Utility of multidimensional pain assessment tools in surgical cohorts: A systematic review protocol

Aim: To identify and synthesise evidence on the measurement properties and clinical utility of multidimensional patient reported pain assessment instruments used in adults during acute postoperative recovery following general surgery.Background: Postoperative pain assessment commonly relies on unidimensional measures of pain intensity, which may inadequately capture movement-evoked pain and pain-related functional interference during recovery. Multidimensional instruments assess pain alongside broader dimensions of the pain experience, yet many were developed for chronic pain populations and evidence supporting their measurement properties and clinical utility in acute postoperative surgical settings remains unclear.Design/Methods: A systematic review of outcome measurement instruments will be conducted using established methodology for systematic reviews of measurement properties and reported in accordance with PRISMA-COSMIN for Outcome Measurement Instruments. MEDLINE, CINAHL, PsycINFO, Embase, and CENTRAL will be searched for English-language studies published between November 2015 and September 2026. Two independent reviewers will screen studies, extract data and assess methodological quality using the COSMIN Risk of Bias checklist, applying the relevant domain according to the measurement property being investigated. Results for each measurement property will be evaluated using COSMIN criteria for good measurement properties, and certainty of evidence assessed using a modified GRADE approach. Clinical utility, including feasibility, acceptability, and interpretability relevant to acute postoperative practice will be synthesised separately.Discussion: This review will establish the strength and certainty of evidence supporting the measurement properties of multidimensional patient reported pain assessment instruments acute postoperative care, and determine what is known about their clinical utility. Identifying instruments that capture clinically important aspects of postoperative pain, while considering their feasibility and acceptability in acute surgical settings, should reveal instruments with the strongest potential for further evaluation and translation into postoperative practice.