An Instrument to Assess the Functional Impact of Chronic Pain

项目摘要/摘要 慢性疼痛的评估和治疗是导致医疗成本上升的主要因素。虽然是准确的 疼痛和功能评估是成功的慢性疼痛管理的基石，系统、客观 疼痛的功能影响的评估在实践中仍然具有极大的挑战性。错综复杂的性质 慢性疼痛需要一种全面、多模式的评估方法，将患者的主观因素结合起来 具有客观数据的报告结果(PRO)。有巨大的潜力来降低相关的成本 通过利用新颖、尖端的传感技术，缓解慢性疼痛并同时改善结果 以及分析方法，提供新的疼痛评估和治疗评估信息。 拟议的Fast Track SBIR工作将开发和验证可靠、低成本的KnowPain仪器。 KnowPain将使用以下措施客观和定量地评估慢性疼痛(FIP)的功能影响 源自六自由度(6-DOF)运动、心率、皮肤表面温度和皮肤传导性 通过专门设计的人体工学手腕佩戴的生物识别感应仪收集。新的评估 仪器将把先进的心理测量方法应用于生理和运动学数据，以提供精确的 慢性疼痛导致的功能障碍评分。经过验证的仪器将是一台全自动、 可供临床医生在各种环境下评估和治疗慢性疼痛。 KnowPain仪器将由患者佩戴长达一周，之后收集 数据将由系统的自定义软件使用多维项目自动上载和处理 反应理论模型。评估结果将以易于理解的形式呈现给临床医生 报告，并将包括纵向结果、置信度估计和规范数据，以便进行比较 无论是在病人内部还是在病人之间。该系统将包括提供与电子病历接口 (EMRS)。 准确的功能评估是有效治疗慢性疼痛的关键组成部分。这个 建议的方法将补充现有的评估患者功能的方法(例如，PRO)，通过提供 提供新奇且高度互补的信息，以更完整(且通常未被观察到)了解 慢性疼痛对患者功能的影响。KnowPain措施将提供有关实际后果的重要数据 对疼痛和治疗效果的影响。慢性疼痛对日常生活的影响是患者最关心的问题； 患者非常重视疼痛干预，以提高他们参与正常日常活动的能力。 拟议的KnowPain系统将提供目前无法获得的客观数据，以促进知情和 有效的疼痛管理决策，导致：(1)减少功能障碍，增加行动能力，以及 改善生活质量；(2)不再强调药物，特别是阿片类药物；和(3)减少残疾和 相关的医疗费用，包括工人补偿。

Project Summary/Abstract Evaluation and treatment for chronic pain are major contributors to rising healthcare costs. Although accurate assessment of pain and function is the cornerstone to successful chronic pain management, systematic, objective assessment of the functional impact of pain remains exceptionally challenging in practice. The intricate nature of chronic pain demands a comprehensive, multi-mode assessment methodology that combines subjective Patient Reported Outcomes (PROs) with objective data. There is significant potential to reduce the costs associated with chronic pain and simultaneously improve outcomes by leveraging novel, cutting-edge sensing technology and analytical methods to provide new pain assessment and treatment evaluation information. The proposed Fast Track SBIR effort will develop and validate the reliable, low-cost KnowPain instrument. KnowPain will objectively and quantitatively assess the functional impact of chronic pain (FIP) using measures derived from six degrees-of-freedom (6-DOF) motion, heart rate, skin surface temperature, and skin conductivity collected via a specially designed, ergonomic wrist-worn biometric sensing instrument. The new assessment instrument will apply advanced psychometric methods to both physiologic and kinematic data to provide precise scores for functional impairment due to chronic pain. The validated instrument will be a fully-automated, stand-alone product available to clinicians assessing and treating chronic pain in a variety of settings. The KnowPain instrument will be worn by the patient for a period of up to one week, after which collected data will automatically be uploaded and processed by the system's custom software using Multidimensional Item Response Theory models. The assessment results will be presented to the clinician in an easy-to-understand report and will include longitudinal results, confidence estimates, and normative data to enable comparisons both within and between patients. The system will include provision to interface with electronic medical records (EMRs). Accurate functional assessment is a crucial component in the effective treatment of chronic pain. The proposed approach will supplement existing methods for assessing patient function (e.g., PROs) by providing novel and highly complementary information for a more complete (and often unobserved) picture of the impact of chronic pain on patient function. KnowPain measures will provide important data on the practical consequences of pain and on treatment efficacy. The impact of chronic pain on daily life is a primary concern for patients; patients assign great value to pain interventions that improve their ability to participate in normal daily activities. The proposed KnowPain system will provide currently unavailable objective data to facilitate informed and effective pain management decisions, leading to: (1) reduced functional impairment, increased mobility, and improved quality-of-life; (2) de-emphasis on medications, particularly opioids; and (3) reduced disability and associated healthcare costs, including worker's compensation.