Systematic review on the measurement properties of acute postoperative pain assessment tools

Accurate pain assessment is essential for postoperative recovery and prevention of complications. However, few studies have evaluated the measurement properties of acute pain assessment tools specifically for adult patients. This study aimed to systematically assess the measurement properties of the tools used to evaluate acute postoperative pain in adults (aged ≥18 years).

A systematic literature search was conducted across eight electronic databases following the Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines. Studies were included if they assessed the development of or at least one measurement property of acute postoperative pain assessment tools. The COnsensus-based Standards for the selection of health Measurement INstruments for systematic reviews was used to evaluate the study quality, synthesize findings, and determine the applicability of each tool.

From the 20 included studies, 17 pain assessment tools were extracted, including 12 behavioral observation measures and 5 behavioral and physiological indicators. A notable limitation across the studies was the insufficient reporting of measurement properties, particularly in terms of content validity, structural validity, and reliability.

This review identified the Acute Pain Assessment 5, Critical-Care Pain Observation Tool, and Multidimensional Objective Pain Assessment Tool as promising for assessing acute postoperative pain, though their limitations must be considered. Future studies should focus on evaluating underreported measurement properties to strengthen the evidence supporting these tools. Additionally, a high risk of bias was observed in many studies, further highlighting the need for rigorous psychometric evaluations to improve the reliability and validity of acute pain assessment methods.