Developing a digital Ecological Momentary assessment tool for use with paediatric populations with chronic pain

该项目旨在改善5至11岁儿童对儿科慢性疼痛的评估。通过在研究不足的年龄组中改进疼痛评估，因此可以更好地理解、了解和重视他们的护理。更好的评估也会带来更好的护理，这意味着该项目支持柳叶刀儿童和青少年健康委员会地区转变儿科疼痛护理，使疼痛变得重要、可理解、可见和更好。现有措施的问题是，它们是单一的和具有追溯性的，影响了数据收集的质量和准确性。单一维度的测量往往不能捕捉到生物、心理和社会对疼痛影响的复杂性。回顾工具引入了认知偏差，如：最近效应、情绪突显和回忆偏差。因此，这些工具可能导致临床实践中的非最佳治疗计划和临床试验的不准确措施。为了解决一维问题，该项目将侧重于多维工具和数据三角测量的使用。多维工具评估痛苦体验的不同方面，例如：严重程度、强度、位置和对生活质量的影响。数据三角可以收集不同的数据模式和利益攸关方的观点，从而产生比单一的自我报告更有意义的产出。5-11岁年龄组对三角测量特别感兴趣，因为父母/监护人和同一老师全天都需要更高水平的照顾(而不是每个对象都不同)。生态瞬时评估(EMA)是一种旨在通过对参与者日常生活中的经验进行频繁采样来减少认知偏差的方法。研究表明，由于它能够捕捉个体间随时间变化的差异，从而能够详细评估治疗效果，因此在常规护理和临床试验中具有潜在的用途。该项目将侧重于电子媒体评估的数字化实施，因为与纸质日记和数据收集质量等非数字替代方案相比，遵守率有所提高。数字工具的使用还在遵守、数据通信和可伸缩性方面提供了额外的好处。然而，这些方法的组合：多维评估、三角测量和EMA将产生大量的数据。因此，本项目还应重点关注如何与多个利益攸关方沟通和理解这些数据，这一点很重要。此外，为了进一步推进这一点，必须了解如何激励儿童参与这一进程。

This project aims to improve the assessment of paediatric chronic pain for five- to eleven-year-olds. By improving the assessment of pain in an under-researched age group better understanding, visibility, and importance can therefore be placed on their care. Better assessment also leads to better care meaning this project supports The Lancet Child & Adolescent Health Commissions areas to transform paediatric pain care of making pain matter, understood, visible and better. Problems with existing measures are that they are unidimensional and retrospective, affecting the quality and accuracy of data collection. Unidimensional measures often do not capture the complexity of biopsychosocial influences on pain. Retrospective tools introduce cognitive biases such as: recency effects, emotional salience and recall bias. Thereby these tools can lead to non-optimal treatment plans in clinical practice and inaccurate measures for clinical trials. To address uni-dimensionality this project will focus on the use of multidimensional tools and data triangulation. Multidimensional tools assess different facets of a painful experience such as: severity, intensity, location, and impact on quality of life. Data triangulation allows the collection of different data modalities and stakeholders perspective to produce a more meaningful output than a single self-report. The 5-11 age group is especially of interest for triangulation due to the higher level of care required from a parent/guardian and the same teacher throughout the day (rather than changing per subject). Ecological Momentary Assessment (EMA) is a methodology which aims to reduce cognitive biases by frequently sampling participants' experiences throughout their everyday lives. Research has shown potential use in routine care as well as in clinical trials due to its ability to capture inter-individual variability over time and thereby detailed evaluation of treatment effects. This project will focus on the digital implementation of EMA due to the improved adherence rate against non-digital alternatives such as paper diaries and the quality of data collection. The use of a digital tool also provides additional benefits in relation to adherence, data communication and scale-ability. However, the combination of these methods: multidimensional assessment, triangulation and EMA will produce a significant amount of data. It is therefore important that this project also focuses on how this data can be communicated with and understood by multiple stakeholders. Additionally to further this point it is important to understand how children can be motivated to engage in this process.