Predicting Readiness to Attend an Interdisciplinary Pain Management Program: What’s better for Clinical Decision-Making? Clinical Judgment or a Patient Self- Report Questionnaire?
Bibliographic record
Abstract
Background: Chronic Pain (CP) can have a substantial negative impact on one's life.Patients often seek Pain Management Programs (PMPs) as a means to treat their CP condition.The Michael G. DeGroote Pain Clinic, located in Hamilton, Ontario is a PMP that admits patients based on a variety of clinically important factors.Patients assessed are either recommended or not recommended into the program after consideration of these factors.Aims: The objective of this study was to examine if readiness, as assessed by the Pain Stages of Change Questionnaire (PSOCQ), is associated with a clinical judgment of readiness in recommending a person into a PMP.Additionally, to investigate whether PSOCQ scores or clinician judgment predicted readiness to attend a PMP.Methods: One-hundred and eight people were approached and recruited to this study.The 108 patients referred to the PMP in Ontario, were either recommended or not recommended into a PMP after completing an initial assessment.Associations between clinician rating, recommendation status and PSOCQ subscale scores were analyzed using independent t-tests, Pearson Correlation, and Stepwise Regression.We hypothesize that readiness assessed by the PSOCQ would be associated with clinical judgment of readiness in recommending a person into the PMP but that clinical judgment would be superior in predicting readiness to attend a PMP rather than the PSOCQ scores.Results: Those recommended to the PMP had higher assessor ratings, lower pre-contemplation and higher contemplation scores.There were significant relationships between the clinician's rating, pre-contemplation, contemplation, and recommendation status.Stepwise regression methods revealed that while there may be benefit to using questionnaire measures of readiness to change, clinical judgment was the best predictor for recommendation into the PMP.Conclusions: Clinical judgment in the initial assessment process was superior in clinical decision-making regarding a patient's readiness to attend a PMP, as compared to a self-report questionnaire.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.032 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".