The Utilization of a Computerized Pain Assessment Tool-PAINReportIt® in Adolescents with Sickle Cell Disease.
Bibliographic record
Abstract
Abstract Abstract 1535 Poster Board I-558 Introduction Pain in sickle cell disease (SCD) is a common acute and chronic complication across the life span, but a single multidimensional pain assessment tool is not available that can be used in children, adolescents and adults. The Adolescent Pediatric Pain Tool (APPT) is a self-administered, paper and pencil tool that has been validated in children and adolescents with SCD; the McGill Pain Questionnaire (MPQ) is valid for adolescents and adults. To begin to create a multidimensional pain assessment tool that is valid across the life span, we compared the APPT to the PAINReportIt®, a self-administered computerized version of the MPQ in adolescent outpatients with SCD. The use of a computer/web based system would allow for ease of storage and retrieval of data. The utilization of a computerized pain assessment tool may provide clues to treatment of the multidimensional pain experience of pediatric patients with SCD. Patients and Methods Patients with sickle cell disease (Hb SS, Hb SC, Hb Sβ0 and Hb Sβ+ thalassemia) aged 14 years of age and older were eligible for this study. A convenience sample of patients attending comprehensive sickle cell clinics were recruited for enrollment. In random order, on the same day, patients completed the PAINReportIt® and the APPT in an outpatient clinic. The number of pain sites, pain intensity, qualitative pain descriptors (sensory, affective, and evaluative), pain pattern, as well as nociceptive and neuropathic descriptors were analyzed with descriptive, correlation, and independent t-test statistics. Results A total of 49 patients completed both pain assessment tools. 26 were female (53%) and 23 were male (47%). 41 (84%) patients had Hb SS, 7 (14.3%) had Hb SC, and 1 patient (2%) had Hb SB0 thalassemia. 46 (94%) of the patients described themselves as African American, 2 (4%) as Hispanic, and one (2%) as other. The mean number of pain sites with PAINReportIt® was 3.65 +/- 3.4; the mean number of pain sites with the APPT was 4.71 +/- 4.87 (r= 0.76, p= 0.01). Pain sites where more than 25% of the patients had pain included the chest, abdomen and forearm. More than 35% of the patients had pain in the thighs, knees and lower legs, and 59% of the patients reported pain in the lower back. The pain intensity with PAINReportIt® was 3.76 +/- 2.53 (on a 10-point scale) and with the APPT was 4.63 +/- 3.12 (on a 10-point scale) (r= 0.29, p= 0.05). In terms of qualitative pain descriptors between the tools, sensory (r= 0.69, p= 0.01), affective (r= 0.69, p= 0.01), and evaluative (r= 0.48, p= 0.001) terms each had a statistically significant correlation. There also was a statistically significant correlation between tools with the patient's pain pattern (r= 0.35, p= 0.01). There was a statistically significant difference by gender with the number of pain sites (females: 4.88 +/- 4.07, males: 2.26 +/-1.60, p= 0.005), and with the following qualitative pain descriptors: neuropathic (females: 4.31 +/- 3.08, males: 2.04 +/- 1.89, p= 0.03), nociceptive (females: 6.58 +/- 3.97, males: 3.91 +/- 2.71, p= 0.008), sensory (females: 17.54 +/- 8.29, males: 12.69 +/- 7.11, p= 0.03) and affective (females: 4.65 +/- 4.08, males: 2.27 +/- 2.70, p= 0.02). There was a statistically significant correlation with both tools regardless of which tool was completed first for the number of pain sites and with the use of sensory and affective qualitative descriptive terms (data not shown). Conclusion There were significant, moderate to strong correlations between the PAINReportIt® and the APPT with regard to pain location, intensity, quality and pattern, validating the use of PAINReportIt® in adolescent patients with SCD. This is the first study utilizing this important tool in pediatric patients with SCD. The minor differences in scores between the two tools may reflect differences in instructions. This computerized pain assessment tool may become an important diagnostic tool to assist pediatric practitioners in the management of the multidimensional components of pain in SCD. Disclosures No relevant conflicts of interest to declare.
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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 | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
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".