HEDEN Pain Scale: A Shortened Behavioral Scale for Assessment of Prolonged Cancer or Postsurgical Pain in Children Aged 2 to 6 Years

Few observational scales are available for assessing chronic or recurrent pain in children with cancer because overt behavioral signs of chronic pain dissipate as time passes, making them difficult to detect reliably. The Douleur Enfant Gustave Roussy (DEGR) scale developed by Gauvain-Piquard to monitor prolonged pain in children with cancer aged 2–6 years is currently the only validated tool available for this purpose, but is time consuming and difficult to use in daily clinical practice. To shorten composite measurement scales, we developed the Hetero Evaluation Douleur Enfant (HEDEN) scale from the DEGR scale. We present here the process and validation of this scale. Expert consensus was used for the elaboration of HEDEN: 5/10 DEGR items were chosen with three rating levels. Concurrent validity was tested in a first cohort with correlation analysis between HEDEN and DEGR. The HEDEN scale was then validated in a second cohort. In the first step, the study (59 children) showed acceptable correlation betw...