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|38208‑5||CO||A Pain Score made using the Numerical Rating Scale (NRS), where pain is assessed on a scale from 0 to 10.
|38208‑5||CO||A Pain Score made using the Numerical Rating Scale (NRS), where pain is assessed on a scale from 0 to 10.
|-
|38221‑8||CO||A Pain Score made using Wong-Baker Faces rating scale, usually used in pediatric settings, where the pain is assessed by relating the pain to a simple picture of a face in pain.
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|38214‑3||REAL||A Pain Score made usuing a visual analog scale, where pain is assessed on a scale from 0 to 10, but where the assessment is performed by selecting a position along the range, which allows for more refined measurement of pain.
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|}


===== <value xsi:type='CO|REAL' /> =====
===== <value xsi:type='CO|REAL' /> =====
The <value> element records the assessed pain score.  If using the NRS or Wong-Baker Faces rating scale, the pain is assessed using coded ordinal values that range from 0 to 10.  The use of the coded ordinal type is required because while pain assessments are ordered values, and can be compared, the differences between two pain assessment values cannot be compared, and so these values are not really numbers.  When using the visual analog pain scale, the value is a real number from 0 to 10.  The reason that this scale is numeric is that it measures a real physical quantity, which is the position that the patient indicates along a line.
The <value> element records the assessed pain score.  If using the NRS the pain is assessed using coded ordinal values that range from 0 to 10.  The use of the coded ordinal type is required because while pain assessments are ordered values, and can be compared, the differences between two pain assessment values cannot be compared, and so these values are not really numbers.


===== <interpretationCode code='301379001{{!}}40196000{{!}}76948002{{!}}67849003' codeSystem='2.16.840.1.113883.6.96' codeSystemName='SNOMED CT'/> =====
===== <interpretationCode code='301379001{{!}}40196000{{!}}76948002{{!}}67849003' codeSystem='2.16.840.1.113883.6.96' codeSystemName='SNOMED CT'/> =====

Revision as of 14:35, 30 May 2007

Development Only

The PCC Wiki Content is used only for development of IHE PCC Content. The Normative content of the PCC Technical Framework and the current supplements can be found at http://www.ihe.net/Technical_Framework/index.cfm#PCC

Pain Score Observation 1.3.6.1.4.1.19376.1.5.3.1.1.12.3.1

The pain score observation is a Simple Observation that records the patient's assessment of their pain on a scale from 0 to 10.


Parent Template

The parent of this template is Simple Observation.

Uses

See Templates using Pain Score Observation

Specification
Pain Score Observation Example 

<observation typeCode='OBS' moodCode='EVN'>
 <templateId root='1.3.6.1.4.1.19376.1.5.3.1.4.13'/>
 <templateId root=1.3.6.1.4.1.19376.1.5.3.1.4.13'/>
 <id root=' ' extension=' '/>
 <code code='38208‑5|38221‑8|38214‑3' codeSystem='2.16.840.1.113883.6.1' codeSystemName='LOINC'/>
 <text><reference value='#xxx'/></text>
 <statusCode code='completed'/>
 <effectiveTime value=' '/>
 <repeatNumber value=' '/>
 <value xsi:type='CO|REAL' />
 <interpretationCode code='301379001|40196000|76948002|67849003' codeSystem='2.16.840.1.113883.6.96' codeSystemName='SNOMED CT'/>
 <methodCode code=' ' codeSystem=' ' codeSystemName=' '/>
 <targetSiteCode code=' ' codeSystem=' ' codeSystemName=' '/>
</observation>


<templateId root='1.3.6.1.4.1.19376.1.5.3.1.4.13'/>

The <templateId> identifies this as a Pain Score Observation, and shall be present as shown above.

<code code='38208‑5|38221‑8|38214‑3' codeSystem='2.16.840.1.113883.6.1' codeSystemName='LOINC'/>

The <code> element indicates what kind of pain observation was made. It may be one of the three values shown above, corresponding to the pain score observations described in the table below.

Pain Score Codes
Code Data Type Description
38208‑5 CO A Pain Score made using the Numerical Rating Scale (NRS), where pain is assessed on a scale from 0 to 10.
<value xsi:type='CO|REAL' />

The <value> element records the assessed pain score. If using the NRS the pain is assessed using coded ordinal values that range from 0 to 10. The use of the coded ordinal type is required because while pain assessments are ordered values, and can be compared, the differences between two pain assessment values cannot be compared, and so these values are not really numbers.

<interpretationCode code='301379001|40196000|76948002|67849003' codeSystem='2.16.840.1.113883.6.96' codeSystemName='SNOMED CT'/>

The <interpretationCode> element should be present, and provides an interpretation of the pain scale assessment using SNOMED CT.

Pain Score Interpretation Codes
Pain Score Range Code Description
0 301379001 No Present Pain
2-4 40196000 Mild Pain
6-8 76948002 Severe Pain
10 67849003 Excruciating Pain

See also SNOMED Pain Numerical Rating Scale Mapping

Note: This mapping was funded by The Office of the Assistant to the Secretary for Planning and Evaluation within the US Department of Health and Human Services.


For Public Comment The mapping provided does not cover all possible pain scale scores using a single SNOMED code, which is required by the CE data type. What should be done about that? Should additional SNOMED CT concepts be requested to fill the gaps? Should the mapping be improved? In what way?


<methodCode code=' ' codeSystem=' ' codeSystemName=' '/>

The <methodCode> should not be present in a Pain Score Observation, as the method is implied by the <code> element.

<targetSiteCode code=' ' codeSystem=' ' codeSystemName=' '/>

The <targetSiteCode> element should be present, and shall indicate the location of the pain being assessed.

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