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Coppens S, Hoogma DF, Dewinter G, Wolthuis A, Rex S. Postoperative analgesic efficacy of anterior quadratus lumborum block for laparoscopic colorectal surgery: a reply. Anaesthesia 2024; 79:440. [PMID: 38150114 DOI: 10.1111/anae.16228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/18/2023] [Indexed: 12/28/2023]
Affiliation(s)
- S Coppens
- University Hospitals of Leuven, Leuven, Belgium
| | - D F Hoogma
- University Hospitals of Leuven, Leuven, Belgium
| | - G Dewinter
- University Hospitals of Leuven, Leuven, Belgium
| | - A Wolthuis
- University Hospitals of Leuven, Leuven, Belgium
| | - S Rex
- University Hospitals of Leuven, Leuven, Belgium
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Gunsilius CZ, Heffner J, Bruinsma S, Corinha M, Cortinez M, Dalton H, Duong E, Lu J, Omar A, Owen LLW, Roarr BN, Tang K, Petzschner FH. SOMAScience: A Novel Platform for Multidimensional, Longitudinal Pain Assessment. JMIR Mhealth Uhealth 2024; 12:e47177. [PMID: 38214952 PMCID: PMC10818247 DOI: 10.2196/47177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 10/03/2023] [Accepted: 11/30/2023] [Indexed: 01/13/2024] Open
Abstract
Chronic pain is one of the most significant health issues in the United States, affecting more than 20% of the population. Despite its contribution to the increasing health crisis, reliable predictors of disease development, progression, or treatment outcomes are lacking. Self-report remains the most effective way to assess pain, but measures are often acquired in sparse settings over short time windows, limiting their predictive ability. In this paper, we present a new mobile health platform called SOMAScience. SOMAScience serves as an easy-to-use research tool for scientists and clinicians, enabling the collection of large-scale pain datasets in single- and multicenter studies by facilitating the acquisition, transfer, and analysis of longitudinal, multidimensional, self-report pain data. Data acquisition for SOMAScience is done through a user-friendly smartphone app, SOMA, that uses experience sampling methodology to capture momentary and daily assessments of pain intensity, unpleasantness, interference, location, mood, activities, and predictions about the next day that provide personal insights into daily pain dynamics. The visualization of data and its trends over time is meant to empower individual users' self-management of their pain. This paper outlines the scientific, clinical, technological, and user considerations involved in the development of SOMAScience and how it can be used in clinical studies or for pain self-management purposes. Our goal is for SOMAScience to provide a much-needed platform for individual users to gain insight into the multidimensional features of their pain while lowering the barrier for researchers and clinicians to obtain the type of pain data that will ultimately lead to improved prevention, diagnosis, and treatment of chronic pain.
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Affiliation(s)
- Chloe Zimmerman Gunsilius
- Robert J. and Nancy D. Carney Institute for Brain Science, Brown University, Providence, RI, United States
- Neuroscience Graduate Program, Department of Neuroscience, Brown University, Providence, RI, United States
- Warren Alpert Medical School, Brown University, Providence, RI, United States
| | - Joseph Heffner
- Department of Cognitive, Linguistic, and Psychological Sciences, Brown University, Providence, RI, United States
| | - Sienna Bruinsma
- Robert J. and Nancy D. Carney Institute for Brain Science, Brown University, Providence, RI, United States
- Department of Neuroscience, Brown University, Providence, RI, United States
| | - Madison Corinha
- Robert J. and Nancy D. Carney Institute for Brain Science, Brown University, Providence, RI, United States
| | - Maria Cortinez
- Warren Alpert Medical School, Brown University, Providence, RI, United States
| | - Hadley Dalton
- Center for Computation and Visualization, Brown University, Providence, RI, United States
| | - Ellen Duong
- Center for Computation and Visualization, Brown University, Providence, RI, United States
| | - Joshua Lu
- Center for Computation and Visualization, Brown University, Providence, RI, United States
| | - Aisulu Omar
- Center for Computation and Visualization, Brown University, Providence, RI, United States
| | - Lucy Long Whittington Owen
- Robert J. and Nancy D. Carney Institute for Brain Science, Brown University, Providence, RI, United States
| | - Bradford Nazario Roarr
- Center for Computation and Visualization, Brown University, Providence, RI, United States
| | - Kevin Tang
- Industrial Design, Rhode Island School of Design, Providence, RI, United States
| | - Frederike H Petzschner
- Robert J. and Nancy D. Carney Institute for Brain Science, Brown University, Providence, RI, United States
- Department of Psychiatry and Human Behavior, Brown University, Providence, RI, United States
- Center for Digital Health, Brown University, Lifespan, Providence, RI, United States
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Kawji Y, Almoaswes H, Bise C, Kawji L, Murphy A, Reed TD, Klapper RJ, Ahmadzadeh S, Shekoohi S, Cornett EM, Kaye AD. Electronic Health Record Recording of Patient Pain: Challenges and Discrepancies. Curr Pain Headache Rep 2023; 27:737-745. [PMID: 37740879 DOI: 10.1007/s11916-023-01170-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/10/2023] [Indexed: 09/25/2023]
Abstract
PURPOSE OF REVIEW In the present review, various categories of pain, clinician-observed pain scales, and patient-reported pain scales are evaluated to better understand factors that impact patient pain perceptions. Additionally, the expansion of areas that require further research to determine the optimal way to evaluate pain scale data for treatment and management are discussed. RECENT FINDINGS Electronic health record (EHR) data provides a starting point for evaluating whether patient predictors influence postoperative pain. There are several ways to assess pain and choosing the most effective form of pain treatment. Identifying individuals at high risk for severe postoperative pain enables more effective pain treatment. However, there are discrepancies in patient pain reporting dependent on instruments used to measure pain and their storage in the EHR. Additionally, whether administered by a physician or another healthcare practitioner, differences in patient pain perception occur. While each scale has distinct advantages and limitations, pain scale data is a valuable therapeutic tool for assisting clinicians in providing patients with optimal pain control. Accurate assessment of patient pain perceptions by data extraction from electronic health records provides a potential for pain alleviation improvement. Predicting high-risk postoperative pain syndromes is a difficult clinical challenge. Numerous studies have been conducted on factors that impact pain prediction. Postoperative pain is significantly predicted by the kind of operation, the existence of prior discomfort, patient anxiety, and age.
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Affiliation(s)
- Yasmeen Kawji
- School of Medicine, Louisiana State University Health Sciences Center New Orleans, 433 Bolivar Street, New Orleans, LA, 70112, USA
| | - Hanna Almoaswes
- School of Medicine, Louisiana State University Health Sciences Center New Orleans, 433 Bolivar Street, New Orleans, LA, 70112, USA
| | - Claire Bise
- School of Medicine, Louisiana State University Health Sciences Center New Orleans, 433 Bolivar Street, New Orleans, LA, 70112, USA
| | - Lena Kawji
- Department of Internal Medicine, School of Medicine, Louisiana State University Health Sciences Center at Shreveport, 1501 Kings Highway, Shreveport, LA, 71103, USA
| | - Adrienne Murphy
- School of Medicine, Louisiana State University Health Sciences Center New Orleans, 433 Bolivar Street, New Orleans, LA, 70112, USA
| | - Tanner D Reed
- School of Medicine, Louisiana State University Health Sciences Center New Orleans, 433 Bolivar Street, New Orleans, LA, 70112, USA
| | - Rachel J Klapper
- Department of Radiology, Louisiana State University Health Sciences Center at Shreveport, 1501 Kings Highway, Shreveport, LA, 71103, USA
| | - Shahab Ahmadzadeh
- Department of Anesthesiology, Louisiana State University Health Sciences Center at Shreveport, 1501 Kings Highway, Shreveport, LA, 71103, USA
| | - Sahar Shekoohi
- Department of Anesthesiology, Louisiana State University Health Sciences Center at Shreveport, 1501 Kings Highway, Shreveport, LA, 71103, USA.
| | - Elyse M Cornett
- Department of Anesthesiology, Louisiana State University Health Sciences Center at Shreveport, 1501 Kings Highway, Shreveport, LA, 71103, USA
| | - Alan D Kaye
- Department of Anesthesiology, Louisiana State University Health Sciences Center at Shreveport, 1501 Kings Highway, Shreveport, LA, 71103, USA
- Departments of Anesthesiology and Pharmacology, Toxicology, and Neurosciences, Louisiana State University Health Sciences Center at Shreveport, 1501 Kings Highway, Shreveport, LA, 71103, USA
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Smith MG, Farrar LC, Gibson RJ, Russo RN, Harvey AR. Chronic pain interference assessment tools for children and adults who are unable to self-report: A systematic review of psychometric properties. Dev Med Child Neurol 2023; 65:1029-1042. [PMID: 36740907 DOI: 10.1111/dmcn.15535] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 01/04/2023] [Accepted: 01/11/2023] [Indexed: 02/07/2023]
Abstract
AIM To identify and evaluate psychometric properties of assessment tools for assessing pain interference in children, adolescents, and adults with chronic pain and the inability to self-report. METHOD The protocol was registered with PROSPERO (CRD42022310102). A search was run in MEDLINE, Embase, and PsycInfo (29th March 2022) to identify articles reporting psychometric properties of pain interference assessment tools for children, adolescents, and adults with chronic pain and the inability to objectively self-report pain. Retrieved studies were reviewed by two authors (MGS, LCF) and study quality was assessed using COSMIN. RESULTS Psychometric properties of 10 pain interference tools were assessed from 33 studies. The Paediatric Pain Profile (PPP) had low-quality evidence for content validity and internal consistency with children and adolescents who are unable to self-report. No tools for adults had evidence for content validity and internal consistency. No tool had evidence for all nine psychometric properties. INTERPRETATION The PPP is recommended for pain interference assessment in children and adolescents with chronic pain and the inability to self-report. Few tools are available for adults. Three tools for children (Patient-Reported Outcome Measurement Information System Pediatric Proxy Pain Interference Scale; Bath Adolescent Pain Questionnaire for Parents; modified Brief Pain Inventory-Proxy [mBPI]) and three tools for adults (Doloplus-2; Patient-Reported Outcome Measurement Information System Pain Interference Scale-proxy; Brief Pain Inventory-proxy) are promising but require further investigation.
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Affiliation(s)
- Meredith G Smith
- School of Allied Health Science and Practice, University of Adelaide, Adelaide, Australia
| | - Lucy C Farrar
- School of Allied Health Science and Practice, University of Adelaide, Adelaide, Australia
| | - Rachel J Gibson
- School of Allied Health Science and Practice, University of Adelaide, Adelaide, Australia
| | - Remo N Russo
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
- Paediatric Rehabilitation Department, Women's and Children's Hospital, Adelaide, Australia
| | - Adrienne R Harvey
- Neurodisability and Rehabilitation, Murdoch Children's Research Institute, Melbourne, Australia
- Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
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Thomas HW, Adeboye AA, Hart R, Senapathi H, Hsu M, Singh S, Maganti T, Kolade V, Ankam A, Gondal A. Phase 2 Assessment of a New Functional Pain Scale by Comparing It to Traditional Pain Scales. Cureus 2022; 14:e24522. [PMID: 35651383 PMCID: PMC9138198 DOI: 10.7759/cureus.24522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2022] [Indexed: 12/05/2022] Open
Abstract
Background Assessment of pain has always been subjective and is commonly assessed using a numeric pain scale (NPS) or Wong-Baker faces scale. The pain intensity score is not standardized and relies on individuals’ past experiences. The disadvantage of using such pain assessment scales and treating the numbers can lead to overdosing on analgesics leading to unwanted side effects. The Robert Packer Hospital/Functional Pain Scale (RPH/FPS) was developed as a tool for the objective assessment of pain and its impact on a patient’s function. Aim The study aimed to validate the RPH/FPS scale against NPS and Wong-Baker faces scale in medical, surgical, and trauma patients. The patients’ were also asked to rank the scales as one (1) being the most preferred to three (3) being the least preferred. Design This prospective, observational cohort study compares the two most common pain scales, the NPS and the Wong-Baker Faces, to the RPH/FPS. Methods Spearman correlation was used to test for correlation between the three scales, and Wilcoxon rank-sum test was used to compare means between the RPH/FPS and NPS. The study participants were also asked to rate their preferences for the scales by rating the most preferred of the three scales as one (1) and the least preferred number three (3). Results The RPH/FPS had a strong correlation with both the NPS and Wong-Baker Faces scales (RPH/FPS vs. NPS R=0.69, p<0.001: RPH-FPS vs. Wong-Baker Faces R=0.69, P<0.001). As for preferences, the RPH/FPS was ranked first on 36.9% of the surveys followed by NPS on 35.9%, and the Wong-Baker Faces on 22.3%. There were 4.9% of the surveys missing the preference rankings. Conclusion The results validate the RPH/FPS scale against the NPS and Wong-Baker Faces scales. This gives the clinicians a tool for objective assessment of pain and its effect on the recovery process, thereby minimizing the observed disconnect that sometimes happens between the reported pain intensity level and the providers' observation of the patient.
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Otterwell S, Baker MJ. Assessment and management of a person experiencing pain from pancreatic cancer ascites: a case study. BRITISH JOURNAL OF NURSING (MARK ALLEN PUBLISHING) 2022; 31:S16-S20. [PMID: 35271354 DOI: 10.12968/bjon.2022.31.5.s16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The most common type of pancreatic cancer is pancreatic adenocarcinoma, which affects the exocrine ducts. There are many risk factors associated with pancreatic cancer, including smoking, obesity, poor diet, diabetes, inactivity and genetics. In the UK, pancreatic cancer is the 10th most common cancer with a poor prognosis, with only 24% of people surviving the first year after diagnosis and 7% surviving for 5 years. The lives of those with the condition are impacted in a number of ways. This case study of a patient with pancreatic cancer explores the nursing assessment, management and evaluation of care provided from a student nurse perspective under the supervision of a qualified nurse.
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Affiliation(s)
- Siouxsie Otterwell
- Second-year Student Nurse, Florence Nightingale School of Nursing and Midwifery, King's College London
| | - Mark J Baker
- Lecturer, Florence Nightingale School of Nursing and Midwifery, King's College London
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Adeboye A, Hart R, Senapathi SH, Ali N, Holman L, Thomas HW. Assessment of Functional Pain Score by Comparing to Traditional Pain Scores. Cureus 2021; 13:e16847. [PMID: 34522490 PMCID: PMC8425136 DOI: 10.7759/cureus.16847] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2021] [Indexed: 11/30/2022] Open
Abstract
Background: Pain assessments, such as the Numerical Pain Scale (NPS) and Wong-Baker FACEs (FACEs), offer methods to quantify pain with simplistic descriptions on a scale of 0-10 or facial expressions. These tools have limitations and deliver insufficient information to the provider developing a pain management plan. A new Functional Pain Scale (FPS) assesses other scopes of pain, including the loss of function in activities of daily living, sleep habits, and communication. Although NPS and FACEs are traditionally used in clinical practice, FPS provides a functional assessment to help patients self-report their pain to their providers. Aim: Our study attempts to show a comparative data analysis of the FPS to NPS and FACEs. The purpose of our study is not to demonstrate FPS's superiority over NPS and FACEs but to fill the gaps of information necessary to communicate the type of pain a patient has to their provider. Due to its descriptive nature and clear scores, FPS should be implemented within electronic medical records (EMR) to help providers assess patients’ pain and evaluate the efficacy of interventions selected based on that pain. Design: A prospective, observational, single-center, cohort study was performed, with simultaneously administered surveys to compare pains scores on a new FPS to the common NPS and FACEs. The target sample was postoperative orthopedic patients above 18 years of age who can read and speak English. Patients were surveyed on all three pain scales: FPS, NPS, and FACEs and were asked to rate their pain perioperatively after their respective orthopedic procedures. Methods: Spearman correlation method was used to test for correlation between the three pain scales and Wilcoxon rank-sum test was used to compare means between FPS and NPS. Results: FPS has a strong correlation with FACEs (r = 0.647, p<0.05) and with NPS (r = 0.634, p<0.05). There is a significant difference in mean scores between FPS and NPS. Conclusion and study implications: The most reliable marker of pain is patient self-reporting. In routine assessment, because pain is one-dimensional, we as providers need to better define the range of 0-10. This can only be done via an algorithm regarding which functions are lost as pain intensities increase. FPS fits those requirements by offering suitable descriptions with each pain score. The implications of the study include a chance to remedy the opioid crisis that plagues healthcare. We need tools that assess and educate patients about their pain level and appropriately convey that information to providers. Furthermore, this study is a chance for innovative tools to be implemented to better change healthcare practice. If FPS gains traction, it can improve pain communication between patients and providers.
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Affiliation(s)
- Adeolu Adeboye
- Surgery, Guthrie Clinic and Robert Packer Hospital, Sayre, USA
| | - Rachel Hart
- Surgery/Trauma and Critical Care, Guthrie Clinic and Robert Packer Hospital, Sayre, USA
| | | | - Naaila Ali
- Medicine, Lake Erie College of Osteopathic Medicine (LECOM), Erie, USA
| | - Lee Holman
- Surgery, Guthrie Clinic and Robert Packer Hospital, Sayre, USA
| | - Harris W Thomas
- Anesthesiology/Pain Management, Guthrie Clinic and Robert Packer Hospital, Sayre, USA
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Eriksen LE, Terkelsen AJ, Blichfeldt-Eckhardt MR, Sørensen JCH, Meier K. Spinal cord stimulation in severe cases of complex regional pain syndrome: A retrospective cohort study with long-term follow-up. Eur J Pain 2021; 25:2212-2225. [PMID: 34196075 DOI: 10.1002/ejp.1834] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Complex regional pain syndrome (CRPS) is a debilitating pain condition often resistant to standard treatment modalities. In these cases, spinal cord stimulation (SCS) can be an option, but the effect on CRPS remains disputed. We aimed to assess the long-term effect of SCS on CRPS. METHODS We retrospectively analysed 51 CRPS patients implanted with an SCS system at the University Hospitals in Aarhus or Odense, Denmark, with a median follow-up time of 4.4 years. Primary outcomes were pain intensity on a numeric rating scale (NRS) and the Patients' Global Impression of Change (PGIC). Secondary outcomes were patient satisfaction, work status, consumption of pain medication, the Major Depression Inventory (MDI), Pain Catastrophizing Scale (PCS) and quality of life (QoL) measured using the Short-Form Health Survey (SF-36). For each outcome measure, baseline data were compared to the latest collected data point. RESULTS A significant pain relief was found with a mean reduction in NRS score of 2.4 (95% CI: 1.7-3.0, p < 0.0001). 68.8% reported 'much improved' or 'very much improved' on the PGIC scale. 87.5% would choose SCS again for the same outcome. A significant beneficial impact was found on MDI score, PCS, SF-36 summary scores and consumption of tricyclic antidepressants, antiepileptic drugs and opioids. No statistical effect was found on work status. CONCLUSION Pain intensity, depression, pain catastrophizing, pain medication use and QoL were significantly improved after SCS implantation, with high patient satisfaction rates in CRPS patients. This study supports the continued use of SCS in the treatment of severe CRPS. SIGNIFICANCE This study presents detailed data from a large, well-characterized cohort of Danish CRPS patients treated with SCS, analyzing several outcome measures. The results serve to document SCS as an effective treatment for severe CRPS and expands the cumulative level of evidence in favor of its use. Additionally, analysis of preoperative patient characteristics suggests that SCS treatment should not be withheld in patients with a high degree of psychological distress or high consumption of analgesics.
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Affiliation(s)
- Linda Elise Eriksen
- Department of Neurology and Danish Pain Research Center, Aarhus University Hospital, Aarhus, Denmark.,Department of Neurosurgery, Aarhus University Hospital, Aarhus, Denmark
| | - Astrid Juhl Terkelsen
- Department of Neurology and Danish Pain Research Center, Aarhus University Hospital, Aarhus, Denmark
| | - Morten Rune Blichfeldt-Eckhardt
- Department of Neurosurgery, Odense University Hospital, Odense, Denmark.,Department of Anesthesiology and Critical Care, Odense University Hospital, Odense, Denmark
| | | | - Kaare Meier
- Department of Neurosurgery, Aarhus University Hospital, Aarhus, Denmark.,Department of Anesthesiology, Aarhus University Hospital, Aarhus, Denmark
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