The reliability of body pain diagrams in the quantitative measurement of pain distribution and location in patients with musculoskeletal pain: a systematic review.
OBJECTIVE
The purpose of this study was to perform a systematic review of test-retest, intraexaminer, and interexaminer reliability of measuring pain location and distribution using the body pain diagram.


METHODS
We conducted a systematic review of the literature using a search conducted in Medline, CINAHL, and Nursing and Allied Health from inception to March 1, 2012. Articles were screened and selected by pairs of reviewers using predetermined inclusion criteria. Internal validity was assessed independently by 2 reviewers using a modified version of the QUADAS instrument. Articles with adequate internal validity were included in the best evidence synthesis.


RESULTS
We reviewed 10 studies. Of those, 6 were included in the best evidence synthesis. We found varying levels of evidence that pain location and pain distribution can be measured reliably using the body pain diagram in patients with acute and chronic low back pain with or without radiculopathy. The test-retest reliability for measuring pain distribution ranged from intraclass correlation coefficient of 0.58 to 0.94. Similarly, the test-retest reliability for measuring pain location ranged from kappa (κ) of 0.13 to 0.85. The intraexaminer and interexaminer reliability for measuring pain distribution were intraclass correlation coefficient of 0.99 and 0.99, respectively. The intraexaminer and interexaminer reliability for measuring pain location ranged from κ of 0.77 to 0.88 and 0.61 to 1.00, respectively.


CONCLUSIONS
We found important variations in the test-retest reliability of pain location and distribution across different test-retest scenarios and across body regions. The intraexaminer and interexaminer reliability for the measurement of pain distribution and pain location using the body pain diagram in patients with acute and chronic low back pain with or without radiculopathy are adequate.
['Southerst|Danielle|D|', 'Côté|Pierre|P|', 'Stupar|Maja|M|', 'Stern|Paula|P|', 'Mior|Silvano|S|']
D000208:Acute Disease D000328:Adult D001830:Body Surface Area D002908:Chronic Disease D005069:Evaluation Studies as Topic D019317:Evidence-Based Medicine D005260:Female D006801:Humans D017116:Low Back Pain D008297:Male D008875:Middle Aged D059352:Musculoskeletal Pain D015588:Observer Variation D010147:Pain Measurement D015203:Reproducibility of Results D012680:Sensitivity and Specificity D012720:Severity of Illness Index
Pain Pain Measurement Reproducibility of Results