Based on available evidence , the NRS-11 , FPS-R , and CAS were strongly recommended for self-report of acute pain .
Only weak recommendations could be made for self-report measures for postoperative and chronic pain .
No measures were recommended for children younger than 6 years , identifying a need for further measurement refinement in this age range .
Abstract In 2006 , PAIN published a systematic review of the measurement properties of self-report pain intensity measures  in children and adolescents ( Stinson JN , Kavanagh T , Yamada J , Gill N , Stevens B. Systematic review of the psychometric properties , interpretability and feasibility of self-report pain intensity measures for use in clinical trials in children and adolescents .
Key developments in pediatric pain necessitate an up date of this work , most notably growing use of the 11-point numeric rating scale ( NRS-11 ) .
Our aim was to review the measurement properties of single-item self-report pain intensity measures in children 3 to 18 years old .
A secondary aim was to develop evidence -based recommendations for measurement of child and adolescent self-report of acute , postoperative , and chronic pain .
Do 0–10 Numeric Rating Scores Translate into Clinically Meaningful Pain Measures for Children?
BACKGROUND : Self-reported pain scores are used widely in clinical and research setting s , yet little is known about their interpretability in children . In this prospect i ve , observational study we evaluated the relationship between 0 to 10 numerical rating scale ( NRS ) pain scores and other self-reported , clinical ly meaningful outcomes , including perceived need for medicine ( PNM ) , pain relief ( PR ) , and perceived satisfaction ( PS ) with treatment in children postoperatively . METHODS : This study included children ages 7 to 16 years undergoing surgery associated with postoperative pain . One to 4 observations were recorded in each child within the first 24 hours postoperatively . At each assessment , children rated their pain with the NRS , stated their PNM , and rated their satisfaction with  pain management .  Assessment s were repeated within 1 to 2 hours , and children additionally rated their PR as the same , better , or worse in comparison with the earlier assessment . Receiver operator characteristic curves were developed to examine potential NRS cut-points for PNM and PS , and the minimum clinical ly significant difference ( MCSD ) in pain score associated with PR was calculated . RESULTS : Three hundred ninety-seven observations ( including 189 pairs ) were recorded in 113 children .  NRS scores associated with PNM were significantly higher than “ no need ” ( median 6 vs. 3 ; P < 0.001 ) . NRS scores > 4 had good sensitivity ( 0.81 ) and specificity ( 0.70 ) to discriminate PNM , but with a large number of false positives and negatives ( e.g. , 42 % of children with scores > 4 did not need analgesia ) . The MCSD in NRS scores was −1 ( 95 % confidence interval [ CI ] −0.5 to 1 ) or + 1 ( CI 0.5 to 2.7 ) in relation to feel “ a little better ” or “ worse , ” respectively ( P < 0.001 vs. the same ) . NRS scores > 6 had a sensitivity of 0.82 and specificity of 0.76 in discriminating dissatisfaction with treatment , yet 46 % and 24 % of children with scores > 6 , respectively , were somewhat to very satisfied with their analgesia . CONCLUSIONS : This study provides important information regarding the clinical interpretation of NRS pain scores in children . Data further support the NRS as a valid measure of pain intensity in relation to the child 's PNM , PR , and PS in the acute postoperative setting . However , the variability in scores in relation to other clinical ly meaningful outcomes suggests that application of cut-points for individual treatment decisions is inappropriate
Based on available evidence , the NRS-11 , FPS-R , and CAS were strongly recommended for self-report of acute pain .
Only weak recommendations could be made for self-report measures for postoperative and chronic pain .
No measures were recommended for children younger than 6 years , identifying a need for further measurement refinement in this age range .
Abstract In 2006 , PAIN published a systematic review of the measurement properties of self-report pain intensity measures  in children and adolescents ( Stinson JN , Kavanagh T , Yamada J , Gill N , Stevens B. Systematic review of the psychometric properties , interpretability and feasibility of self-report pain intensity measures for use in clinical trials in children and adolescents .
Key developments in pediatric pain necessitate an up date of this work , most notably growing use of the 11-point numeric rating scale ( NRS-11 ) .
Our aim was to review the measurement properties of single-item self-report pain intensity measures in children 3 to 18 years old .
A secondary aim was to develop evidence -based recommendations for measurement of child and adolescent self-report of acute , postoperative , and chronic pain .