Wellness and Healthy Living

Pain gets a price tag: New method outshines standard pain assessments

Pain gets a price tag: New method outshines standard pain assessments
Translating pain into money has created a more accurate way of measuring suffering
Translating pain into money has created a more accurate way of measuring suffering
View 3 Images
Translating pain into money has created a more accurate way of measuring suffering
1/3
Translating pain into money has created a more accurate way of measuring suffering
The monetary methods outperformed standard pain scales
2/3
The monetary methods outperformed standard pain scales
Inaccurate pain measurements can mean inadequate pain management, which has a personal and global cost
3/3
Inaccurate pain measurements can mean inadequate pain management, which has a personal and global cost
View gallery - 3 images

Pain is hard to measure. One person’s “ouch” is another’s agony. Now, scientists say they’ve found a better way of assessing pain: putting a price on it. By translating pain into dollars, they’ve created a more accurate, comparable way to measure suffering.

If you’ve been an inpatient in a hospital with a painful condition or following surgery, you have very probably been asked, “How would you rate your pain on a scale from zero to 10?” While it’s widely used, the limitations of this approach are well-known and boil down to this: one person’s “10” is another person’s “4”.

In a study led by the UK’s Lancaster University, researchers investigated a novel way of accurately – and more objectively – assessing people’s pain, and it came down to translating pain into something that’s familiar to everyone: money.

“We’ve all been asked to rate our pain from one to 10 – but one person’s three might be another’s five, and those numbers can shift with experience,” said Carlos Alós-Ferrer, Chair Professor of Economics at Lancaster University Management School and the study’s corresponding author. “Our research proposes a better way: turning pain into money – not to commodify suffering, but to create a scale we can all share.”

Inaccurate pain measurements can mean inadequate pain management, which has a personal and global cost
Inaccurate pain measurements can mean inadequate pain management, which has a personal and global cost

Inaccurate pain measurements can lead to inadequate pain management. For people with chronic conditions, this can mean a reduction in quality of life. In addition, the global cost of treating pain is enormous (and complex). In the US alone, the estimated cost was between US$560 billion and $635 billion per year. That figure, which is now 15 years old, comprises direct healthcare costs, days off work, hours off work, and lower wages. It’s understandable, then, that the researchers would want to investigate a better system of pain measurement.

They ran three randomized experiments with 330 healthy adults aged between 18 and 60. In one, participants were exposed to mild electrical pain; in another, it was heat pain; in the third, participants received the same heat stimulus but were given either a placebo or a topical anesthetic. In each experiment, participants completed three standard pain scales for comparison: the numerical (0-10) rating scale; the visual analog scale, and the general labeled magnitude scale (gLMS). The gLMS is a tool where pain intensity is rated along a line with verbal anchors such as “no sensation” to “strongest imaginable sensation”.

Alongside these pain assessments using traditional methods, the researchers tested their “monetary equivalence” (ME) method. Participants were repeatedly asked whether they would accept a certain amount of money to experience the same painful stimulus again, or choose a smaller amount to avoid it. Example: “Would you rather get 15 Swiss francs and feel the pain again, or 10 Swiss francs and no pain?” The point where a participant switched from “no pain” to “pain” revealed how much the pain was “worth” to them in monetary terms. Two versions of the ME method were tested: ME1, where questions were listed in increasing order of money (enforcing consistency); and ME2, where the same questions were asked randomly (allowing for some inconsistency).

Across all three experiments, the monetary methods (ME1 and ME2) outperformed the traditional scales at distinguishing between high- and low-pain conditions. Effect sizes – that is, how strongly the measure distinguished between groups – were dramatically larger for ME1 and ME2 (“very large”) compared to standard pain scales (“small to medium”). Even in the analgesic study, where traditional scales often failed or even showed misleading results (for example, participants reporting more pain after receiving an analgesic), the monetary measures correctly and significantly detected differences. This likely happened because participants expected the anesthetic to eliminate the pain completely, and when it didn’t, they rated their pain higher. It’s a psychological effect the monetary method avoids.

The monetary methods outperformed standard pain scales
The monetary methods outperformed standard pain scales

Statistical analyses showed “decisive evidence” that the monetary methods predicted pain levels much better than standard ones. Further testing confirmed that ME1 was the most accurate predictor of whether someone had been in the high-pain group, even when controlling for factors like income or gender. Moreover, the ME approach worked for both electrical and heat pain, suggesting it’s not limited to a specific kind of stimulus. It remained reliable even when participants didn’t know whether they’d received a placebo or analgesic, showing the method is resistant to psychological “expectation effects.”

“Different people still will put a different price on the same pain, but there is no problem interpreting the question,” Alós-Ferrer said about the new method. “As a result, measurements are more precise and the shift from low to high levels of pain is clearly reflected in the monetary scale. This makes it useful for clinical trials to study the effectiveness of painkillers and treatments, because the participants are randomly assigned to different groups.”

As with most studies, this one had limitations. Participants were mostly Swiss uni students, so results may not generalize to older, more diverse, or clinical populations. Because money means different things to people with different incomes, richer individuals might report higher “pain prices.” Random group assignment controls for this in experiments, but real-world use would require adjustments. The study used short, controlled pain stimuli. Chronic pain is a different beast; more complex, it involves emotional and functional dimensions not captured in the present study. The researchers note that more diverse trials, including chronic pain patients, are needed before the method can be used clinically.

Despite its limitations, the study points to several promising uses for a monetary pain scale. In clinical trials, it could dramatically improve the sensitivity of pain measurements when testing new painkillers or other treatments. In the research setting, it provides a more objective way of comparing pain experiences across participants, making results more reliable and reproducible. And in the clinical setting, a monetary pain scale could be used to help tailor pain management plans by quantifying the “cost” of pain in ways that standard scales can’t.

The study was published in the journal Social Science & Medicine.

Source: Lancaster University

View gallery - 3 images
9 comments
9 comments
KR R
I have never been told in my life that the metric was for all humanity. It is for you, based on all of your recollections and current pain, how would you rate your pain right now on a scale of 1 through 10? It is not based on how the rest of the world feels pain. The treatment is for you based on your pain. Why would someone who feels pain differently, who is not in the room, even matter?
Edward Vix
No mention is made of duration of stimulus, a very important variable. Half a second of intense pain versus one minute of the same are profoundly different.
see3d
Perhaps the question should have been, "How much will you pay me to stop this pain?"
NDG
I must admire the creativity that went into developing this model of pain assessment but I am somewhat perplexed by the subjectivity versus objectivity of the measuring. I mean using "money" as a clearer indicator of pain level seems unusual if not somewhat mercenary. Most of us realize that different people have different tolerances for both medications as well as pain thresholds but to have "objective" measures alone is now perceived as inadequate in assessing the actual pain levels someone has. More work seems needed to make this model useful in administering effective medication as well as accurately diagnosing causality and level of developement of underlying issues.
Brian M
Heard of some daft ideas but this takes the biscuit! Money amounts are even more subjective than a scale of 1 to 10. $10 might be everything for a poverty stuck homeless person, but not worth bending down to pick up for a city stock broker.
Perhaps better a metric could be based on how long they could listen to a politician's speech or kept on hold by a software help desk!
TpPa
Sorry I don't agree with the monetary value scale either, X amount of money means something different to everyone, a lot people these days live and breathe for money, and can have a big swing even between spouses. 20+ years of chronic pain under my skin, and also what was a 10 when your issues just started is now a 7 because your so used to dealing with it, but then a new 10 seems to rise up and ruin it all.
jsopr
This is the 21st century version of the Milgram experiment. Just utterly amoral scientists devising an utterly amoral metric. At least back then the shock-delivering subjects were told that it was a morality experiment afterwards; here they are asked to shock themselves and consider it science.
PDM
@jsopr, that’s a dramatic comparison, but it doesn’t hold up under scrutiny. Milgram’s experiments were about obedience, deception, and coercion. Participants were misled and pressured into believing they were harming others. In this study, volunteers were fully informed, consented freely, could withdraw at any time, and experienced only mild, controlled pain (which, mind you, is a standard practice in clinical research). The monetary element isn’t about morality; it’s about creating a measurable, comparable way to quantify pain, something traditional scales often fail to do.
MQ
Love it, after querying the pain value, patient gets that dollar value treatment- eventually they get trained on the real value/score of pain...