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数据可视化作为儿科慢性疼痛的一种干预措施:一项随机对照交叉试验的试点可行性研究方案

Data visualization as an intervention for pediatric chronic pain: a pilot feasibility study protocol for a randomized controlled crossover trial.

作者信息

Boerner Katelynn E, Desai Unma, MacLean Karon E, Munzner Tamara, Foladare Haley, Gill Javed, Oberlander Tim F

机构信息

Department of Pediatrics, University of British Columbia, Vancouver, BC, Canada.

BC Children's Hospital and Research Institute, Vancouver, BC, Canada.

出版信息

Pilot Feasibility Stud. 2022 Oct 3;8(1):223. doi: 10.1186/s40814-022-01170-5.

Abstract

BACKGROUND

Chronic pain is a common and costly condition in youth, associated with negative implications that reach far beyond the pain experience itself (e.g., interference with recreational, social, and academic activities, mental health sequelae). As a self-appraised condition, pain experience is influenced by patient's biases and meaning-making in relation to their symptoms and triggers. We propose that interacting with self-reported data will impact the experience of pain by altering understanding and expectations of symptom experience and how pain interacts with other factors (e.g., sleep, emotions, social interactions). In this study, we aim to establish the feasibility and acceptability of using a data visualization platform to track and monitor symptoms and their relationship with other factors, versus simply daily reporting of symptoms using a smartphone-based Ecological Momentary Assessment (EMA).

METHODS

This protocol is for a randomized, single-center, open-label crossover trial. We aim to recruit 50 typically developing youth aged 12-18 years with chronic pain to take part in two phases of data collection. The trial will utilize an A-B counterbalanced design in which participants will be randomly assigned to receive either Part A (EMA alone for 7 days) or Part B (EMA plus visualization platform for 7 days) first and then receive the opposite phase after a 7-day break (washout period). Key outcomes will be participant reports of acceptability and feasibility, EMA completion rates, barriers, and perceptions of the benefits or risks of participation. Secondary exploratory analyses will examine the relationship between EMA-reported symptoms over time and in relation to baseline measures, as well as pilot data on any improvements in symptoms related to engaging with the data visualization platform.

DISCUSSION

This protocol describes the feasibility and pilot testing of a novel approach to promoting self-management and facilitating symptom appraisal using visualized data. We aim to determine whether there is a sufficient rationale, both from the perspective of feasibility and patient satisfaction/acceptability, to conduct a larger randomized controlled trial of this intervention. This intervention has the potential to support clinical care for youth with chronic pain and other conditions where self-appraisal and understanding of symptom patterns are a critical component of functional recovery.

TRIAL REGISTRATION

Open Science Framework doi: https://doi.org/10.17605/OSF.IO/HQX7C . Registered on October 25, 2021, osf.io/hqx7c.

摘要

背景

慢性疼痛在青少年中很常见且代价高昂,其带来的负面影响远远超出疼痛体验本身(例如,干扰娱乐、社交和学术活动,引发心理健康问题)。作为一种自我评估的状况,疼痛体验受患者对其症状和触发因素的偏见及意义建构的影响。我们认为,与自我报告数据进行交互将通过改变对症状体验的理解和期望以及疼痛与其他因素(如睡眠、情绪、社交互动)的相互作用方式来影响疼痛体验。在本研究中,我们旨在确定使用数据可视化平台来跟踪和监测症状及其与其他因素的关系,相较于单纯使用基于智能手机的生态瞬时评估(EMA)每日报告症状,是否具有可行性和可接受性。

方法

本方案为一项随机、单中心、开放标签的交叉试验。我们旨在招募50名年龄在12 - 18岁、患有慢性疼痛的发育正常的青少年参与两个阶段的数据收集。该试验将采用A - B平衡设计,参与者将被随机分配首先接受A部分(仅EMA,为期7天)或B部分(EMA加可视化平台,为期7天),然后在7天的休息期(洗脱期)后接受相反的阶段。主要结局将是参与者对可接受性和可行性的报告、EMA完成率、障碍以及对参与的益处或风险的认知。次要探索性分析将研究EMA报告的症状随时间的变化及其与基线测量的关系,以及关于与数据可视化平台互动相关的症状改善情况的试点数据。

讨论

本方案描述了一种使用可视化数据促进自我管理和辅助症状评估的新方法的可行性和试点测试。我们旨在从可行性以及患者满意度/可接受性的角度确定是否有充分的理由对该干预措施进行更大规模的随机对照试验。这种干预措施有可能为患有慢性疼痛以及其他自我评估和对症状模式的理解是功能恢复关键组成部分的疾病的青少年提供临床支持。

试验注册

开放科学框架doi: https://doi.org/10.17605/OSF.IO/HQX7C 。于2021年10月25日注册,osf.io/hqx7c。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2412/9528110/a31215dd75e1/40814_2022_1170_Fig1_HTML.jpg

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