Background: Acute and chronic pain affects millions of adults yet it is often inadequately assessed and treated.
Purpose: The purpose of the present meta-analysis was to examine the overall level of pain assessment accuracy among caregivers and providers and identify patient, observer, and assessment level factors that moderate pain assessment accuracy.
Methods: A systematic literature search was conducted in PubMed and PsycINFO to identify studies addressing providers' pain assessment accuracy, or studies that compared patients' self-report of pain with observers' (healthcare providers, caregivers, and strangers) assessment of pain. We present two separate meta-analyses examining the overall effect of under-/overestimation of pain and correlational pain assessment accuracy.
Results: Seventy-six articles meeting inclusion criteria yielded 94 independent effect sizes for the correlational accuracy meta-analysis. Ninety articles yielded 103 independent effect sizes for the paired comparison meta-analysis. The correlational pain assessment meta-analysis showed that in general, observers were significantly better than chance when assessing pain; however, the paired comparison meta-analysis showed that observers significantly underestimated patients' pain. Patient's age and gender, pain type, and provider type moderated these effects.
Conclusions: Results suggest that certain healthcare providers and caregivers need training to more accurately assess patient pain and that there are particular groups of patients who may be at a greater risk for having their pain inaccurately assessed.