An ontology for pain and related disability, mental health and quality of life.

描述(申请人提供)：这个项目的目标是更好地了解疼痛障碍的复杂性，特别是关于不同疼痛类型的评估，以及与疼痛相关的残疾及其与心理健康和生活质量的关系。这将通过开发一个本体论来实现，该本体论将用于整合五个现有的数据集，这些数据集广泛涵盖公认发生在口腔和相关区域的主要疼痛类型(口面部疼痛、颞下颌关节紊乱疼痛、头痛)，并纳入与生物心理社会角度一致的一系列关于疼痛的广泛措施。主诉单一区域持续性疼痛的患者通常表现出暗示不止一种疼痛障碍的症状。目前，尽管仍不确定，但疼痛领域认为不同类型的疼痛是从不同的机制产生的。因此，患有某种特定类型持续性疼痛的患者会根据这种疼痛的分类方式接受治疗，可能是不适当的。这些数据集涵盖同一领域，但在各方面各有不同：(1)数据集中的一些变量相同，但涉及躯体化、抑郁和焦虑等其他变量的变量因使用不同的仪器而有所不同；(2)数据显示出不同的粒度；(3)由于来源不同(美国、英国、瑞典、以色列和德国)，数据集纳入了与疼痛报告相关的文化影响，尽管使用了共同的工具，但这些影响对数据集的可比性产生了影响。本体将使以统一和正式的方式描述数据集成为可能，并且足够通用，一旦它们可用，就可以包括同一领域中的其他数据集。这一努力的重要性在于它对解决一个重要问题的贡献，即许多疼痛状况的表型在感兴趣的疾病亚组的范围、自然病史和/或临床病程方面没有得到充分的定义，最重要的是，关于实验室研究为其提供了重要病因学见解的疾病特征。通过合并这些数据集，我们将能够回答的主要临床问题是，病理解剖学和病理生理学-在这种情况下，在TMD和口面部疼痛的背景下-如何对疼痛相关的残疾和生活质量产生影响。由于本体论将提供精神健康领域中广泛使用的评估工具的正式表示，其适用性将远远超出拟议项目所涵盖的更窄的领域，因为实际原因。本体将遵循开放生物医学本体铸造(OBO-Foundry)中广泛接受和发表的原则，使用基本形式本体(BFO)和参照追踪(RT)作为通用语义技术来构建。通过与国际RDC/TMD联盟网络和国际疼痛研究协会的口腔面部疼痛特别兴趣小组的合作，这种本体论很可能成为该领域的标准。 公共卫生相关性：人们普遍认为，生物医学和生物心理社会相结合的方法最能支持对肌肉骨骼疾病引起的疼痛和功能障碍及其对心理健康和生活质量的影响的评估和管理。在拟议的努力中开发的本体论体现了相关生物医学模型(与颞下颌关节相关的解剖学和病理生理学)、心理模型和生物心理社会模型的概念理论。因此，它支持对涉及疼痛和功能障碍的生理和心理社会因素采取综合和多层面的方法，并将有助于各种保健专业人员对与疼痛有关的疾病的概念化和管理。

DESCRIPTION (provided by applicant): The goal of this project is to obtain better insight into the complexity of pain disorders, specifically concerning the assessment of different pain types as well as pain-related disablement and its association with mental health and quality of life. This will be achieved by developing an ontology which will then be used to integrate five existing datasets that broadly encompass the major types of pain (orofacial pains, temporomandibular disorder pain, headache) recognized to occur in the oral and associated regions and incorporating a broad array of measures consistent with a biopsychosocial perspective regarding pain. Patients complaining of a single regional persistent pain typically manifest symptoms suggestive of more than one pain disorder. Presently, and although still uncertain, the pain field regards different types of pain as emerging from different mechanisms. Consequently, patients suffering from a given type of persistent pain receive treatments based on how that pain has been classified, perhaps inappropriately. The datasets cover the same domain, but are distinct in various respects: (1) some variables are identical across datasets, others involving, for instance, somatization, depression and anxiety, are different because measured with distinct instruments; (2) the data exhibit different levels of granularity; (3) because of their distinct origins (US, UK, Sweden, Israel, and Germany), the datasets incorporate cultural influences related to pain report that have an impact on the comparability of the data sets, despite the use of common instruments. The ontology will make it possible to describe the datasets in a uniform and formal way, and be general enough to include other datasets in the same domain once they become available. The importance of this endeavor lays in its contribution to solving an important problem, namely that the phenotype of many pain conditions is insufficiently defined in terms of the scope, the natural history and/or clinical course of the disease subgroup of interest, and, most importantly, with respect to disease traits for which laboratory research has provided important pathogenetic insight. The main clinical question that we will be able to answer by merging these datasets is how patho-anatomy and pathophysiology - in this case in the context of TMD and orofacial pains - have an impact on pain-related disablement and quality of life. Because the ontology will provide a formal representation of widely used assessment instruments in the domain of mental health, its applicability will exceed by far the more narrow domain that is covered in the proposed project for practical reasons. The ontology will be built following the widely accepted and in Nature published principles adhered to in the Open Biomedical Ontology Foundry (OBO-Foundry, using Basic Formal Ontology (BFO), and Referent Tracking (RT) as generic semantic technologies. By working in collaboration with The International RDC/TMD Consortium Network, and the Orofacial Pain Special Interest Group of the International Association for the Study of Pain, this ontology is likely to become a standard in the domain. PUBLIC HEALTH RELEVANCE: There is general consensus that combined biomedical and biopsychosocial methods best support the assessment and management of pain and dysfunction caused by musculoskeletal disorders and the impact thereof on mental health and quality of life. The ontology to be developed in the proposed effort embodies the conceptual theories underlying relevant biomedical models (anatomy and pathophysiology related to temporomandibular joints), psychological models and biopsychosocial models. It thus supports an integrated and multidimensional approach concerning physical and psychosocial factors involved in pain and dysfunction, and will help in the conceptualization and management of pain-related disorders for various health care professionals.