Swedish-led initiative aims to revolutionise pain assessment in newborns
Despite the widespread use of pain rating scales in neonatal care worldwide, a new Cochrane review shows that current tools for assessing pain in newborns are based on very low quality evidence. According to the review, 75 percent of babies were assessed using scales that are not methodologically reliable enough to measure pain.
The Cochrane analysis, which included 79 studies involving over 7,000 infants across 26 countries, evaluated 27 different clinical rating scales. The findings reveal significant limitations in the reliability and clinical usefulness of all currently available tools, raising concerns about whether healthcare professionals can accurately measure pain in this extremely vulnerable population.
“We were truly hoping that one pain scale would be stronger than another, but instead we found that all of them are poorly developed. In the above article, 25 percent of the infants were assessed without using a rating scale at all, which was already shocking, and 75 percent of the infants were assessed with rating scales that are now known to not be methodologically sound enough to measure pain. So, this unfortunately means that medical professionals cannot be sure whether they are measuring pain at all." says Emma Persad, Phd student at the Department of Women's and Children's Health, Karolinska Institutet.
Yet, from this uncertainty comes a call to action. The researchers hope these findings will spark a global collaborative effort, led by Swedish experts, to develop a new, robust, and evidence-based pain assessment scale for newborns. Such a tool could greatly improve neonatal care worldwide and further establish Sweden as a leader in the field of neonatology.
According to the article “this involves developing better rating scales or physiological techniques to measure pain”.
“This is precisely what we are hoping to do. Through convening the global community we hope these findings and the outcome become a global collaborative effort, driven by Swedish researchers, to finally develop a pain rating scale that is robust and evidence-informed (and will hopefully be properly adapted and translated for use worldwide). We hope that Sweden’s role in neonatology can further be solidified through this work,” says Emma Persad.