Asking people how much money they would accept to experience pain again can provide a more accurate and comparable measure of pain levels than the familiar 1-10 scale, according to an international research team led by Lancaster University.
Published in the journal Social Science & Medicine, the study indicates that people's theoretical willingness to accept money in exchange for enduring pain offers a more reliable way to measure discomfort than conventional 'self-reported' measures of pain levels such as number scales or visual charts.
In a series of experiments involving more than 300 participants, volunteers aged between 18 and 60 were exposed to mild painful stimuli and asked either to rate the intensity on a numerical scale or to indicate how much financial compensation they would require to repeat the experience. The experiment also included an analgesia study of people experiencing the same painful stimuli but with one group receiving a placebo and the other the pain relief cream.
The results revealed that the monetary measure:
· distinguished more clearly between different levels of pain,
· detected the effects of pain relief more consistently, and
· enabled more meaningful comparisons across individuals.
The familiar "rate your pain from one to ten" question is widely used in clinical and research settings, but its limitations are well known. Individuals interpret the scale differently, making it difficult to compare results across people or groups. By contrast, the authors of the study say that putting a price on pain creates a shared frame of reference.
Professor Carlos Alós-Ferrer, from Lancaster University Management School, explained: "We've all been asked to rate our pain from one to ten-but one person's three might be another's five, and those numbers can shift with experience. Our research proposes a better way: turning pain into money-not to commodify suffering, but to create a scale we can all share.
"Different people still will put a different price on the same pain, but there is no problem interpreting the question. As a result, measurements are more precise and the shift from low to high levels of pain is clearly reflected in the monetary scale. This makes it useful for clinical trials to study the effectiveness of painkillers and treatments, because participants are randomly assigned to different groups."
The authors of the study say that refining pain self-reported measurement is important because inaccurate pain measurements can lead to inadequate pain management for example in an emergency, a reduction in quality of life for those with longer term conditions, as well as imposing a considerable burden on health care systems. For example, more than US $600 billion are spent annually in the USA to treat pain, surpassing the cost of treating heart disease and diabetes. The authors suggest that their method provides a complementary approach to reliably measure experienced pain across individuals and could open the door to future research improving pain measurement and management.
Publication details The article, "Standard economic elicitation methods improve the measurement of acute pain," is published in Social Science & Medicine.
