Development and preliminary testing of a computerized adaptive assessment of chronic pain

UMMS Affiliation

Department of Quantitative Health Sciences

Publication Date


Document Type



Activities of Daily Living; Adaptation, Psychological; Chronic Disease; Cohort Studies; *Computers; Disability Evaluation; Female; Humans; Male; Middle Aged; Models, Psychological; Outcome Assessment (Health Care); Pain Measurement; Pain, Intractable; Psychometrics; Quality of Life; *Questionnaires; User-Computer Interface


Bioinformatics | Biostatistics | Epidemiology | Health Services Research


The aim of this article is to report the development and preliminary testing of a prototype computerized adaptive test of chronic pain (CHRONIC PAIN-CAT) conducted in 2 stages: (1) evaluation of various item selection and stopping rules through real data-simulated administrations of CHRONIC PAIN-CAT; (2) a feasibility study of the actual prototype CHRONIC PAIN-CAT assessment system conducted in a pilot sample. Item calibrations developed from a US general population sample (N = 782) were used to program a pain severity and impact item bank (kappa = 45), and real data simulations were conducted to determine a CAT stopping rule. The CHRONIC PAIN-CAT was programmed on a tablet PC using QualityMetric's Dynamic Health Assessment (DYHNA) software and administered to a clinical sample of pain sufferers (n = 100). The CAT was completed in significantly less time than the static (full item bank) assessment (P < .001). On average, 5.6 items were dynamically administered by CAT to achieve a precise score. Scores estimated from the 2 assessments were highly correlated (r = .89), and both assessments discriminated across pain severity levels (P < .001, RV = .95). Patients' evaluations of the CHRONIC PAIN-CAT were favorable. PERSPECTIVE: This report demonstrates that the CHRONIC PAIN-CAT is feasible for administration in a clinic. The application has the potential to improve pain assessment and help clinicians manage chronic pain.

DOI of Published Version



J Pain. 2009 Sep;10(9):932-43. Link to article on publisher's site

Journal/Book/Conference Title

The journal of pain : official journal of the American Pain Society

PubMed ID


Related Resources

Link to Article in PubMed