Using Artificial Intelligence to Improve Pain Assessment and Pain Management: A Scoping Review

Abstract Approximate 50 million U.S. adults experience chronic pain. It is a widely held view that pain has been linked to sleep disturbance, mental problems, and reduced quality of life. Uncontrolled pain has led to increased healthcare utilization, hospitalization, emergency visits, and financial burden. Recognizing, assessing, understanding, and treating pain can improve outcomes of patients and healthcare use. A comprehensive synthesis of the current use of AI-based interventions in pain management and pain assessment and their outcomes will guide the development of future clinical trials. This review aims to investigate the state of the science of AI-based interventions designed to improve pain management and pain assessment for adult patients. The electronic databases Web of Science, CINAHL, PsycINFO, Cochrane CENTRAL, Scopus, IEEE Xplore, and ACM Digital Library were searched. The search identified 2131 studies, and 18 studies met the inclusion criteria. The Critical Appraisals Skills Programme was used to assess the quality. This review provides evidence that machine learning, deep learning, data mining, and natural language processing were used to improve efficient pain recognition and pain assessment (44%), analyze self-reporting pain data (6%), predict pain (6%), and help physicians and patients to more effectively manage with chronic pain (44%). Findings from this review suggest that using AI-based interventions to improve pain recognition, pain prediction, and pain self-management is effective; however, most studies are pilot study which raises concerns about the generalizability of findings. Future research should focus on examining AI-based approaches on a larger cohort and over a longer period of time.

Download Full-text

Role of Family Members in Pain Management in Adult Critical Care

AACN Advanced Critical Care ◽

10.4037/aacnacc2019275 ◽

2019 ◽

Vol 30 (4) ◽

pp. 398-410 ◽

Cited By ~ 1

Author(s):

Émilie Gosselin ◽

Mélissa Richard-Lalonde

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Pain Management ◽

Pain Assessment ◽

Family Members ◽

Future Research ◽

Rigorous Research ◽

Family Member Involvement

This review describes family member involvement in intensive care unit pain assessment and management and generates implications for clinical practice, education, and future research. A literature review was performed in MEDLINE, PubMed, EMBASE, Cochrane, and CINAHL databases from their inception until April 30, 2019. Only 11 studies addressing the topic were identified, and the current quality of evidence is low. Family members can be involved in pain assessment by describing patients’ pain behaviors and in pain management by selecting and delivering nonpharmacological interventions tailored to patients’ needs, if the family members feel comfortable with this role. More-rigorous research is required to describe the role of family members in patients’ pain assessment and management. Advancing knowledge in this field could improve patients’ and family members’ experiences with pain assessment and management in the intensive care unit.

Download Full-text

Pain Assessment: Benefits of Using Pain Scales for Surgical Patients in South Bohemian Hospitals

Healthcare ◽

10.3390/healthcare9020171 ◽

2021 ◽

Vol 9 (2) ◽

pp. 171

Author(s):

Vera Olisarova ◽

Valerie Tothova ◽

Martin Cerveny ◽

Vendula Dvorakova ◽

Petr Sadilek

Keyword(s):

Quality Of Life ◽

Pain Management ◽

Pain Assessment ◽

Exploratory Study ◽

Surgical Patients ◽

The South ◽

Pain Scales ◽

Emotional Component ◽

Attention To Pain

Pain is a medical and nursing problem that is common in surgical departments. Inadequate pain management can lead to patient distress, as well as extending the period in which the patient’s quality of life is reduced. The standardized SF-MPQ-2 questionnaire provides nurses with the opportunity to assess pain within a broader context. The aim of this descriptive and exploratory study was to describe the state of pain assessment in surgical patients in the South Bohemian Region and to highlight the benefits of using a standardized tool for proper pain assessment. The research was carried out using a quantitative survey within the South Bohemian Region (Czech Republic). The participants in the study were nurses working in surgical departments in hospitals in the region as well as hospitalized patients. The results show that nurses pay slightly more attention to pain assessments than doctors. We know that, generally, pain decreases with time after surgery. Nonetheless, returning pain, as well as continuous pain, can occur, both of which have an emotional component. The results of this study are directed at nurses and include a call for more effective pain management through improved assessment.

Download Full-text

Pain management programmes via video conferencing: a rapid review

Scandinavian Journal of Pain ◽

10.1515/sjpain-2020-0112 ◽

2020 ◽

Vol 0 (0) ◽

Author(s):

Jackie Walumbe ◽

Joletta Belton ◽

Diarmuid Denneny

Keyword(s):

Pain Management ◽

Methodological Quality ◽

Peer Group ◽

Video Conferencing ◽

Mesh Term ◽

Rapid Review ◽

Future Research ◽

Chronic Pain Conditions ◽

Pain Services

AbstractObjectivesDuring the current COVID-19 pandemic, healthcare has been transformed by the rapid switch from in person care to use of remote consulting, including video conferencing technology. Whilst much has been published on one-to-one video consultations, little literature exists on use of this technology to facilitate group interventions. Group pain management programmes are a core treatment provided by many pain services. This rapid review aimed to identify the extent of use of video conferencing technology for delivery of group pain management programmes and provide an overview of its use.MethodsA rapid review of the literature published up to April 2020 (PubMed, PsycINFO and PEDro) was performed. The search string consisted of three domains: pain/CP (MeSH term) AND Peer group[MeSH] AND Videoconferencing[MeSH]/Telemedicine[MeSH]/Remote Consultation[MeSH]. The studies were of poor methodological quality and study design, and interventions and chronic pain conditions were varied.ResultsLiterature searching yielded three eligible papers for this review. All studies had low methodological quality and risk of bias. Heterogeneity and variability in outcome reporting did not allow any pooling of data. The results demonstrated that videoconferencing for delivery of group programmes is possible, yet there is little extant literature on how to develop, deliver and measure outcomes of such programmes.ConclusionsThis review demonstrates that there is little evidence to support or guide the use of synchronous videoconferencing to deliver pain management programmes. We present issues to consider, informed by this review and our experience, when implementing video conferencing. Study quality of existing work is variable, and extensive future research is necessary.

Download Full-text

Reassessment of Evidence Synthesis of Occupational Medicine Practice Guidelines for Interventional Pain Management

January 2018 - Pain Physician ◽

10.36076/ppj.2008/11/393 ◽

2008 ◽

Vol 4;11 (8;4) ◽

pp. 393-482

Author(s):

Laxmaiah Manchikanti

Keyword(s):

Chronic Pain ◽

Pain Management ◽

Strong Evidence ◽

Guideline Development ◽

Medial Branch ◽

Low Back ◽

Quality Of Evidence ◽

Interventional Techniques ◽

Interventional Pain Management

Background: Appropriately developed practice guidelines present statements of best practice based on a thorough evaluation of the evidence from published studies on the outcomes of treatments, which include the application of multiple methods for collecting and evaluating evidence for a wide range of clinical interventions and disciplines. However, the guidelines are neither infallible, nor a substitute for clinical judgment. While the guideline development process is a complex phenomenon, conflict of interest in guideline development and inappropriate methodologies must be avoided. It has been alleged that the guidelines by the American College of Occupational and Environmental Medicine (ACOEM) prevent injured workers from receiving the majority of medically necessary and appropriate interventional pain management services. An independent critical appraisal of both chapters of the ACOEM guidelines showed startling findings with a conclusion that these guidelines may not be applied in patient care as they scored below 30% in the majority of evaluations utilizing multiple standardized criteria. Objective: To reassess the evidence synthesis for the ACOEM guidelines for the low back pain and chronic pain chapters utilizing an expanded methodology, which includes the criteria included in the ACOEM guidelines with the addition of omitted literature and application of appropriate criteria. Methods: For reassessment, randomized trials were utilized as it was in the preparation of the guidelines. In this process, quality of evidence was assessed and recommendations were made based on grading recommendations of Guyatt et al. The level of evidence was determined utilizing the quality of evidence criteria developed by the U.S. Preventive Services Task Force (USPSTF), as well as the outdated quality of evidence criteria utilized by ACOEM in the guideline preparation. Methodologic quality of each individual article was assessed utilizing the Agency for Healthcare Research and Quality (AHRQ) methodologic assessment criteria for diagnostic interventions and Cochrane methodologic quality assessment criteria for therapeutic interventions. Results: The results of reassessment are vastly different from the conclusions derived by the ACOEM guidelines. The differences in strength of rating for the diagnosis of discogenic pain by provocation discography and facet joint pain by diagnostic facet joint nerve blocks is established with strong evidence. Therapeutic cervical and lumbar medial branch blocks and radiofrequency neurolysis, therapeutic thoracic medial branch blocks, cervical interlaminar epidural steroid injections, caudal epidural steroid injections, lumbar transforaminal epidural injections, percutaneous and endoscopic adhesiolysis, and spinal cord stimulation qualified for moderate to strong evidence. Additional insight is also provided for evidence rating for intradiscal electrothermal therapy (IDET), automated percutaneous disc decompression, and intrathecal implantables. Conclusion: The reassessment and reevaluation of the low back and chronic pain chapters of the ACOEM guidelines present results that are vastly different from the published and proposed guidelines. Contrary to ACOEM’s conclusions of insufficient evidence for most interventional techniques, the results illustrate moderate to strong evidence for most diagnostic and therapeutic interventional techniques. Key words: Guidelines, evidence-based medicine, systematic reviews, ACOEM, interventional pain management, interventional techniques, guideline development, workers’ compensation, chronic pain guidelines, low back pain guidelines

Download Full-text

Dementia friendly initiatives: A state of the science review

Dementia ◽

10.1177/1471301217731433 ◽

2017 ◽

Vol 18 (5) ◽

pp. 1858-1895 ◽

Cited By ~ 12

Author(s):

Catherine A Hebert ◽

Kezia Scales

Keyword(s):

Interdisciplinary Collaboration ◽

Well Being ◽

Evidence Base ◽

Research Literature ◽

Current Evidence ◽

Future Research ◽

Current Evidence Base ◽

Centered Care ◽

State Of The Science

Background Dementia friendly initiatives share similarities with the age-friendly movement in a focus on active engagement and creating a good quality of life for older adults. Dementia friendly initiatives offer a welcoming optimistic narrative in dementia studies by embracing dignity, empowerment, and autonomy to enable well-being throughout the dementia trajectory. Purpose The purpose of this review is to explore the current science of dementia friendly initiatives, identify gaps, and inform future research. Method Quantitative, qualitative, and conceptual/theoretical peer-reviewed dementia friendly research literature were evaluated for their current evidence base and theoretical underpinnings. Results The dementia friendly initiatives research base is primarily qualitative and descriptive focused on environmental design, dementia awareness and education, and the development of dementia friendly communities. Person-centered care principles appear in dementia friendly initiatives centered in care settings. Strong interdisciplinary collaboration is present. Research is needed to determine the effect of dementia friendly initiatives on stakeholder-driven and community-based outcomes. Due to the contextual nature of dementia, the perspective of persons with dementia should be included as dementia friendly initiatives are implemented. Theory-based studies are needed to confirm dementia friendly initiative components and support rigorous evaluation. Dementia friendly initiatives broaden the lens from which dementia is viewed.

Download Full-text

Experience of using Neurouridine® in various types of peripheral neuropathy

International Professional Journal Medicine ◽

10.31082/1728-452x-2020-217-218-7-8-29-36 ◽

2021 ◽

Vol 7-8 (217-218) ◽

pp. 29-36

Author(s):

Nazira Zharkinbekova ◽

◽

Aiganym Khamidulina ◽

Zhazira Barat ◽

Botagoz Rustemova ◽

...

Keyword(s):

Quality Of Life ◽

Chronic Pain ◽

Peripheral Neuropathy ◽

Pain Assessment ◽

Pain Syndrome ◽

Symptomatic Therapy ◽

Chronic Pain Syndrome ◽

Combination Drug ◽

Face Scale

The quality of life of patients with chronic pain syndrome remains one of the most pressing issues. Pain is considered chronic if it lasts or recurs for more than 3-6 months. This contributes to disability, depression, sleep disorders, poor quality of life, and what is important in this situation, the cost of treatment. According to statistics, the average prevalence of chronic pain in the adult population is 20%. Practitioners everywhere are in search of new methods of pain relief. Purpose of research. The quality of life of patients with chronic pain syndrome has traditionally remained a topical issue. Given the permanent nature of pain and the completeness of approaches to its relief, the modern Clinician is constantly looking for new treatment methods that meet the principles of evidence-based medicine and safety. Material and methods. This paper presents the results of using Neurouridine® in 30 patients with peripheral neuropathy. 30 patients were randomized for a 3-week treatment period. Average age: 47.5±1.5 years. All patients received standard symptomatic therapy, and an oral combination drug containing b vitamins, folic acid, choline, and Uridine was added to the treatment in the 150 mg mode once a day. Patients made three visits to the outpatient neurological office: visit 1-to evaluate pre-treatment, visit 2-after 10 days of treatment, and visit 3-after 20 days of treatment. Each patient was presented with two performance evaluations at each study visit: pain assessment on the CRS NRS scale, and the fps Face scale. Results and discussion. Analysis of the results of the treatment showed improvement in the form of reduced pain, improved quality of life in 65.90%, rapid recovery of performance in 32.10%, reduced need for analgesics in 59.90% and complete disappearance of symptoms in 25.30% of patients. Pain was assessed using the HI NRG scale, the AZA Face scale, and the frequency of analgesics at the patient's first, second, and third visits. Conclusion. The use of Neurouridine® for analgesic purposes has shown a positive effect on reducing symptoms in patients with peripheral neuropathy. The results confirm that this therapy provides a clear regeneration of the nerves, relieving pain, and reducing the soreness characteristic of nerve damage. Keyword: peripheral neuropathy, Neurouridine®, pain assessment, quality of life.

Download Full-text

Tools, Time, Training, and Team—Military Primary Care Providers’ Perspectives on Improving Chronic Pain Assessment and Management

Military Medicine ◽

10.1093/milmed/usab367 ◽

2021 ◽

Author(s):

Asha Mathew ◽

Honor McQuinn ◽

Diane M Flynn ◽

Jeffrey C Ransom ◽

Ardith Z Doorenbos

Keyword(s):

Primary Care ◽

Chronic Pain ◽

Pain Management ◽

Pain Assessment ◽

Insurance Coverage ◽

Primary Care Providers ◽

Stepped Care ◽

Chronic Pain Management ◽

Care Providers ◽

Pain Care

ABSTRACT Introduction Primary care providers are on the front lines of chronic pain management, with many reporting frustration, low confidence, and dissatisfaction in handling the complex issues associated with chronic pain care. Given the importance of their role and reported inadequacies and dissatisfaction in managing this challenging population, it is important to understand the perspectives of primary care providers when considering approaches to chronic pain management. This qualitative descriptive study aimed to comprehensively summarize the provider challenges and suggestions to improve chronic pain care in military primary care settings. Materials and Methods Semi-structured interviews with 12 military primary care providers were conducted in a single U.S. Army medical center. All interviews were audio-recorded and lasted between 30 and 60 minutes. Interview transcripts were analyzed using ATLAS 9.0 software. Narratives were analyzed using a general inductive approach to content analysis. The Framework Method was used to organize the codes and emergent categories. All study procedures were approved by the Institutional Review Board of the University of Washington. Results Four categories captured providers’ challenges and suggestions for improving chronic pain care: (1) tools for comprehensive pain assessment and patient education, (2) time available for each chronic pain appointment, (3) provider training and education, and (4) team-based approach to chronic pain management. Providers suggested use of the Pain Assessment Screening Tool and Outcomes Registry, more time per visit, incorporation of chronic pain care in health sciences curriculum, consistent provider training across the board, insurance coverage for complementary and integrative therapies, patient education, and improved access to interdisciplinary chronic pain care. Conclusions Lack of standardized multifaceted tools, time constraints on chronic pain appointments, inadequate provider education, and limited access to complementary and integrative health therapies are significant provider challenges. Insurance coverage for complementary and integrative health therapies needs to be expanded. The Stepped Care Model of Pain Management is a positive and definite stride toward addressing many of these challenges. Future studies should examine the extent of improvement in guidelines-concordant chronic pain care, patient outcomes, and provider satisfaction following the implementation of the Stepped Care Model of Pain Management in military health settings.

Download Full-text

Systematic Pain Assessment and Management

Palliative Care in Nephrology ◽

10.1093/med/9780190945527.003.0015 ◽

2020 ◽

pp. 148-166

Author(s):

Sara N. Davison

Keyword(s):

Quality Of Life ◽

Chronic Kidney Disease ◽

Chronic Pain ◽

Pain Assessment ◽

Prescribing Patterns ◽

Symptom Screening ◽

Chronic Disorder ◽

Psychosocial Consequences ◽

Clinically Significant

Patients with chronic kidney disease suffer from high rates of pain. Pain is a highly complex, multidimensional, and personal phenomenon with far reaching physical and psychosocial consequences if the pain progresses to become a chronic disorder. Systematic integration of global symptom screening needs to be incorporated into routine kidney care, followed by a comprehensive pain assessment for those with clinically significant pain, keeping in mind the overall goal is to promote functionality and quality of life and not to necessarily completely resolve the pain. There is tremendous variability within and between countries in the management of pain, including the prescribing patterns of analgesics. This chapter outlines a systematic approach to the assessment and management of acute and chronic pain with both nonpharmacologic and pharmacologic interventions.

Download Full-text

Pain in domestic animals and how to assess it: a review

Veterinární Medicína ◽

10.17221/5915-vetmed ◽

2012 ◽

Vol 57 (No. 4) ◽

pp. 185-192 ◽

Cited By ~ 20

Author(s):

L. Landa

Keyword(s):

Pain Management ◽

Animal Welfare ◽

Pain Assessment ◽

Domestic Animals ◽

Current Review ◽

Adult Humans ◽

Clinical Responses ◽

General Signs ◽

Species Specific ◽

Pain Recognition

 In recent years more attention has been paid to the issue of pain in animals, particularly in association with increasing awareness of animal welfare. It is therefore necessary for veterinarians to be able recognise unambiguously whether an animal suffers from pain. Adult humans suffering from pain can more or less characterise their painful experiences, including the site and intensity of the pain. However, pain in animals is in some aspects more complex and it can be rather difficult to evaluate the seriousness and impact of painful events. Therefore, in animals we have to recognise the signs of pain according to indirect markers which involve behavioural, physiological and finally clinical responses. Moreover, in particular the behavioural changes associated with pain can be along with the general signs also species-specific, and hardly recognisable (and for an inexperienced observer seemingly unimportant) which makes pain assessment even more complicated. Therefore, the current review formulates definitions of pain, its classification and is focused on methods that may facilitate pain recognition in animals, which is crucial for an effective pain assessment and consequent effective pain management. The review combines recent knowledge with well proven facts concerning pain and furthermore also highlights the author’s own research on pain assessment.    

Download Full-text

Online paediatric chronic pain management: assessing the needs of UK adolescents and parents, using a cross-sectional survey

British Journal of Pain ◽

10.1177/2049463720940341 ◽

2020 ◽

pp. 204946372094034

Author(s):

Anna Hurley-Wallace ◽

Daniel E Schoth ◽

Suzanne Lilley ◽

Glyn Williams ◽

Christina Liossi

Keyword(s):

Social Media ◽

Chronic Pain ◽

Pain Management ◽

Online Survey ◽

Interdisciplinary Treatment ◽

Future Research ◽

Chronic Pain Management ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Social Media Platforms

Background: Adolescent chronic pain is prevalent, and interdisciplinary treatment is recommended. Although it is well known that technology is a key part of adolescents’ daily lives, there have not been any online, interdisciplinary interventions developed for adolescents with chronic pain in a UK healthcare context. Little is known about how adolescents currently use online resources to manage chronic pain, or what guidance they seek. Methods: Ninety-five participants from the community answered this mixed-methods, online survey (adolescent n = 54, parent n = 41), which assessed the needs of UK-based adolescents for a new online chronic pain management resource. Results: Findings indicated that, at the time of the survey, adolescents frequently used social media platforms, such as Instagram, for chronic pain management. Desired techniques for a new interdisciplinary resource for adolescents included ‘advice on explaining chronic pain to others’ (86.7% of adolescents) and sleep hygiene (82.2% of adolescents), though access to a range of pain management techniques was desired. Qualitative results indicated endorsement of a new programme by adolescents and parents. Conclusions: Adolescents and parents had a positive outlook towards the development of a UK-specific online resource to help manage chronic pain. Such an intervention should aim to be made accessible via the National Health Service. Adolescent use of social media platforms to seek support for chronic pain requires further exploration in future research.

Download Full-text