{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T14:41:59Z","timestamp":1786977719608,"version":"build-2736575974"},"reference-count":53,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2021,6,25]],"date-time":"2021-06-25T00:00:00Z","timestamp":1624579200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["European Journal of Pain"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Assessing pain in mechanically ventilated infants is challenging. The assessment of skin conductance (SC) is based on the sympathetic nervous system response to stress. This study purpose was to evaluate the validity of SC for assessing pain in mechanically ventilated infants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A prospective cross\u2010sectional observational design was used to study SC and its relation to: the category of procedure (i.e., painful or non\u2010painful); the phase of procedure (i.e., before, during and after), and referent pain measurements (i.e., Premature Infant Pain Profile\u2010Revised (PIPP\u2010R) and Neonatal Facial Coding System (NFCS)). Eligible infants were those up to 12\u00a0months of age, in intensive care units, who were mechanically ventilated, and required painful and non\u2010painful procedures.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>From October 2017 to November 2018, 130 eligible infants were identified, and 55 infants were studied. SC (number of waves per second) during painful procedures (median 0.27, interquartile range 0.2\u20130.4) was statistically significantly higher than those during non\u2010painful procedures (0, 0\u20130.09). SC during painful procedures was statistically significantly higher than those before (0, 0\u20130.07) and after painful procedures (0, 0\u20130.07). SC showed moderate statistically significant positive correlations with PIPP\u2010R (Spearman's rho\u00a0=\u00a00.4\u20130.62) and the four\u2010item NFCS (Spearman's rho\u00a0=\u00a00.31\u20130.67) before, during and after painful or non\u2010painful procedures respectively. SC had excellent performance (area under the receiver operator curve\u00a0=\u00a00.979) with excellent sensitivity (92.31%), specificity (95.42%) and negative predictive value (99.21%) but only sufficient positive predictive value (66.67%) when used to discriminate moderate\u2010to\u2010severe pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>SC showed good validity for assessing pain in critically ill infants requiring mechanical ventilation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance of the study<\/jats:title>\n                    <jats:p>Pain assessment in mechanically ventilated infants is challenging. In this study, the validity of skin conductance (SC) for pain assessment is evaluated in the same population of infants during painful and nonpainful procedures. SC showed good validity for assessing acute pain in relation to category of procedure, phase of procedure, and referent pain measurements. SC is a promising method, especially with other pain assessment methods and other determinants of pain, in a multimodal pain assessment approach to understand the complexity of pain in mechanically ventilated infants.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ejp.1816","type":"journal-article","created":{"date-parts":[[2021,6,8]],"date-time":"2021-06-08T21:06:52Z","timestamp":1623186412000},"page":"1994-2006","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["The validity of skin conductance for assessing acute pain in mechanically ventilated infants: A cross\u2010sectional observational study"],"prefix":"10.1002","volume":"25","author":[{"given":"Jiale","family":"Hu","sequence":"first","affiliation":[{"name":"Department of Nurse Anesthesia College of Health Professions Virginia Commonwealth University Richmond VA USA"},{"name":"School of Nursing Faculty of Health Sciences University of Ottawa Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"JoAnn","family":"Harrold","sequence":"additional","affiliation":[{"name":"Faculty of Medicine University of Ottawa Ottawa Ontario Canada"},{"name":"Neonatal Intensive Care Unit Children's Hospital of Eastern Ontario Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janet E.","family":"Squires","sequence":"additional","affiliation":[{"name":"School of Nursing Faculty of Health Sciences University of Ottawa Ottawa Ontario Canada"},{"name":"Research Institute Ottawa Hospital Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shokoufeh","family":"Modanloo","sequence":"additional","affiliation":[{"name":"School of Nursing Faculty of Health Sciences University of Ottawa Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denise","family":"Harrison","sequence":"additional","affiliation":[{"name":"School of Nursing Faculty of Health Sciences University of Ottawa Ottawa Ontario Canada"},{"name":"Department of Nursing Faculty of Medicine, Dentistry and Health Sciences University of Melbourne Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,6,25]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.earlhumdev.2006.05.022"},{"key":"e_1_2_9_3_1","volume-title":"The evidence base of clinical diagnosis: Theory and methods of diagnostic research","author":"Buntinx F.","year":"2009"},{"key":"e_1_2_9_4_1","unstructured":"Canadian Association of Research Ethics Boards. (2010).Guidance on Reporting of Unanticipated Problems including Adverse Events to Research Ethics Boards in Canada. Retrieved fromhttps:\/\/www.careb\u2010accer.org\/sites\/default\/files\/downloads\/careb_guidance_\u2010_ae_reporting_\u2010_july_2010.pdf"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/AJP.0b013e3182400d54"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.earlhumdev.2008.12.005"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/ANC.0b013e3182a41452"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/anae.13018"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000000185"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.earlhumdev.2012.09.008"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1651-2227.2007.00586.x"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1113\/EP085134"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.earlhumdev.2014.01.005"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1136\/adc.65.10_Spec_No.1063"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.90.4.561"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3959(87)90073-X"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3959(90)91142-6"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3959(98)00046-3"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/0962280216680383"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.semperi.2007.07.002"},{"key":"e_1_2_9_21_1","volume-title":"The efficacy of 25% oral sucrose in the reduction of pain associated with heel lancing in the hospitalised infant; a randomised controlled trial","author":"Harrison D.","year":"2001"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1440-1754.2003.00242.x"},{"key":"e_1_2_9_23_1","doi-asserted-by":"publisher","DOI":"10.1177\/1099800414531448"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmn.2011.10.002"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/AJP.0000000000000721"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.5603\/AIT.2013.0028"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.25.2.126"},{"key":"e_1_2_9_28_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10877-011-9314-0"},{"key":"e_1_2_9_29_1","doi-asserted-by":"publisher","DOI":"10.1097\/EJA.0b013e32832bb678"},{"key":"e_1_2_9_30_1","volume-title":"Oxford textbook of paediatric pain","author":"Lee G. Y.","year":"2014"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2012.182543"},{"key":"e_1_2_9_32_1","doi-asserted-by":"publisher","DOI":"10.1111\/apa.14777"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.e3999"},{"key":"e_1_2_9_34_1","volume-title":"Oxford textbook of paediatric pain","author":"McGrath P. J.","year":"2014"},{"key":"e_1_2_9_35_1","unstructured":"Med\u2010Storm Innovation A. S.(2012).Med\u2010storm pain monitor user manual. Retrieved fromhttp:\/\/www.med\u2010storm.com\/pdf\/UserManualEnglsihMA00127_20130424.pdf"},{"key":"e_1_2_9_36_1","doi-asserted-by":"publisher","DOI":"10.1097\/AJP.0000000000000762"},{"issue":"4","key":"e_1_2_9_37_1","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1590\/S0103-05822014000400017","article-title":"Pain assessment scales in newborns: Integrative review","volume":"32","author":"Melo G. M. D.","year":"2014","journal-title":"Revista Paulista De Pediatria"},{"key":"e_1_2_9_38_1","doi-asserted-by":"publisher","DOI":"10.1037\/0003-066X.50.9.741"},{"key":"e_1_2_9_39_1","first-page":"1","article-title":"Prenatal opioid exposure heightens sympathetic arousal and facial expressions of pain\/distress in term neonates at 24\u201348 hours post birth","author":"Oji\u2010Mmuo C. N.","year":"2019","journal-title":"Journal of Maternal\u2010Fetal and Neonatal Medicine"},{"key":"e_1_2_9_40_1","doi-asserted-by":"publisher","DOI":"10.1080\/14767058.2019.1580690"},{"key":"e_1_2_9_41_1","doi-asserted-by":"publisher","DOI":"10.1590\/S1516-31801999000200005"},{"key":"e_1_2_9_42_1","doi-asserted-by":"publisher","DOI":"10.1097\/00002508-200311000-00003"},{"key":"e_1_2_9_43_1","doi-asserted-by":"publisher","DOI":"10.1002\/pne2.12006"},{"key":"e_1_2_9_44_1","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000000598"},{"key":"e_1_2_9_45_1","doi-asserted-by":"publisher","DOI":"10.2147\/JPR.S165810"},{"issue":"4","key":"e_1_2_9_46_1","first-page":"203","article-title":"Measures of diagnostic accuracy: Basic definitions","volume":"19","author":"\u0160imundi\u0107 A.\u2010M.","year":"2009","journal-title":"EJIFCC"},{"key":"e_1_2_9_47_1","doi-asserted-by":"publisher","DOI":"10.1097\/AJP.0b013e3182906aed"},{"key":"e_1_2_9_48_1","doi-asserted-by":"publisher","DOI":"10.1097\/00002508-199603000-00004"},{"key":"e_1_2_9_49_1","first-page":"67","volume-title":"Pain in neonates and infants","author":"Stevens B.","year":"2007"},{"key":"e_1_2_9_50_1","doi-asserted-by":"publisher","DOI":"10.1002\/9781444322743.ch6"},{"key":"e_1_2_9_51_1","doi-asserted-by":"publisher","DOI":"10.1097\/ACO.0b013e3283183fe4"},{"key":"e_1_2_9_52_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcl.2012.07.012"},{"key":"e_1_2_9_53_1","doi-asserted-by":"publisher","DOI":"10.1097\/AJP.0000000000000670"},{"key":"e_1_2_9_54_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40138-016-0089-y"}],"container-title":["European Journal of Pain"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ejp.1816","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ejp.1816","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ejp.1816","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,29]],"date-time":"2023-08-29T04:21:20Z","timestamp":1693282880000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ejp.1816"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,6,25]]},"references-count":53,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2021,10]]}},"alternative-id":["10.1002\/ejp.1816"],"URL":"https:\/\/doi.org\/10.1002\/ejp.1816","archive":["Portico"],"relation":{},"ISSN":["1090-3801","1532-2149"],"issn-type":[{"value":"1090-3801","type":"print"},{"value":"1532-2149","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,6,25]]},"assertion":[{"value":"2021-06-25","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}