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Table 2 Key elements of the proposed PAIC tool and toolkit

From: An international road map to improve pain assessment in people with impaired cognition: the development of the Pain Assessment in Impaired Cognition (PAIC) meta-tool

Theme

Required element

Process

• Makes use of the best items from existing instruments, developing a meta-tool with a pool of useful items

• To provide a toolkit, not a single tool, out of which instruments can be created for different contexts of application (type of cognitive impairment, setting etc.)

• Provide potential to create specific tools (or additional scales) for specific pain associated conditions (such as oral-facial pain, back pain, neuropathic pain)

• Includes a guideline-and web-based, multilingual application

• Instruments for use in both clinical practice and research

• Creation and validation of instruments follows a predefined process, following the COSMIN* criteria.

Quality

• Practicable and feasible in different settings (home care, long term care, palliative care and acute hospital care) and different countries (with first the focus on the Western world)

• Sound psychometric properties, i.e. a reliable and valid instrument

• Sensitive to change, i.e. identify new pain and detect changes after successful intervention, for instance with pain medication

• Feasible and valid in several important groups of people with cognitive impairment, such as dementias, coma/pvs and people with a mental handicap or learning disability.

  1. *COSMIN: COnsensus-based Standards for the selection of health Measurement [18].