1.3.6.1.4.1.19376.1.5.3.1.1.12.3.1

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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.
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.
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.

<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.

<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.