Using confirmatory factor analysis to evaluate construct validity of the Brief Pain Inventory (BPI) Journal Article


Authors: Atkinson, T. M.; Rosenfeld, B. D.; Sit, L.; Mendoza, T. R.; Fruscione, M.; Lavene, D.; Shaw, M.; Li, Y.; Hay, J.; Cleeland, C. S.; Scher, H. I.; Breitbart, W. S.; Basch, E.
Article Title: Using confirmatory factor analysis to evaluate construct validity of the Brief Pain Inventory (BPI)
Abstract: Context: The Brief Pain Inventory (BPI) is a frequently used instrument designed to assess the patient-reported outcome of pain. The majority of factor analytic studies have found a two-factor (i.e., pain intensity and pain interference) structure for this instrument; however, because the BPI was developed with an a priori hypothesis of the relationship among its items, it follows that construct validity investigations should use confirmatory factor analysis (CFA). Objectives: The purpose of this work was to establish the construct validity of the BPI using a CFA framework and demonstrate factorial invariance using a range of demographic variables. Methods: A retrospective CFA was completed in a sample of individuals diagnosed with HIV/AIDS and cancer (n = 364; 63% male; age 21-92 years, M = 51.80). A baseline one-factor model was compared against two-factor and three-factor models (i.e., pain intensity, activity interference, and affective interference) that were developed based on the hypothetical design of the instrument. Results: Fit indices for the three-factor model were statistically superior when compared with the one-factor model and marginally better when compared with the two-factor model. This three-factor structure was found to be invariant across disease, age, and ethnicity groups. Conclusion: The results of this study provide evidence to support a three-factor representation of the BPI, and the originally hypothesized two-factor structure. Such findings will begin to provide clinical trialists, pharmaceutical sponsors, and regulators with confidence in the psychometric properties of this instrument when considering its inclusion in clinical research. © 2011 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.
Keywords: adult; controlled study; aged; major clinical study; neoplasm; reproducibility of results; demography; pain; retrospective study; age; affect; intermethod comparison; construct validity; human immunodeficiency virus; acquired immune deficiency syndrome; physical activity; pain assessment; ethnic group; psychometrics; factor analysis; factorial analysis; brief pain inventory; affective symptoms; confirmatory factor analysis
Journal Title: Journal of Pain and Symptom Management
Volume: 41
Issue: 3
ISSN: 0885-3924
Publisher: Elsevier Inc.  
Date Published: 2011-03-01
Start Page: 558
End Page: 565
Language: English
DOI: 10.1016/j.jpainsymman.2010.05.008
PROVIDER: scopus
PMCID: PMC3062715
PUBMED: 21131166
DOI/URL:
Notes: --- - "Export Date: 23 June 2011" - "CODEN: JPSME" - "Source: Scopus"
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MSK Authors
  1. Yuelin Li
    219 Li
  2. William S Breitbart
    505 Breitbart
  3. Ethan Martin Basch
    180 Basch
  4. Thomas Michael Atkinson
    155 Atkinson
  5. Jennifer L Hay
    264 Hay
  6. Howard Scher
    1130 Scher
  7. Laura S Sit
    22 Sit
  8. Dawn Lavene
    4 Lavene
  9. Mary Catherine Shaw
    12 Shaw