliability of pressure pain threshold testing in healthy pain free young adults
title_sort reliability of pressure pain threshold testing in healthy pain free young adults
url http://hdl.handle.net/20.500.11937/17476