Trial Search Results

Effective Screening for Pain Study

In light of the importance of pain and widespread interest in patient-centeredness, the Department of Veterans Affairs (VA) has been emphasizing and successfully making pain and its management a routine feature of the health record and a focus of care. Awareness of pain and efforts to improve pain management rest on the VA's '5th Vital Sign' - a policy and practice of nursing staff routinely screening for 'pain now' at every health encounter using a 0-10 Numeric Rating Scale (NRS).

The team's previous research on VA's '5th Vital Sign' informs the specific design of this Effective Screening for Pain (ESP) study as well as the proposed research products.

Alternatives to the current pain screening approach may improve the sensitivity and specificity of screening for chronic pain. These alternatives include the nurse administered NRS with a one week look back period and a three item scale (PEG) incorporating intensity and emotional and physical interference. The PEG is very similar to the gold standard Brief Pain Inventory (BPI) from which it is derived, in its sensitivity, specificity, and sensitivity to change in detecting clinically important, functionally impairing pain.

The investigators plan to evaluate alternatives to the VA's current '5th Vital Sign' for pain screening, focusing on simple, feasible measures that can be used cross-sectionally for pain screening. In the setting of a primary care clinic, the investigators plan to cross-sectionally evaluate three arms - a tablet based DVPRS, a tablet computer-based NRS one week, and a tablet computer-based PEG. All arms will be compared with the nurse administered NRS.

Stanford is currently not accepting patients for this trial.

Lead Sponsor:

VA Office of Research and Development

Stanford Investigator(s):


  • Behavioral: NRS pain one week
  • Behavioral: PEG
  • Behavioral: DVPRS




Inclusion Criteria:

   - All Veterans are eligible to participate in the clinical trial when presenting for
   routine care in the primary care clinic at all sites (VA at Palo Alto, Minneapolis,
   and Portland).

   - All are eligible who do not opt out of participation.

   - All participants in the baseline tablet intervention will also be eligible for a one
   week follow up telephone interview - unless they are unable to complete a phone
   interview (see exclusions).

   - For the qualitative Veteran component, all Veterans who can hear and respond in an
   interview are eligible.

   - Providers/staff must be clinic and facility staff including administrative clerks,
   regular part time or full time employees in primary care who routinely participate in
   the care of Veterans who have painful conditions.

Exclusion Criteria:

   - Veterans who meet either of the following exclusion criteria that may interfere with
   outcome assessment will be ineligible for the follow up telephone interview:

      - a) no working telephone (home, office, or mobile)

      - b) hearing impaired and unable to complete a phone survey

Ages Eligible for Study

18 Years - N/A

Genders Eligible for Study


Not currently accepting new patients for this trial

Contact Information

Stanford University
School of Medicine
300 Pasteur Drive
Stanford, CA 94305
Karl A Lorenz, MD MSHS
650-493-5000 Ext. 22173
Not Recruiting