Psychometric Evaluation of the Electronic Pain Assessment Tool: An Innovative Instrument for Individuals with Moderate-to-Severe Dementia

Dement Geriatr Cogn Disord. 2017;44(5-6):256-267. doi: 10.1159/000485377. Epub 2018 Jan 23.


Background/aims: Pain is common in aged care residents with dementia; yet it often goes undetected. A novel tool, the electronic Pain Assessment Tool (ePAT), was developed to address this challenging problem. We investigated the psychometric properties of the ePAT.

Methods: In a 10-week prospective observational study, the ePAT was evaluated by comparison against the Abbey Pain Scale (APS). Pain assessments were blindly co-performed by the ePAT rater against the nursing staff of two residential aged care facilities. The residents were assessed twice by each rater: at rest and following movement.

Results: The study involved 34 residents aged 85.5 ± 6.3 years, predominantly with severe dementia (Psychogeriatric Assessment Scale - Cognitive Impairment score = 19.7 ± 2.5). Four hundred paired assessments (n = 204 during rest; n = 196 following movement) were performed. Concurrent validity (r = 0.911) and all reliability measures (κw = 0.857; intraclass correlation coefficient = 0.904; α = 0.950) were excellent, while discriminant validity and predictive validity were good.

Conclusion: The ePAT is a suitable tool for the assessment of pain in this vulnerable population.

Keywords: Application; Automated facial analysis; Automated facial recognition; Dementia; Electronic Pain Assessment Tool; Facial action units; Observational pain scales; Pain; Psychometric properties; Reliability; Validity.

Publication types

  • Observational Study
  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cognition
  • Dementia / complications
  • Dementia / psychology*
  • Female
  • Homes for the Aged
  • Humans
  • Male
  • Neuropsychological Tests*
  • Observer Variation
  • Pain Measurement / methods*
  • Predictive Value of Tests
  • Prospective Studies
  • Psychometrics*
  • Reproducibility of Results