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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”