The Sensation and Pain Rating Scale: easy to use, clear to interpret, and responsive to clinical change

BackgroundThe Sensation and Pain Rating Scale (SPARS) allows rating of non-painful as well as painful percepts. While it performs well in the experimental context, its clinical utility is untested. This prospective, repeated-measures study mixed qualitative and quantitative methods to examine the utility and performance of the SPARS in a clinical context, and to compare it with the widely used 11-point NRS for pain. MethodsPeople presenting for outpatient physiotherapy (n = 121) provided ratings on the SPARS and NRS at first consultation, before and after sham and active clinical interventions, and at follow-up consultation. Clinicians (n = 9) reported each scales usability and interpretability using Likert-type scales and free text, and answered additional questions with free text. Each data type was initially analysed separately: quantitative data were visualised and the ES II metric was used to estimate SPARS internal responsiveness; qualitative data were analysed with a reflexive inductive thematic approach. Data types were then integrated for triangulation and complementarity. ResultsThe SPARS was well received and considered easy to use, after initial familiarisation. Clinicians favoured the SPARS over the NRS for clarity of interpretation and inter-rater reliability. SPARS sensitivity to change was good (ESII=0.9; 95%CI: 0.75-1.10). The greater perceptual range of the SPARS was deemed especially relevant in the later phases of recovery, when pain may recede into discomfort that still warrants clinical attention. ConclusionThe SPARS is a promising tool for assessing patient percept, with strong endorsement from clinicians for its clarity and superior perceptual scope. SignificanceClinicians in this mixed-methods study favoured the Sensation and Pain Rating Scale (SPARS) over a 0-10 Numerical Rating Scale for pain because the SPARS provides a clearly labelled range for rating non-painful events, which supports inter-rater reliability and clear interpretation. Clinicians reported rapid adjustment to the SPARS structure. The SPARS had good internal responsiveness to change. The SPARS may be particularly useful as a person recovers from a painful episode, when residual discomfort still requires clinical attention.