Patient-centeredness and psychometric properties of the Defense and Veterans Pain Rating Scale 2.0 (DVPRS)

Ryan C Costantino; Laura E Gressler; Krista B Highland; Elisabeth M Oehrlein; Ester Villalonga-Olives; Eleanor M Perfetto

doi:10.1093/pm/pnad125

Patient-centeredness and psychometric properties of the Defense and Veterans Pain Rating Scale 2.0 (DVPRS)

Pain Med. 2024 Jan 4;25(1):57-62. doi: 10.1093/pm/pnad125.

Authors

Ryan C Costantino^{1

2}, Laura E Gressler³, Krista B Highland^{4

5

6}, Elisabeth M Oehrlein⁷, Ester Villalonga-Olives², Eleanor M Perfetto²

Affiliations

¹ Enterprise Intelligence and Data Solutions Program Management Office, Program Executive Office, Defense Healthcare Management Systems, Rosslyn, VA 22209, United States.
² Department of Practice, Sciences, and Health Outcomes Research, University of Maryland School of Pharmacy, Baltimore, MD 21201, United States.
³ Division of Pharmaceutical Evaluation and Policy, College of Pharmacy, University of Arkansas for Medical Sciences, Little Rock, AR 72205, United States.
⁴ Department of Military and Emergency Medicine, Uniformed Services University, Bethesda, MD 20814, United States.
⁵ Department of Anesthesiology, Uniformed Services University, Bethesda, MD 20814, United States.
⁶ Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc, Bethesda, MD 20817, United States.
⁷ Applied Patient Engagement, Washington, DC 20007, United States.

PMID: 37699011
DOI: 10.1093/pm/pnad125

Abstract

Objective: This study aims to assess the patient-centeredness and psychometric properties of the Defense and Veterans Pain Rating Scale 2.0 (DVPRS) as a patient-reported outcome measure (PROM) for pain assessment in a military population.

Design: A critical evaluation of the DVPRS was conducted, considering its fit-for-purpose as a PROM and its patient-centeredness using the National Health Council's Rubric to Capture the Patient Voice.

Setting: The study focused on the use of the DVPRS within the Department of Defense (DoD) and Veterans Health Administration (VA) healthcare settings.

Subjects: The DVPRS was evaluated based on published studies and information provided by measure developers. The assessment included content validity, reliability, construct validity, and ability to detect change. Patient-centeredness and patient engagement were assessed across multiple domains.

Methods: Two independent reviewers assessed the DVPRS using a tool/checklist/questionnaire, and any rating discrepancies were resolved through consensus. The assessment included an evaluation of psychometric properties and patient-centeredness based on established criteria.

Results: The DVPRS lacked sufficient evidence of content validity, with no patient involvement in its development. Construct validity was not assessed adequately, and confirmatory factor analysis was not performed. Patient-centeredness and patient engagement were also limited, with only a few domains showing meaningful evidence of patient partnership.

Conclusions: The DVPRS as a PROM for pain assessment in the military population falls short in terms of content validity, construct validity, and patient-centeredness. It requires further development and validation, including meaningful patient engagement, to meet current standards and best practices for PROMs.

Keywords: Veterans; defense; military; pain; pain rating scale; patient reported outcome measure.

MeSH terms

Humans
Pain
Pain Measurement
Patient Participation
Patient Reported Outcome Measures
Psychometrics
Reproducibility of Results
Veterans*