Taking into account the observers' uncertainty: a graduated approach to the credibility of the patient's pain evaluation.

This article presents two experiments aiming to investigate the adoption of a graduated measure to describe credibility attribution by observers who evaluate patients' pain accounts. A total of 160 medical students were required to express a credibility judgment on the pain intensity level of hypothetical patients. We used 16 vignettes based on a factorial mixed-design. Within-participants factors were the reported pain, the presence of a physical sign, the patient's facial expression and the patient's gender, and between-groups factors were the patient's age and the geographical distribution of the patient's name. Results confirm the well-established tendency not to believe patients' self-reports and provide information regarding the evaluators' uncertainty. The findings suggest that a graduated measure is useful for assessing the degree of uncertainty of the observers and subtle effects of different factors upon the judgment of patient's pain.