Multidimensional Experience of Pain in Adults With Cirrhosis: A Cross-sectional Survey Study
Bibliographic record
Abstract
Background and Aims: Patients with liver disease report unrelieved pain. Exploring the multidimensional nature of pain provides insights into its burden and management needs in cirrhosis. This study explored biopsychosocial factors of pain and the relationship between pain intensity and liver disease severity. Methods: A cross-sectional survey design was conducted at a Canadian ambulatory hepatology clinic in 2021. Eligible participants were ≥18 years with a documented the Model for End-stage Liver Disease with Sodium (MELD-Na) score. We report pain characteristics, self-care management, and pain interference using the Brief Pain Inventory. Multiple linear regression analyses examined the relationship between MELD-Na and pain intensity. Results: Of 118 participants (98% response rate), 61.9% were male, 59 ± 11.8 years of age. Leading diagnoses were alcohol related (34.7%) and viral hepatitis (21.2%), and 89.8% had decompensated cirrhosis. The composite pain intensity mean score was 4 ± 2.4. Common pain sites included: abdomen (83.1%), lower legs (59.3%), and lower back (56.8%). Pain interference scores ranged from general activity 5.8 ± 3.1, walking ability 5.7 ± 3.3, and sleep 5.6 ± 3.6. Use of self-management strategies for pain was reported by 37.3%, primarily oral analgesics; no social or psychological strategies were reported. Multiple regression analysis indicated that pain intensity was associated with liver disease severity. MELD-Na 23-31 (β = 0.43), 21-22 (β = 0.28), and 17-20 (β = 0.19). Physical factors associated with pain intensity included ascites (β = 0.16) and edema (β = 0.28). Conclusion: We observed moderate pain and pain-related activity interference in adults with cirrhosis. Ascites, edema, and liver disease severity were associated with pain intensity. More research is needed to explore biopsychosocial pain management interventions for this population.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 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) | 0.000 | 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 teacher head, 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".