All 4 faces pain scales were found to be adequately supported by psychometric data .
When given a choice between faces scales , children preferred the WBFPRS .
Confounding of pain intensity with affect caused by use of smiling and crying anchor faces is a disadvantage of the WBFPRS .
: For clinical use , we found no grounds to switch from 1 faces scale to another when 1 of the scales is in use .
CONTEXT : Numerous faces scales have been developed for the measurement of  pain intensity in children .
It remains unclear whether any one of the faces scales is better for a particular purpose with regard to validity , reliability , feasibility , and preference .
OBJECTIVES : To summarize and systematic ally review faces pain scales most commonly used to obtain self-report of pain intensity in children for evaluation of reliability and validity and to compare the scales for preference and utility .
Validation of 2 pain scales for use in the pediatric emergency department.
OBJECTIVE To determine the construct , content , and convergent validity of 2 self-report pain scales for use in the untrained child in the emergency department ( ED ) . METHODS A prospect i ve study was conducted of all children who presented to an urban ED between 5 and 16 years of age inclusive after written informed consent was obtained . Children were excluded if they were intoxicated , had altered sensorium , were clinical ly unstable , did not speak English , or had developmental delays . Children marked their current pain severity on a st and ardized Color Analog Scale ( CAS ) and a 7-point Faces Pain Scale ( FPS ) . They were then asked whether their pain was mild , moderate , or severe . Children were then administered an analgesic at the discretion of the attending physician and asked to repeat these measurements . For assessing content validity , the scales were also administered to age- and gender-matched children in the ED for nonpainful conditions . Convergent validity was assessed by determining the Spearman correlation coefficient between the 2 pain scales . RESULTS A total of 60 children were enrolled , 30 with pain and 30 without , with a mean age of 9.3 + /- 3.3 years . Boys accounted for 38 of the enrollees ( 63.3 % ) . The median score before analgesic administration was 6.0 cm ( interquartile range [ IQR ] : 4.0 - 8.0 ) on the CAS and 3.0 faces ( IQR : 2.0 - 5.0 ) on the FPS ; after analgesic administration , the median scores decreased to 3.1 cm ( IQR : 1.1 - 4.3 ) and 2.0 faces ( IQR : 1.0 - 3.0 ) , respectively . As the reported pain intensity increased , so did the scores on the 2 pain scales . The 30 children with no pain had a median score on the CAS of 0.0 ( IQR : 0.0 - 1.0 ) and on the FPS of 0.0 ( IQR : 0.0 - 1.0 ) , whereas the 13 children with severe pain had a median CAS of 7.0 ( IQR : 6.0 - 8.0 ) and a median FPS of 5.0 ( IQR : 4.0 - 6.0 ) . The Spearman correlation coefficient between the CAS and the FPS was positive and strong ( r = 0.894 ) . CONCLUSION The CAS and the FPS exhibit construct , content , and convergent validity in the measurement of acute pain in children in the ED
All 4 faces pain scales were found to be adequately supported by psychometric data .
When given a choice between faces scales , children preferred the WBFPRS .
Confounding of pain intensity with affect caused by use of smiling and crying anchor faces is a disadvantage of the WBFPRS .
: For clinical use , we found no grounds to switch from 1 faces scale to another when 1 of the scales is in use .
CONTEXT : Numerous faces scales have been developed for the measurement of  pain intensity in children .
It remains unclear whether any one of the faces scales is better for a particular purpose with regard to validity , reliability , feasibility , and preference .
OBJECTIVES : To summarize and systematic ally review faces pain scales most commonly used to obtain self-report of pain intensity in children for evaluation of reliability and validity and to compare the scales for preference and utility .