Fry M, et al. – This randomized controlled trial was performed to estimate the effect of an observational pain assessment dementia tool on time from ED arrival to the first dose of analgesic medicine. Although there was a clinically important but non–significant improvement in the cognitively impaired patient group, use of the Pain Assessment in Advanced Dementia (PAINAD) was not associated with a shorter time to analgesia. To address this clinically important and complex issue, further research was needed.