Protocol - Adolescent Pediatric Pain Tool (APPT)
The Adolescent Pediatric Pain Tool (APPT) is a multidimensional self-administered pain assessment tool. The APPT is used with children and adolescents to evaluate pain intensity, location, and quality (including sensory, temporal, affective, and evaluative). The APPT can be used with individuals experiencing pain for various reasons, such as sickle cell disease (SCD), postoperative pain, allergy testing, orthopedic, traumatic injury, and cancer. The APPT was modeled after the McGill Pain Questionnaire and is available in English and Spanish.
Adolescent Pediatric Pain Tool (APPT)
The Adolescent Pediatric Pain Tool (APPT) provides five subscale scores:
- Number of pain sites as a measure of pain location from marks on a body outline.
- Pain intensity measured by the Word Graphic Rating Scale (WGRS) and anchored by the words no pain, little, medium, large, and worst possible pain.
- Number of pain quality descriptors, which yields percent scores for the sensory, affective, and evaluative subscales.
- Number of temporal descriptors, which yields a percent temporal subscale.
- Percent of total pain quality and temporal descriptors as a total subscale.
The introduction of the Jacob et al. 2014 publication (see the Source section) contains details and source information regarding the above subscales.
Protocol Name from Source:
Personnel and Training Required
|Specialized requirements for biospecimen collection||No|
|Average time of greater than 15 minutes in an unaffected individual||No|
Mode of Administration
Individuals ages 8 to 17 years old.
The Sickle Cell Disease Neurology, Quality of Life, and Health Services Working Group selected the Adolescent Pediatric Pain Tool (APPT) because it provides a comprehensive evaluation of pain, is well validated, widely used, and has minimal participant burden.
Additionally, the APPT was modeled after the McGill Pain Questionnaire (see Pain (Type and Intensity)-Adults). By using both of these tools, investigators can collect comparable pain data in pediatric and adult populations.
|Common Data Elements (CDE)||Adolescent Pediatric Pain Tool Assessment Score||4924395||CDE Browser|
|Human Phenotype Ontology||Abdominal pain||HP:0002027||HPO|
|Human Phenotype Ontology||Abnormality of the gastrointestinal tract||HP:0011024||HPO|
Process and Review
Jacob, E., Mack, A. K., Savedra, M., Van Cleve, L., & Wilkie, D. J. (2014). Adolescent pediatric pain tool for multidimensional measurement of pain in children and adolescents. Pain Management Nursing 15(3), 694-706.
Fernandes, A., De Campos, C., Batalha, L., Perdigão, A., & Jacob, E. (2014). Pain assessment using the Adolescent Pediatric Pain Tool: A systematic review. Pain Research and Management, 19(4), 212-218.
Franck, L., Treadwell, M., Jacob, E., & Vichinsky, E. (2002). Assessment of Sickle Cell Pain in Children and Young Adults Using the Adolescent Pediatric Pain Tool. Journal of Pain Symptom Management, 23, 114-120.
Jacob, E., Miaskowski, C., Savedra, M., Beyer, J., Treadwell, M., & Styles, L. (2003). Changes in intensity, location, and quality of vaso-occlusive pain in children with sickle cell disease. Pain, 102, 187-193.
Jacob, E., Stinson, J., Duran, J., Gupta, A., Gerla, M., Lewis, M. A., & Zeltzer L. (2012). Usability testing of a smartphone for accessing a web-based e-diary for self-monitoring of pain and symptoms in sickle cell disease. Journal of Pediatric Hematology/Oncology, 34, 326-335.
Savedra, M. C., Tesler, M. D., Holzemer, W. L., & Ward, J. A. (1992). Adolescent Pediatric Pain Tool (APPT): User’s manual. San Francisco, CA: University of California, School of Nursing.
Savedra, M. C., Tesler, M. D., Holzemer, W. L., & Brokaw, P. (1995). A strategy to assess the temporal dimension of pain in children and adolescents. Nursing Research, 44(5), 272-276.
Savedra, M. C., Holzemer, W. L., Tesler, M. D., & Wilkie, D. J. (1993). Assessment of postoperation pain in children and adolescents using the adolescent pediatric pain tool. Nursing Research, 42(1), 5-9.
Savedra, M. C., Tesler, M. D., Holzemer, W. L., Wilkie, D. J., & Ward, J. A. (1989). Pain location: Validity and reliability of body outline markings by hospitalized children and adolescents. Research in Nursing & Health, 12(5), 307-314.
Tesler, M. D., Savedra, M. C., Holzemer, W. L., Wilkie, D. J., Ward, J. A., & Paul, S. M. (1991). The word-graphic rating scale as a measure of children’s and adolescents’ pain intensity. Research in Nursing & Health, 14(5), 361-371.
Wilkie, D. J., Holzemer, W. L., Tesler, M. D., Ward, J. A., Paul, S. M., & Savedra, M. C. (1990). Measuring pain quality: Validity and reliability of children’s and adolescents’ pain language. Pain, 41(2), 151-159.
|Variable Name||Variable ID||Variable Description||dbGaP Mapping|
|PX190902050100||Point to or circle as many of these words more||N/A|
|PX190902050200||Point to or circle as many of these words more||N/A|
|PX190902050300||Point to or circle as many of these words more||N/A|
|PX190902050400||Point to or circle as many of these words more||N/A|
|PX190902040000||Place a straight, up and down mark on this more||N/A|
|PX190902030000||Color in the areas on these drawings to show more||N/A|
Pain (Type and Intensity)
July 30, 2015
This is a measure to assess pain and related symptoms.
To provide a comprehensive measure of pain symptoms and conditions.
Adolescent Pediatric Pain Tool, APPT, Adolescent, Child, Pain, Ache, Muscle soreness, Muscle stiffness, Pain intensity, Pain measurement, Pain assessment, Pain symptoms, Postoperative, Sickle cell disease, SCD, Allergy testing, Orthopedic, Traumatic injury, proprietary