Boudreau SA1, Galve Villa M2, S. Palsson T1
1Aalborg University, Center for Neuroplasticity and Pain (CNAP), SMI, Aalborg, Denmark, 2Aalborg University, Center for Neuroplasticity and Pain (CNAP), Aalborg, Denmark
Background: Traditionally pain drawings served to record the general location of pain from patient to clinician and until recently played a minor role in pain assessment. A common and primary use of pain drawings is to document widespread pain by assessing the number of pain sites however, remarkable distributions and detailed pain patterns within chronic pain conditions as drawn on digital maps of the human body are emerging. These digital pain maps are establishing and reinventing pain drawings as bidirectional communication tool for clinicians and a big data tool for clinical researchers. Paper based pain drawings inherently lack ease of use for assessing patients at home, real-time tracking and objective comparison of pain distributions and extent (such as total area), whilst a digital twin overcomes such obstacles with little resistance.
Purpose: To present research and clinical possibilities and adoption barriers learned from implementing, testing and assessing digital pain drawings submitted by patients from home using a complete cloud-based mapping platform over a period of 3-6 months.
Methods: Fifty patients recruited from physiotherapy and neurology clinics and social media nationally with referred back or neck pain participated in an online-only observational study. Using a cloud-based digital mapping software, participants submitted their current and usual pain intensity together with digital pain drawings (anterior, posterior and lateral views) detailing the intensity and distribution of pain qualities (12 options) on a 3D digital avatar. Upon receiving regular weekly reminders to submit pain drawings and after three months participants completed a System Usability Scale, Modified Technology Acceptance Model, and Technology Specific questionnaire. Assessments of drawing behavior and evolution pain symptoms expressed as a change in pain or quality symptoms (distribution and extent).
Results: Patients used a number of different pain types to report their referred pain patterns (burning, numbness, aching, tingling). Digital pain drawings were completed as requested on a weekly basis by approximately 50% of the participants, allowing technology to map and track changes to the pain type, perceived intensity rating (0-10) and extent (pixels). Furthermore, patients showed a tendency to improve detail in the pain reports across the first 3-6 pain chart submissions. Overall, more than 70% believed digital drawings revealed critical aspects and provided faster and easier communication of symptoms. Patients submitting relatively fewer charts over the 3 - 6 months assessment interval relied on weekly reminders and felt less confident using the digital technology. A majority of patients used annotation notes (restricted to 40 characters) to describe an activity explaining their current pain or as an option to express an emotional component of their pain.
Conclusion(s): Adding data objectivity to otherwise subjective patient reports of pain and sensory discomforts using digital mapping technology is a feasible method enabling a more comprehensive picture of clinical pain for patients with chronic pain conditions.
Implications: Digital body mapping enables clinicians to rely on real-time patient generated reports and can offer objective measures extracted from the pain map as support for clinical reasoning. Other benefits may include an improved patient-clinician relationship, improved understanding of patient symptoms, and faster communication of symptoms.
Keywords: Digital health technology, Pain drawings, Pain distribution
Funding acknowledgements: Talent Management Grant (Aalborg University)
Purpose: To present research and clinical possibilities and adoption barriers learned from implementing, testing and assessing digital pain drawings submitted by patients from home using a complete cloud-based mapping platform over a period of 3-6 months.
Methods: Fifty patients recruited from physiotherapy and neurology clinics and social media nationally with referred back or neck pain participated in an online-only observational study. Using a cloud-based digital mapping software, participants submitted their current and usual pain intensity together with digital pain drawings (anterior, posterior and lateral views) detailing the intensity and distribution of pain qualities (12 options) on a 3D digital avatar. Upon receiving regular weekly reminders to submit pain drawings and after three months participants completed a System Usability Scale, Modified Technology Acceptance Model, and Technology Specific questionnaire. Assessments of drawing behavior and evolution pain symptoms expressed as a change in pain or quality symptoms (distribution and extent).
Results: Patients used a number of different pain types to report their referred pain patterns (burning, numbness, aching, tingling). Digital pain drawings were completed as requested on a weekly basis by approximately 50% of the participants, allowing technology to map and track changes to the pain type, perceived intensity rating (0-10) and extent (pixels). Furthermore, patients showed a tendency to improve detail in the pain reports across the first 3-6 pain chart submissions. Overall, more than 70% believed digital drawings revealed critical aspects and provided faster and easier communication of symptoms. Patients submitting relatively fewer charts over the 3 - 6 months assessment interval relied on weekly reminders and felt less confident using the digital technology. A majority of patients used annotation notes (restricted to 40 characters) to describe an activity explaining their current pain or as an option to express an emotional component of their pain.
Conclusion(s): Adding data objectivity to otherwise subjective patient reports of pain and sensory discomforts using digital mapping technology is a feasible method enabling a more comprehensive picture of clinical pain for patients with chronic pain conditions.
Implications: Digital body mapping enables clinicians to rely on real-time patient generated reports and can offer objective measures extracted from the pain map as support for clinical reasoning. Other benefits may include an improved patient-clinician relationship, improved understanding of patient symptoms, and faster communication of symptoms.
Keywords: Digital health technology, Pain drawings, Pain distribution
Funding acknowledgements: Talent Management Grant (Aalborg University)
Topic: Pain & pain management; Outcome measurement; Robotics & technology
Ethics approval required: No
Institution: Den Videnskabsetiske Komité for Region Nordjylland
Ethics committee: Region Nordjylland
Reason not required: The study does not need the committees approval, hence the fact that you are (only) collecting data from questionnaires. This is not included in the definition of a ‘sundhedsvidenskabeligt forskningsprojekt’ jf. Komitélovens § 14, stk. 2, and therefore it does not need the committees approval.
All authors, affiliations and abstracts have been published as submitted.
