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Table 3 Differences between observed pain responses and imputed pain responses among nursing home residents with moderate or severe cognitive impairment (n = 770,139)

From: Multiple imputation to quantify misclassification in observational studies of the cognitively impaired: an application for pain assessment in nursing home residents

Pain

Moderate Cognitive Impairment

Severe Cognitive Impairment

n

∆ (95% Confidence Interval (CI))

N

∆ (95% CI)

Any Pain

 Staff-Assessed

33,967

-7.2 (-8.3 to -6.0)

72,231

-7.2 (-8.0 to -6.3)

 Resident-reported

397,072

-4.5 (-5.4 to -3.6)

271,192

-10.2 (-10.9 to -9.4)

Resident-reported pain detailsa

 Pain Frequency

394,128

 

265,555

 

  No pain

 

4.8 (3.9 to 5.6)

 

11.0 (10.2 to 11.7)

  Rarely

 

-2.0 (-2.8 to -1.2)

 

-2.0 (-2.8 to -1.2)

  Occasionally

 

3.8 (2.4 to 5.2)

 

-0.0 (-1.2 to 1.2)

  Frequently

 

-2.1 (-3.5 to -0.7)

 

-4.4 (-5.6 to -3.3)

  Almost Constantly

 

-4.4 (-6.0 to -2.9)

 

-4.5 (-5.8 to -3.2)

 Pain Numeric Rating Scale

338,813

-0.8 (-0.9 to -0.7)

232,527

-1.2 (-1.3 to -1.1)

 Pain Verbal Descriptor Scale

258,391

 

212,453

 

  No pain

 

17.0 (16.3 to 17.7)

 

18.9 (18.3 to 19.6)

  Mild

 

-6.0 (-7.2 to -4.9)

 

-6.6 (-7.7 to -5.5)

  Moderate

 

-1.8 (-2.8 to -0.7)

 

-3.9 (-4.9 to -2.9)

  Severe

 

-4.3 (-5.1 to -3.5)

 

-4.1 (-5.9 to -3.4)

  Very Severe

 

-4.9 (-5.9 to -3.8)

 

-4.3 (-5.2 to -3.3)

  1. ∆: Absolute difference, calculated as the mean value of observed – expected. For categorical variables, converted to percentile by multiplying difference by 100. For the pain numeric rating scale calculated as observed rating-expected rating
  2. aFor resident-reported details, values were set to “no pain” if explicitly documented as “no pain” or if missing and staff-assessed or resident reported any-pain was “no pain”