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creating a better ruler

Measurement is a foundation of much of what we do in the PIRL. We have considerable expertise in measurement science, from Classical Test Theory (CTT) - based approaches to newer Rasch and Item Response Theory (IRT) approaches that we use to both improve upon existing clinical measurement tools (self-report or observational) and build new ones. More recently we have started adopting more qualitative methods and employed critical measurement theory to really get at questions like: what are we measuring when we measure what we think we’re measuring? These are non-equivocal questions - when a study reports no significant effect of a new intervention or no association between a clinical sign/symptom such as imaging and a clinical outcome, most assume the problem is with the intervention or the diagnostic test, but we believe it is just as likely that the problem is with the clinical outcome. As quantitative research is dependent upon sound measurement, we see this as perhaps our most important contributions to the field of pain science.

Established tools that we have explored and either refined or reconceptualized have included the Neck Disability Index, the Pain Catastrophizing Scale (including a forthcoming 4-item brief version), the Tampa Scale for Kinesiophobia, the Brief Pain Inventory, the Brief Illness Perceptions Questionnaire, the Numeric Pain Rating Scale, Pressure Pain Detection Threshold, Conditioned Pain Modulation (forthcoming), a new computer-aided approach to quantifying intervertebral disc shape in the lumbar spine (forthcoming), and several others.

Tools that we have developed using novel methods to fill what we see as important gaps are, to date, the Traumatic Injuries Distress Scale, the MultiDimensional Symptom Index, and the Satisfaction and Recovery Index. Additional scales are forthcoming, including a new Gender, Pain, and Expectations Scale and a Post-Traumatic Resilience and Optimism Scale, the latter intended to flip the traditional practice in the pain field of measuring what’s wrong with the way people think about pain, and instead ask what’s right about it, and how we can build on existing strengths. More information on many of these tools can be found on the Clinician Resources section of this site, or can be obtained by contacting Dave Walton at dwalton5@uwo.ca.

Measurement is a powerful tool for change - resources are usually only dedicated to those things that are being measured - and at the PIRL we take this very seriously.