Development and testing of a computerized pain body map in patients with advanced cancer.
CONTEXT
Pain localization is an important part of pain assessment. Development of pain tools for self-report should include expert and patient input, and patient testing in large samples.


OBJECTIVES
To develop a computerized pain body map (CPBM) for use in patients with advanced cancer.


METHODS
Three studies were conducted: 1) an international expert survey and a pilot study guiding the contents and layout of the CPBM, 2) clinical testing in an international symptom assessment study in eight countries and 17 centers (N = 533), and 3) comparing patient pain markings on computer and paper body maps (N = 92).


RESULTS
Study 1: 22 pain experts and 28 patients participated. A CPBM with anterior and posterior whole body views was developed for marking pain locations, supplemented by pain intensity ratings for each location. Study 2: 533 patients (286 male, 247 female, mean age 62 years) participated; 80% received pain medication and 81% had metastatic disease. Eighty-five percent completed CPBM as intended. Mean ± SD number of marked pain locations was 1.8 ± 1.2. Aberrant markings (15%) were mostly related to software problems. No differences were found regarding age, gender, cognitive/physical performance, or previous computer experience. Study 3: 70% of the patients had identical markings on the computer and paper maps. Only four patients had completely different markings on the two maps.


CONCLUSION
This first version of CPBM was well accepted by patients with advanced cancer. However, several areas for improvement were revealed, providing a basis for the development of the next version, which is subject to further international testing.