Development of and psychometric testing for the Brief Pain Inventory-Facial in patients with facial pain syndromes: Clinical article

John Y.K. Lee, H. Isaac Chen, Christopher Urban, Anahita Hojat, Ephraim Church, Sharon X. Xie, John T. Farrar

Research output: Contribution to journalArticle

43 Citations (Scopus)

Abstract

Object. Outcomes in clinical trials on trigeminal pain therapies require instruments with demonstrated reliability and validity. The authors evaluated the Brief Pain Inventory (BPI) in its existing form plus an additional 7 facial-specific items in patients referred to a single neurosurgeon for a diagnosis of facial pain. The complete 18-item instrument is referred to as the BPI-Facial. Methods. This study was a cross-sectional analysis of patients who completed the BPI-Facial. The diagnosis of classic versus atypical trigeminal neuralgia (TN) was made before analyzing the questionnaire results. A hypothesis-driven factor analysis was used to determine the principal components of the questionnaire. Item reliability and questionnaire validity were tested for these specific constructs. Results. Data from 156 patients were analyzed, including 114 patients (73%) with classic and 42 (27%) with atypical TN. Using orthomax rotation factor analysis, 3 factors with an eigenvalue > 1.0 were identified - pain intensity, interference with general activities, and facial-specific pain interference - accounting for 97.6% of the observed item variance. Retention of the 3 factors was confirmed via a Cattell scree plot. Internal reliability was demonstrated by calculating Cronbach's α: 0.86 for pain intensity, 0.89 for interference with general activities, 0.95 for facial-specific pain interference, and 0.94 for the entire instrument. Initial validity of the BPI-Facial instrument was supported by the detection of statistically significant differences between patients with classic versus atypical pain. Patients with atypical TN rated their facial pain as more intense (atypical 6.24 vs classic 5.03, p = 0.013) and as having greater interference in general activities (atypical 6.94 vs classic 5.43, p = 0.0033). Both groups expressed high levels of facial-specific pain interference (atypical 6.34 vs classic 5.95, p = 0.527). Conclusions. The BPI-Facial is a rigorous measure of facial pain in patients with TN and appears to have sound psychometric properties and is responsive to differences between classic and atypical TN. Future studies must assess the instrument's test-retest reliability, validity in additional populations, and responsiveness with respect to changes in patient outcomes following neurosurgical interventions and medical therapies.

Original languageEnglish (US)
Pages (from-to)516-523
Number of pages8
JournalJournal of neurosurgery
Volume113
Issue number3
DOIs
StatePublished - Sep 1 2010

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Facial Neuralgia
Facial Pain
Psychometrics
Equipment and Supplies
Trigeminal Neuralgia
Neuralgia
Reproducibility of Results
Pain
Statistical Factor Analysis

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology

Cite this

Lee, John Y.K. ; Chen, H. Isaac ; Urban, Christopher ; Hojat, Anahita ; Church, Ephraim ; Xie, Sharon X. ; Farrar, John T. / Development of and psychometric testing for the Brief Pain Inventory-Facial in patients with facial pain syndromes : Clinical article. In: Journal of neurosurgery. 2010 ; Vol. 113, No. 3. pp. 516-523.
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title = "Development of and psychometric testing for the Brief Pain Inventory-Facial in patients with facial pain syndromes: Clinical article",
abstract = "Object. Outcomes in clinical trials on trigeminal pain therapies require instruments with demonstrated reliability and validity. The authors evaluated the Brief Pain Inventory (BPI) in its existing form plus an additional 7 facial-specific items in patients referred to a single neurosurgeon for a diagnosis of facial pain. The complete 18-item instrument is referred to as the BPI-Facial. Methods. This study was a cross-sectional analysis of patients who completed the BPI-Facial. The diagnosis of classic versus atypical trigeminal neuralgia (TN) was made before analyzing the questionnaire results. A hypothesis-driven factor analysis was used to determine the principal components of the questionnaire. Item reliability and questionnaire validity were tested for these specific constructs. Results. Data from 156 patients were analyzed, including 114 patients (73{\%}) with classic and 42 (27{\%}) with atypical TN. Using orthomax rotation factor analysis, 3 factors with an eigenvalue > 1.0 were identified - pain intensity, interference with general activities, and facial-specific pain interference - accounting for 97.6{\%} of the observed item variance. Retention of the 3 factors was confirmed via a Cattell scree plot. Internal reliability was demonstrated by calculating Cronbach's α: 0.86 for pain intensity, 0.89 for interference with general activities, 0.95 for facial-specific pain interference, and 0.94 for the entire instrument. Initial validity of the BPI-Facial instrument was supported by the detection of statistically significant differences between patients with classic versus atypical pain. Patients with atypical TN rated their facial pain as more intense (atypical 6.24 vs classic 5.03, p = 0.013) and as having greater interference in general activities (atypical 6.94 vs classic 5.43, p = 0.0033). Both groups expressed high levels of facial-specific pain interference (atypical 6.34 vs classic 5.95, p = 0.527). Conclusions. The BPI-Facial is a rigorous measure of facial pain in patients with TN and appears to have sound psychometric properties and is responsive to differences between classic and atypical TN. Future studies must assess the instrument's test-retest reliability, validity in additional populations, and responsiveness with respect to changes in patient outcomes following neurosurgical interventions and medical therapies.",
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Development of and psychometric testing for the Brief Pain Inventory-Facial in patients with facial pain syndromes : Clinical article. / Lee, John Y.K.; Chen, H. Isaac; Urban, Christopher; Hojat, Anahita; Church, Ephraim; Xie, Sharon X.; Farrar, John T.

In: Journal of neurosurgery, Vol. 113, No. 3, 01.09.2010, p. 516-523.

Research output: Contribution to journalArticle

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T1 - Development of and psychometric testing for the Brief Pain Inventory-Facial in patients with facial pain syndromes

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AU - Lee, John Y.K.

AU - Chen, H. Isaac

AU - Urban, Christopher

AU - Hojat, Anahita

AU - Church, Ephraim

AU - Xie, Sharon X.

AU - Farrar, John T.

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N2 - Object. Outcomes in clinical trials on trigeminal pain therapies require instruments with demonstrated reliability and validity. The authors evaluated the Brief Pain Inventory (BPI) in its existing form plus an additional 7 facial-specific items in patients referred to a single neurosurgeon for a diagnosis of facial pain. The complete 18-item instrument is referred to as the BPI-Facial. Methods. This study was a cross-sectional analysis of patients who completed the BPI-Facial. The diagnosis of classic versus atypical trigeminal neuralgia (TN) was made before analyzing the questionnaire results. A hypothesis-driven factor analysis was used to determine the principal components of the questionnaire. Item reliability and questionnaire validity were tested for these specific constructs. Results. Data from 156 patients were analyzed, including 114 patients (73%) with classic and 42 (27%) with atypical TN. Using orthomax rotation factor analysis, 3 factors with an eigenvalue > 1.0 were identified - pain intensity, interference with general activities, and facial-specific pain interference - accounting for 97.6% of the observed item variance. Retention of the 3 factors was confirmed via a Cattell scree plot. Internal reliability was demonstrated by calculating Cronbach's α: 0.86 for pain intensity, 0.89 for interference with general activities, 0.95 for facial-specific pain interference, and 0.94 for the entire instrument. Initial validity of the BPI-Facial instrument was supported by the detection of statistically significant differences between patients with classic versus atypical pain. Patients with atypical TN rated their facial pain as more intense (atypical 6.24 vs classic 5.03, p = 0.013) and as having greater interference in general activities (atypical 6.94 vs classic 5.43, p = 0.0033). Both groups expressed high levels of facial-specific pain interference (atypical 6.34 vs classic 5.95, p = 0.527). Conclusions. The BPI-Facial is a rigorous measure of facial pain in patients with TN and appears to have sound psychometric properties and is responsive to differences between classic and atypical TN. Future studies must assess the instrument's test-retest reliability, validity in additional populations, and responsiveness with respect to changes in patient outcomes following neurosurgical interventions and medical therapies.

AB - Object. Outcomes in clinical trials on trigeminal pain therapies require instruments with demonstrated reliability and validity. The authors evaluated the Brief Pain Inventory (BPI) in its existing form plus an additional 7 facial-specific items in patients referred to a single neurosurgeon for a diagnosis of facial pain. The complete 18-item instrument is referred to as the BPI-Facial. Methods. This study was a cross-sectional analysis of patients who completed the BPI-Facial. The diagnosis of classic versus atypical trigeminal neuralgia (TN) was made before analyzing the questionnaire results. A hypothesis-driven factor analysis was used to determine the principal components of the questionnaire. Item reliability and questionnaire validity were tested for these specific constructs. Results. Data from 156 patients were analyzed, including 114 patients (73%) with classic and 42 (27%) with atypical TN. Using orthomax rotation factor analysis, 3 factors with an eigenvalue > 1.0 were identified - pain intensity, interference with general activities, and facial-specific pain interference - accounting for 97.6% of the observed item variance. Retention of the 3 factors was confirmed via a Cattell scree plot. Internal reliability was demonstrated by calculating Cronbach's α: 0.86 for pain intensity, 0.89 for interference with general activities, 0.95 for facial-specific pain interference, and 0.94 for the entire instrument. Initial validity of the BPI-Facial instrument was supported by the detection of statistically significant differences between patients with classic versus atypical pain. Patients with atypical TN rated their facial pain as more intense (atypical 6.24 vs classic 5.03, p = 0.013) and as having greater interference in general activities (atypical 6.94 vs classic 5.43, p = 0.0033). Both groups expressed high levels of facial-specific pain interference (atypical 6.34 vs classic 5.95, p = 0.527). Conclusions. The BPI-Facial is a rigorous measure of facial pain in patients with TN and appears to have sound psychometric properties and is responsive to differences between classic and atypical TN. Future studies must assess the instrument's test-retest reliability, validity in additional populations, and responsiveness with respect to changes in patient outcomes following neurosurgical interventions and medical therapies.

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