Assessing Multidimensional Pain in Gero-Oncology: A Clinical Infometrics Approach

评估老年肿瘤学中的多维疼痛：临床信息计量方法

• 批准号: 7199441
• 负责人: CHIH-HUNG CHANG
• 金额: $ 15.1万
• 依托单位: NORTHWESTERN UNIVERSITY AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-02-01 至 2008-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7199441
• 关键词: Cancer Patient; Clinical; Complex; Condition; Disease Outcome; Elderly; Intervention; Malignant Neoplasms; Measures; Modeling; Pain; Pain Measurement; Pain Research; Pain management; Palliative Care; Palliative Medicine; Patients; Population; Questionnaires; System; Techniques; Testing; Time; Treatment Effectiveness; Writing; base; biobehavior; biopsychosocial; computerized; demographics; design; experience; improved; instrument; mRNA Differential Displays; novel; oncology; prototype; response

DESCRIPTION (provided by applicant): We propose to develop a model-driven, evidence-based pain item bank for use in pain assessment that is specific to geriatric oncology (gero-oncology) patients. This will build on our Novel Pain Assessment and Intervention Network (NoPAIN) project (Chang, PI, 1R21CA113191-01), and continue its Clinical Infometrics approach. This proposed study is designed in response to PA-03-152 (Biobehavioral Pain Research) to "refine existing techniques for measuring pain and develop new techniques that are disease- and outcome- specific for different populations." We have chosen the condition of pain in this population because: pain is a complex multidimensional experience; a critical mass of pain instruments now exist and there is an urgent need to refine and implement them; and pain management in cancer among older adults is a pressing issue given societal demographics. We also aim to construct a computerized adaptive testing platform for this item bank that: 1) can reliably measure the multidimensional pain experience of heterogeneous cancer patients; and 2) is sensitive to change so that it can assess the effectiveness of treatments over time. Our four distinct but related specific aims are: 1) To identify and refine the domains of pain assessment for a gero-oncology population, using existing theoretical frameworks in biopsychosocial medicine and palliative care as a guide; 2) To compile the items for a multidimensional pain item bank, drawing from existing pain questionnaires and supplementing with newly written items; 3) To develop empirically a pain item bank applicable to a gero-oncology population; and 4) To pilot test a computerized adaptive testing (CAT) platform to administer individualized pain assessments in clinical settings. At the end of this R21 project, we expect that (1) the conceptual model of the gero-oncology pain measurement can be improved; (2) the initial sets of pain items can be constructed; (3) items displaying differential item functioning (DIF) can be identified and revised; and (4) the CAT prototype will demonstrate how the system should be implemented and tested in clinical settings.

描述（由申请人提供）：我们建议开发一个模型驱动的循证疼痛项目库，用于老年肿瘤（老年肿瘤）患者的疼痛评估。这将建立在我们的新型疼痛评估和干预网络（NoPAIN）项目（Chang，PI，1 R21 CA 113191 -01）的基础上，并继续其临床信息计量学方法。这项拟议的研究是为了响应PA-03-152（生物行为疼痛研究）而设计的，旨在“改进测量疼痛的现有技术，并开发针对不同人群的疾病和结果的新技术。“我们选择了这一人群的疼痛状况，因为：疼痛是一种复杂的多维体验;现在存在大量的疼痛工具，迫切需要改进和实施它们;考虑到社会人口统计数据，老年人癌症的疼痛管理是一个紧迫的问题。我们还旨在为该项目库构建一个计算机化的自适应测试平台，该平台：1）可以可靠地测量异质性癌症患者的多维疼痛体验; 2）对变化敏感，以便随着时间的推移评估治疗的有效性。我们的四个不同但相关的具体目标是：1）确定和完善老年肿瘤学人群的疼痛评估领域，使用现有的生物心理社会医学和姑息治疗的理论框架作为指导; 2）汇编多维疼痛项目库的项目，从现有的疼痛问卷中提取并补充新编写的项目; 3）根据经验开发适用于老年肿瘤学人群的疼痛项目库;以及4）对计算机化自适应测试（CAT）平台进行试点测试，以在临床环境中进行个性化疼痛评估。在这个R21项目结束时，我们期望（1）老年肿瘤疼痛测量的概念模型可以得到改进;（2）可以构建疼痛项目的初始集合;（3）可以识别和修改显示差异项目功能（DIF）的项目;（4）CAT原型将演示如何在临床环境中实施和测试该系统。