• Boaz Gedaliahu Samolsky Dekel, Alberto Gori, Alessio Vasarri, Maria Cristina Sorella, Gianfranco Di Nino, and Rita Maria Melotti.
• University of Bologna, Department of Medicine and Surgery Sciences, Via Massarenti 9, 40138 Bologna, Italy; Azienda Ospedaliera-Universitaria di Bologna Policlinico S. Orsola-Malpighi, Via Massarenti 9, 40138 Bologna, Italy; University of Bologna, Post-Graduate School of Anaesthesia and Intensive Care, Via Massarenti 9, 40138 Bologna, Italy.
• Pain Res Manag. 2016 Jan 1; 2016: 9267536.

AbstractBiased pain evaluation due to automated heuristics driven by symptom uncertainty may undermine pain treatment; medical evidence moderators are thought to play a role in such circumstances. We explored, in this cross-sectional survey, the effect of such moderators (e.g., nurse awareness of patients' pain experience and treatment) on the agreement between n = 862 inpatients' self-reported pain and n = 115 nurses' pain ratings using a numerical rating scale. We assessed the mean of absolute difference, agreement (κ-statistics), and correlation (Spearman rank) of inpatients and nurses' pain ratings and analyzed congruence categories' (CCs: underestimation, congruence, and overestimation) proportions and dependence upon pain categories for each medical evidence moderator (χ (2) analysis). Pain ratings agreement and correlation were limited; the CCs proportions were further modulated by the studied moderators. Medical evidence promoted in nurses overestimation of low and underestimation of high inpatients' self-reported pain. Knowledge of the negative influence of automated heuristics driven by symptoms uncertainty and medical-evidence moderators on pain evaluation may render pain assessment more accurate.

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