Assessing Postoperative Pain in Patients Who Underwent Total Knee Arthroplasty Using an Automated Self-Logging Patient-Reported Outcome Measure Collection Device: Retrospective Cohort Study
Bibliographic record
Abstract
Background: Patient-reported outcome measures (PROMs) are tools for assessing symptoms and the quality of care. Despite their growing use, conventional data collection methods limit widespread PROM implementation. In orthopedics, pain is a frequent patient complaint and a common PROM, especially following total knee arthroplasty (TKA). Although TKA is generally successful, some patients still report postoperative pain, potentially due to tourniquet use. Using an improved PROM data-gathering technique may help to address tourniquet use during a TKA procedure and its impact on postoperative pain. The PainPad, an automated self-logging device, was developed to capture patient pain levels accurately. Objective: The aim of the study is to assess the feasibility and effectiveness of the PainPad device in quantifying in-hospital postoperative pain following TKA with or without tourniquet use. Methods: A retrospective study with 234 patients who underwent TKA from 2018 to 2021 at Milton Keynes University Hospital was conducted. Patients were categorized as receiving TKA with an intraoperative tourniquet (tourniquet group) or TKA without a tourniquet (nontourniquet group). Postoperative pain during the first 24 hours was self-reported every 2 hours using the PainPad device. From both groups, data on hospital length of stay, total tourniquet time, and the presence of postoperative deep vein thrombosis were also collected. Results: There were 115 TKAs with tourniquets (72/115, 62.6% female patients; mean age 69.26, SD 9.93 years) and 119 TKAs without tourniquets (91/119, 76.4% female patients; mean age 70.97, SD 9.01 years). When assessing 24-hour mean postoperative pain scores, the PainPad device data indicated no significant difference (P=.53; 95% CI -0.76 to 0.39) between the tourniquet (mean pain score 3.31, SD 2.34) and nontourniquet groups (mean pain score 3.12, SD 2.15). There was no correlation between tourniquet times and the pain scores retrieved from the PainPad device. A subgroup analysis comparing longer (>90 minutes) versus shorter (<90 minutes) tourniquet times showed no significant difference in terms of pain and length of stay. Conclusions: The PainPad device is a feasible and effective method for collecting and evaluating in-hospital postoperative pain following TKA, allowing for the quantification of individual pain levels. This study aligns with the current health care trend toward leveraging innovative technologies and personalized data to enhance patient-centered care.
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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 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 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".