Transcript of The revised FLACC behavioural pain score: Reliability and validation for pain assessment in children...
- Slide 1
- The revised FLACC behavioural pain score: Reliability and
validation for pain assessment in children with cerebral palsy Line
Kjeldgaard Pedersen, MD Ole Rahbek, MD, Ph.D Lone Nikolajsen, MD,
Ph.D, DMSc Bjarne Mller-Madsen, MD, DMSc EP84 No conflicts of
interest declared
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- Background Pain in children with severe cerebral palsy (CP) is
underrecognized and undertreated A self-rating assessment tool is
not possible in children with severe cognitive impairments A valid
observational or behavioral pain score is needed r-FLACC: revised
Face, Legs, Activity, Cry and Consolability behavioural pain score
r-FLACC: Incorporates individual typical and atypical pain
behaviour
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- Background The quality of the r-FLACC can be assessed by the
COSMIN Checklist: The quality domain reliability is based on
internal consistency (Crohnbachs Alpha, Factoranalysis) and intra-
and inter rater reliability (Intra-Class Correlation) The quality
domain validity is based on content validity (core pain
behaviours), construct validity (expected change in pain) and
criterion validity (Pearsons Correlation Coefficient) The aim of
this study is to assess reliability and validity of the r-FLACC
pain score for use in Scandinavian children with CP.
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- Methods 27 children with CP undergoing orthopedic surgery 2 min
standardized video recording was made for r-FLACC scoring.
Parent-assessed Observational Visual Analog Scale (VAS-OBS) Two
nurses r-FLACC scored the recordings independently. Ten of the
recordings were reviewed again 1 year later.
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- Results Excellent internal consistency with Crohnbachs alpha:
0.93 / 0.98, Factoranalysis indicates unidimensionality Excellent
intra-rater reliability (ICC=0.98) and good inter-rater reliability
(ICC=0.75) Content validity was tested by the originators of the
r-FLACC Construct validity supported by an increase in r-FLACC
scores following surgery (p=0.0427) Criterion validity was
acceptable when comparing VAS-OBS and r- FLACC scores (Pearsons
Correlation Coefficient: 0.76 / 0.59)
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- Conclusion The r-FLACC have excellent reliability and validity
The translated version of the r-FLACC behavioural pain score is
valid for use in postoperative pain assessment in children with
CP