In hospital patients who cannot self-report pain, the REPOS is a reliable and valid tool for the assessment of postoperative and chronic pain, as explained in the 'Pain Practise'. The Rotterdam Elderly Pain Observation Scale (REPOS) helps to assess pain in non-communicative and cognitively impaired nursing home residents.

Structured pain assessment is a significant part of pain management in hospitals but depends primarily on self-report, which is often impossible for cognitively impaired, non -communicative, demented or delirious patients. Hence, pain treatment for these patient groups is often insufficient.

Boerlage A. A. et al. investigated if the REPOS is also reliable and valid for pain assessment in the hospital setting. This prospective multicenter observational study considered the surgical patients who were observed perioperatively at the bedside and the internal medicine patients who were filmed during a possible painful moment and in rest. The pain behaviour was examined from the video recordings using REPOS and Pain Assessment Checklist for Seniors with Severe Dementia - Dutch language (PACSLAC-D). The longitudinal associations between REPOS, numerical pain ratings from observers and nurses (NRSobs and NRSproxy) corrected for patients' gender were examined using the linear mixed models.

A total of 72 patients were included; 118 observations of surgical and 68 observations of internal medicine patients were explored. Inter-observer reliability between the researcher and other two observers was good, with Cohen's kappa- 0.71 and 0.84. Intra-observer reliability of the principal investigator was good with Cohen's kappa- 0.82. The Linear mixed modeling portrayed a connection between the REPOS and NRSobs of 0.67 and the REPOS and NRSproxy of 0.73. An optimal sensitivity (78%) and specificity (90%) for pain detection were found with a REPOS cutoff score ≥ 3 via NRS ≥ 4 as a reference value."This pain observation scale is easy to use with good sensitivity and specificity, which might persuade hospital nurses to use a REPOS observation regularly" concluded the investigators.