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Cascella M, Di Gennaro P, Crispo A, Vittori A, Petrucci E, Sciorio F, Marinangeli F, Ponsiglione AM, Romano M, Ovetta C, Ottaiano A, Sabbatino F, Perri F, Piazza O, Coluccia S. Advancing the integration of biosignal-based automated pain assessment methods into a comprehensive model for addressing cancer pain. BMC Palliat Care 2024; 23:198. [PMID: 39097739 PMCID: PMC11297625 DOI: 10.1186/s12904-024-01526-z] [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] [Received: 09/02/2023] [Accepted: 07/19/2024] [Indexed: 08/05/2024] Open
Abstract
BACKGROUND Tailoring effective strategies for cancer pain management requires a careful analysis of multiple factors that influence pain phenomena and, ultimately, guide the therapy. While there is a wealth of research on automatic pain assessment (APA), its integration with clinical data remains inadequately explored. This study aimed to address the potential correlations between subjective and APA-derived objectives variables in a cohort of cancer patients. METHODS A multidimensional statistical approach was employed. Demographic, clinical, and pain-related variables were examined. Objective measures included electrodermal activity (EDA) and electrocardiogram (ECG) signals. Sensitivity analysis, multiple factorial analysis (MFA), hierarchical clustering on principal components (HCPC), and multivariable regression were used for data analysis. RESULTS The study analyzed data from 64 cancer patients. MFA revealed correlations between pain intensity, type, Eastern Cooperative Oncology Group Performance status (ECOG), opioids, and metastases. Clustering identified three distinct patient groups based on pain characteristics, treatments, and ECOG. Multivariable regression analysis showed associations between pain intensity, ECOG, type of breakthrough cancer pain, and opioid dosages. The analyses failed to find a correlation between subjective and objective pain variables. CONCLUSIONS The reported pain perception is unrelated to the objective variables of APA. An in-depth investigation of APA is required to understand the variables to be studied, the operational modalities, and above all, strategies for appropriate integration with data obtained from self-reporting. TRIAL REGISTRATION This study is registered with ClinicalTrials.gov, number (NCT04726228), registered 27 January 2021, https://classic. CLINICALTRIALS gov/ct2/show/NCT04726228?term=nct04726228&draw=2&rank=1.
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Affiliation(s)
- Marco Cascella
- Department of Medicine, Surgery and Dentistry, Anesthesia and Pain Medicine, University of Salerno, Via Salvador Allende 43, Baronissi Salerno, 84081, Italy
| | - Piergiacomo Di Gennaro
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori, IRCCS Fondazione G. Pascale, Via Mariano Semmola 53, Naples, 80131, Italy
| | - Anna Crispo
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori, IRCCS Fondazione G. Pascale, Via Mariano Semmola 53, Naples, 80131, Italy
| | - Alessandro Vittori
- Department of Anesthesia and Critical Care, ARCO Roma, Ospedale Pediatrico Bambino Gesù IRCCS, Piazza S. Onofrio 4, Rome, 00165, Italy.
| | - Emiliano Petrucci
- Department of Anesthesia and Intensive Care Unit, San Salvatore Academic Hospital of L'Aquila, Via Lorenzo Natali, 1, Coppito L'Aquila, 67100, Italy
| | - Francesco Sciorio
- Department of Anesthesiology, Intensive Care and Pain Treatment, University of L'Aquila, Piazzale Salvatore Tommasi, 1,, Coppito, AQ, 67100, Italy
| | - Franco Marinangeli
- Department of Anesthesiology, Intensive Care and Pain Treatment, University of L'Aquila, Piazzale Salvatore Tommasi, 1,, Coppito, AQ, 67100, Italy
| | - Alfonso Maria Ponsiglione
- Department of Information Technology and Electrical Engineering, University of Naples Federico II, Corso Umberto I, 40, Napoles, 80138, Italy
| | - Maria Romano
- Department of Information Technology and Electrical Engineering, University of Naples Federico II, Corso Umberto I, 40, Napoles, 80138, Italy
| | - Concetta Ovetta
- Department of Information Technology and Electrical Engineering, University of Naples Federico II, Corso Umberto I, 40, Napoles, 80138, Italy
| | - Alessandro Ottaiano
- SSD Innovative Therapies for Abdominal Metastases, Abdominal Oncology, INT IRCCS Foundation "G. Pascale", Via Mariano Semmola 53, Naples, 80131, Italy
| | - Francesco Sabbatino
- Department of Medicine, Surgery and Dentistry, Oncology Unit, University of Salerno, Via Salvador Allende 43, Baronissi Salerno, 84081, Italy
| | - Francesco Perri
- Medical and Experimental Head and Neck Oncology Unit, Istituto Nazionale Tumori - IRCCS Fondazione G. Pascale, Via Mariano Semmola 53, Naples, 80131, Italy
| | - Ornella Piazza
- Department of Medicine, Surgery and Dentistry, Anesthesia and Pain Medicine, University of Salerno, Via Salvador Allende 43, Baronissi Salerno, 84081, Italy
| | - Sergio Coluccia
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori, IRCCS Fondazione G. Pascale, Via Mariano Semmola 53, Naples, 80131, Italy
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