Validity of the cold pressor test and pain sensitivity questionnaire via online self-administration

PLoS One. 2020 Apr 16;15(4):e0231697. doi: 10.1371/journal.pone.0231697. eCollection 2020.

Abstract

To determine the feasibility of complex home-based phenotyping, 1,876 research participants from the customer base of 23andMe completed an online version of a Pain Sensitivity Questionnaire (PSQ) as well as a cold pressor test (CPT) which is used in clinical assessments of pain. Overall our online version of the PSQ performed similarly to the original pen-and-paper version. Construct validity of the PSQ total was demonstrated by internal consistency and consistent discrimination between more and less painful items. Criterion validity was demonstrated by correlation with pain sensitivity as measured by the CPT. Within the same cohort we performed a cold pressor test using a layperson description and household equipment. Comparison with published reports from controlled studies revealed similar distributions of cold pain tolerance times (i.e., time elapsed before removing the hand from the water). Of those who elected to participate in the CPT, a large majority of participants did not report issues with the test procedure or noncompliance with the instructions (97%). We confirmed a large sex difference in CPT thresholds in line with published data, such that women removed their hands from the water at a median of 54.2 seconds, with men lasting for a median time of 82.7 seconds (Kruskal-Wallis statistic, p < 0.0001), but other factors like age or current pain treatment were at most weakly associated, and inconsistently between men and women. We introduce a new paradigm for performing pain testing, called testing@home, that, in the case of cold nociception, showed comparable results to studies conducted under controlled conditions and supervision of a health care professional.

MeSH terms

  • Adult
  • Aged
  • Cold Temperature / adverse effects
  • Female
  • Humans
  • Male
  • Middle Aged
  • Pain / etiology
  • Pain Measurement / methods*
  • Pain Threshold*
  • Sex Characteristics
  • Sex Factors
  • Surveys and Questionnaires
  • Young Adult

Grants and funding

This research was conducted by 23andMe and Grünenthal GmbH. The funder provided support in the form of salaries for authors, but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript.