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Reliability is Necessary but Far From Sufficient

How Might the Validity of Pain Ratings be Improved?

Dworkin, Robert H. PhD*; Burke, Laurie B. RPh, MPH; Gewandter, Jennifer S. PhD, MPH*; Smith, Shannon M. PhD*

The Clinical Journal of Pain: July 2015 - Volume 31 - Issue 7 - p 599–602
doi: 10.1097/AJP.0000000000000175

*Department of Anesthesiology, University of Rochester, Rochester, NY

Lora Group LLC, Royal Oak, MD

All authors are associated with the Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks (ACTTION) public-private partnership with the US Food and Drug Administration (FDA) Silver Spring, MD, which has provided financial support for the pain rating training system discussed in this article. ACTTION has received research contracts and grants from the FDA, multiple pharmaceutical and device companies, and other sources. The authors declare no conflict of interest.

Reprints: Robert H. Dworkin, PhD, Department of Anesthesiology, University of Rochester Medical Center, 601 Elmwood Ave., Box 604, Rochester, NY 14642 (e-mail:

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