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Parental Proxy PROMIS Pain Interference Scores are Only Modestly Concordant With Their Child’s Scores

An Effect of Child Catastrophizing

Scott, Eric L. PhD*,†; Foxen-Craft, Emily PhD*; Caird, Michelle MD; Philliben, Riley BS; deSebour, Trevor BS; Currier, Emily BS; Voepel-Lewis, Terri PhD†,§

The Clinical Journal of Pain: January 2020 - Volume 36 - Issue 1 - p 1–7
doi: 10.1097/AJP.0000000000000772
Original Articles

Objectives: Pediatric patients with chronic musculoskeletal conditions such as idiopathic scoliosis awaiting surgical correction can experience pain that interferes with their daily functioning. Reports of this interference are commonly gathered from patients through the Patient-Reported Outcomes Measurement Information System (PROMIS) Pain Interference Scale and through parent-proxy scores. However, the child and parent/caregiver reports vary. To provide appropriate treatment for young patients with pain, the nature of the discrepancies and under which circumstances the reports differ needs to be understood. This report offers new information on the level of concordance among parent and child report of pain interference within this patient population, and which parent and child characteristics may influence concordance rates.

Methods: Youth (age=10 to 17 y) with a history of musculoskeletal disorders, including idiopathic scoliosis, under consideration for surgical correction of that scoliosis and parent/caregiver dyads (n=103) completed the PROMIS Pain Interference Scale during an orthopedic presurgical visit. The current data was taken from a larger study examining postsurgical pain among patients undergoing orthopedic surgical procedures to correct scoliosis. The purpose of the current study was to measure the degree of agreement between parent and child reports of pain interference and discovery of relationships among predictors of pain interference score correspondence among dyads.

Results: Correspondence between parent/caregiver and child reports of pain interference was modest (intraclass correlation coefficient=0.530). In total, 46% of dyads had similar pain interference scores, whereas 24% of parents reported higher pain interference in comparison to their child, the remaining 30% reported lower pain interference in relation to their child’s report. Among children where discrepancies appeared, using logistic regression models, only child catastrophizing scores were associated with differences in parent and child estimation of child’s pain interference scores. No parental characteristics predicted discrepancies between dyad pain interference reports.

Discussion: Parent-proxy and child reports generally correspond, but when discrepant, 24% of parents reported higher pain interference in relationship to the child report of pain interference and 31% noted less intense pain interference than their child’s pain interference. Given these results, care should be taken when interpreting parent reports of child pain interference, especially when a child reports higher degrees of pain interference.

Departments of *Pediatrics


Orthopedic Surgery, Michigan Medicine and the University of Michigan Medical School

§School of Nursing, University of Michigan, Ann Arbor, MI

Institutional Review Board Approval obtained from the Institutional Review Boards of the University of Michigan Medical School (IRBMED); Approval ID: HUM00086972.

The authors declare no conflict of interest.

Reprints: Eric L. Scott, PhD, Department of Pediatrics, D2234 MPB, 1500 East Medical Centre Drive, SPC 5718, Ann Arbor, MI 48109-5718 (e-mail:

Received February 4, 2019

Received in revised form September 10, 2019

Accepted September 30, 2019

Online date: October 9, 2019

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