Department of Informatics, Bioengineering, Robotics and System Engineering, University of Genoa, Genoa, Italy.
Unit for Research in Anaesthesia, Istituto di Ricovero e Cura a Carattere Scientifico Giannina Gaslini, Genoa, Italy.
JMIR Form Res. 2024 Oct 8;8:e56674. doi: 10.2196/56674.
Pain management is a vital and essential part of postoperative pectus excavatum (PE) care. Given the lack of an international consensus on guidelines for postoperative handling and evaluation, further research is necessary to compare the efficacy of existing pain management methods regarding pain relief, side effects, and long-term outcomes. In this context, the use of eHealth solutions for data mining can enhance data collection efficiency, reduce errors, and improve patient engagement. However, these digital health care frameworks are currently underused in the context of pain management for PE.
This research is part of the broader Cryoanalgesia for Pain Management After Pectus Excavatum Repair (COPPER) study conducted by Giannina Gaslini Children's Hospital to address postoperative pain and recovery in PE patients treated with either standard thoracic epidural analgesia or cryoanalgesia, which is considered its innovative alternative approach. Specifically, this work is aimed at introducing a valuable tool for a comprehensive and quantitative comparison of the 2 analgesia strategies. The tool is a web and mobile app designed to facilitate data collection, management, and analysis of clinical data for pain assessment.
The adopted approach involves a careful design based on clinician input, resulting in an intuitive app structure with 3 main screens. Digital surveys are borrowed from paper surveys, including medical history and preoperative, postoperative, and follow-up evaluations. XTENS 2.0 was used to manage the data, and Ionic facilitated cross-platform app development, ensuring secure and adaptable data handling.
Preliminary analysis on a pilot cohort of 72 patients (36 treated with standard therapy and 36 treated with cryoanalgesia) indicated successful patient enrollment and balanced representation across treatment groups and genders. Notably, hospital stay was significantly shorter with cryoanalgesia than with standard therapy (Mann-Whitney-Wilcoxon 2-sided test with Bonferroni correction; P<.001; U statistic=287.5), validating its treatment efficacy.
This work is a step toward modernizing health care through digital transformation and patient-centered models. The app shows promise in streamlined data collection and patient engagement, although improvements in multilingual support, data validation, and incentivization of questionnaire completion are warranted. Overall, this study highlights the potential of digital health solutions in revolutionizing health care practices, fostering patient involvement, and improving care quality.
疼痛管理是漏斗胸（PE）术后护理的重要组成部分。由于缺乏关于术后处理和评估的国际共识指南，因此有必要进一步研究比较现有的疼痛管理方法在缓解疼痛、副作用和长期结果方面的疗效。在这种情况下，电子健康解决方案的数据挖掘可以提高数据收集效率，减少错误并提高患者参与度。然而，在 PE 的疼痛管理中，这些数字医疗保健框架目前并未得到充分利用。
这项研究是 Giannina Gaslini 儿童医院进行的 Cryoanalgesia for Pain Management After Pectus Excavatum Repair（COPPER）研究的一部分，旨在解决接受标准胸椎硬膜外镇痛或冷冻镇痛治疗的 PE 患者的术后疼痛和康复问题，冷冻镇痛被认为是其创新的替代方法。具体来说，这项工作旨在引入一种有价值的工具，用于全面和定量比较这两种镇痛策略。该工具是一个网络和移动应用程序，旨在促进疼痛评估的临床数据的收集、管理和分析。
所采用的方法基于临床医生的输入进行了精心设计，从而形成了一个具有 3 个主要屏幕的直观应用程序结构。数字调查借鉴了纸质调查，包括病史以及术前、术后和随访评估。XTENS 2.0 用于管理数据，而 Ionic 则促进了跨平台应用程序的开发，确保了数据的安全和适应性处理。
对 72 例患者（36 例接受标准治疗，36 例接受冷冻镇痛治疗）的试点队列进行的初步分析表明，患者成功入组，并且治疗组和性别之间的代表性平衡。值得注意的是，冷冻镇痛组的住院时间明显短于标准治疗组（Mann-Whitney-Wilcoxon 双侧检验，Bonferroni 校正；P<.001；U 统计量=287.5），验证了其治疗效果。
这项工作是朝着通过数字化转型和以患者为中心的模式实现医疗保健现代化迈出的一步。该应用程序在简化数据收集和患者参与方面显示出了潜力，但需要改进多语言支持、数据验证和激励问卷完成等方面。总的来说，这项研究强调了数字健康解决方案在彻底改变医疗保健实践、促进患者参与和提高护理质量方面的潜力。
