Pain, 61) (1995) 341-347 © 1995 Elsevier Science B.V. All rights reserved 0304-3959/95/$09.50 341 PAIN 2667 Frequent measurement of chronic pain: an electronic diary and empMcal findings Beverley Lewis d Daniel Lewis and Geoff Cumming "'~ " School of P~ychoh~gy, La ~¥obe Unicersitv, Bundoora 3083 (Australia) b Department of Rheumatole~gy, Monash Medical Centre, Clayton 3168 (Australia) (Received 30 March 1994, accepted 8 July 1994) Summary The P|PER (Prompting Intensity of Pair, Electronic Recorder) is a compact data-logging device, easily worn by a subject. ;t emits audible beeps at pre-programmed times, promptirag the subject to enter a pain rating by button press. Ratings are stored, for later down-loading. We report two studies suggesting that PIPER pain ratings have good reliability, and good validity assessed against the VAS. In a third study, the PIPER was found practical for use by elderly subjects, and for periods of more than 2 months. In addition, PIPER pain ratings taken 4 times per day were found to have different properties than 4 other measures of chronic pain, suggesting that very frequent measures should be taken if a full understanding of chronic pain is to be obtained. Key words: Chronic pain; Pain measurement; Computer application; Reliability; Validity; Knee Introduction Pain, as a complex multidimensional experience, poses great problems of measurement (Chapman 1989). Use of multiple measures can often be justified in an attempt to understand pain and its relief (Chapman and Loeser 1989). Chronic pain is especially difficult to characterise because it may be especially strongly influ- enced by general dispositional and attitudinal vari- ables, and so be relatively less influenced by immediate and s 1990) time and 1 probl almo' cessi~ so is reliar meml .............. "- "-:rskine et al. pain over a Dry for pain, omplex and ~hronic pain in over suc- lengthy, and arising from avoid such tracking of * Correspondbzg author: Dr. Geoff Cumming, School of Psycholo~, La Trobe University, Bundoora 3083, Australia. TeL: (613) 479- 2820; FAX: (613) 479-2443; E-mail: cumming~.~latcsl.lat.oz.au. current Pare could be regarded as an ideal, even if probably unattainable in practice. Research on chronic pain, therefore, requires particular attention to thc likely complexity of subjects' pain response, and to the frequency with which pain measurements are obtained. In research concerning the efficacy of TENS for chronic pain due to osteoarthrities (OA) of the knee (Lewis 1990; Lewis et al. 1994b) we used 4 different conventional measures of pain in an attempt to give a rounded assessment of subjects' knee pain. None of these measures, however, was taken more often than daily and so, to round out further our assessment of pain, and in particular to approach the ideal of track- ing current pain continuously, we wished also to record pain ratings very frequently. We aimed to record pain ratings several times per day, over a period of months, in elderly subjects with minimum disruption to a subject's daily routine. To achieve this we developed a compact, portable, battery-powered electronic device worn by the subject that gives an audible prompt at pre-programmed times of day. The device -- the PIPER (Prompting Intensity of Pain Electronic Recorder) -- may be regarded as an 'electronic diary' in that it stores, for later down-load- ing, the subject's pain rating given in the form of a button press in response to the prompt. SSDI 0304-3959(94)00143-X