Assessing the Functional Impact of Chronic Pain

描述(由申请人提供)：拟议的研发计划的总体目标是开发和演示一种新的方法，用于客观地测量疼痛及其在患者治疗过程中的变化对功能的影响。该方法旨在补充现有的评估患者功能的方法，这些方法目前是基于自我报告、临床医生观察、患者与家庭的和谐以及物理治疗师和/或职业治疗师的“快照”功能评估。第一阶段工作的中心目标将是证明拟议的新方法在评估慢性或亚急性疼痛疼痛临床患者的疼痛功能影响(FIP)方面的心理测量学效用(即有效性和可靠性)。第一阶段结构效度的成功设计将通过基于n次交叉验证技术的Bland-Altman分析(以及相应的零偏差、等标准差和显著R2值的统计测试)来展示新方法在预测每个传统心理测量学工具分数时的准确性。此外，还将计算工具间的相关性，并进行探索性因素分析，以评估数据中所代表的行为维度的数量。为了证明内部一致性的可靠性，将计算每一种传统心理测量学工具以及新方法的克朗巴赫的阿尔法和项目-总相关性。内部一致性信度的成功将通过证明克朗巴赫α=0.70和项目-总分相关在0.30-0.70范围内的值来定义，这是通常推荐值。此外，还将评估新的FIP评估方法的“可用性”(相对于“功能性”)。志愿人员将被要求完成可用性调查，其中的信息将用于在实施第二阶段系统之前改进新的FIP评估方法。功能能力是评估任何慢性疼痛状况的关键组成部分。虽然已经相当重视开发有助于评估疼痛相关残疾的心理测量工具，但通过问卷收集准确数据在实践中仍然是一个问题(例如，自我报告测量的性质并不反映患者在日常活动中的感觉和功能)。这项拟议的技术为克服目前在准确评估疼痛的功能影响方面的局限性提供了一种新的方法。

DESCRIPTION (provided by applicant): The overall goal of the proposed R&D program is to develop and demonstrate a new approach for objectively measuring the functional impact of pain, and changes thereto, during the course of a patient's treatment. The approach is intended to be a supplement to existing methods for assessing patient functioning, which are presently based on self-report, clinician observation, patient and family concordance, and "snapshot" functional assessments by physical therapists and/or occupational therapists. The central objective of the Phase I effort will be to demonstrate the psychometric utility (i.e., validity and reliability) of the proposed new approach for assessing the functional impact of pain (FIP) in pain clinic patients with chronic or subacute pain. Success for construct validity in Phase I will be designed by demonstrating the accuracy of the new approach in predicting each of the conventional psychometric instrument scores via Bland- Altman analysis (and corresponding statistical tests for zero bias, equal standard deviations, and significant R2 values) based on an n-fold cross-validation technique. Additionally, inter-instrument correlations will be computed and exploratory factor analysis will be performed to assess the number of behavioral dimensions represented in the data. To demonstrate internal-consistency reliability, Cronbach's alpha and item-total correlations will be computed for each of the conventional psychometric instruments as well as for the new approach. Success for internal-consistency reliability will be defined by demonstrating values for Cronbach's alpha = 0.70 and item-total correlations in the range 0.30-0.70, which are the generally recommended values. Additionally, the "usability" (as contrasted with "functionality") of the new FIP assessment method will be assessed. Volunteers will be asked to complete usability surveys, the information from which will be used to improve the new FIP assessment method prior to implementation of the Phase II system. Functional ability is a crucial component of the assessment of any chronic pain condition. Although considerable attention has been given to the development of psychometric instruments that facilitate the assessment of pain-related disability, collection of accurate data via questionnaires remains an issue in practice (e.g., self- report measures, by their nature, do not reflect how the patient feels and functions in day-to-day activity). The proposed technology offers a novel method for overcoming present limitations in accurately assessing the functional impact of pain.