The Pediatric Pain Screening Tool (PPST) can Rapidly Identify Elevated Pain and Psychosocial Symptomatology in Treatment-Seeking Youth with Acute Musculoskeletal Pain

Abstract

This cross-sectional study examines the utility of the Pediatric Pain Screening Tool (PPST) for rapidly assessing pain and psychosocial symptomatology in treatment-seeking youth with acute musculoskeletal pain. Participants were 166 youth (10-18 years, 53.6% female) participating in one of two larger cohort studies of youth with acute musculoskeletal pain. Youth completed the PPST and measures of pain, pain-related fear, pain catastrophizing, pain-related disability, and sleep quality. Participants were categorized into PPST risk groups using published cut-offs. ANOVA and chi-square examined associations between PPST risk groups and self-report measures; receiver operating characteristic (ROC) analyses examined associations among PPST scores and clinical reference cut-offs. The PPST classified 28.3% of youth as high, 23.5% as moderate, and 48.2% as low-risk. Females were more likely to be high-risk. ANOVAs revealed differences in clinical factors by PPST risk group particularly differences among youth labeled high versus low-risk. ROC analyses showed the PPST is effective in discriminating "cases" versus "non-cases" on pain-related disability, pain-fear and catastrophizing. Results reveal the PPST is effective for rapidly screening youth with acute pain for pain and psychosocial symptomatology. An important next step will be to examine the validity of the PPST in predicting recovery outcomes of acute pain samples. PERSPECTIVE: This article presents the Pediatric Pain Screening Tool (PPST) as a measure for rapidly screening youth with acute pain for pain and psychosocial symptomatology. The tool categorizes youth into low, moderate or high-risk groups and discriminates among those with versus without clinically significant levels of disability, pain-related fear and catastrophizing.

Keywords: acute pain; musculoskeletal; pediatric; risk; screening.

Figure 1:

Receiver operating characteristics for the PPST total score against CALI-9 cases defined as > 1 SD above sample mean. Sensitivity and specificity notated in boxes on line.

Figure 2:

Receiver operating characteristics for the PPST Psychosocial subscale against i) Pain Catastrophizing Scale (PCS-C) cases defined as ≥ 26 and ii) Fear of Pain Questionnaire (FOPQ-C) cases as defined by ≥ 51. Sensitivity and specificity notated in boxes on line.

Figure 2:

Receiver operating characteristics for the PPST Psychosocial subscale against i) Pain Catastrophizing Scale (PCS-C) cases defined as ≥ 26 and ii) Fear of Pain Questionnaire (FOPQ-C) cases as defined by ≥ 51. Sensitivity and specificity notated in boxes on line.