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

我们建议开发一个模型驱动的，基于证据的疼痛项目库，用于疼痛评估， 专门针对老年肿瘤学（老年肿瘤学）患者。这将建立在我们的新疼痛评估和 干预网络（NoPAIN）项目（Chang，PI，1 R21 CA 113191 -01），并继续其临床信息计量学 approach.本拟定研究旨在响应PA-03-152（生物行为疼痛研究）， “改进现有的测量疼痛的技术，并开发新的技术， 针对不同人群。“我们选择了这个人群的疼痛状况，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 需要完善和实施它们;老年人癌症的疼痛管理是一个紧迫的问题 考虑到社会人口统计学。 我们的目标是为该试题库构建一个计算机化的自适应测试平台， 测量异质性癌症患者的多维疼痛体验; 2）对 改变，以便它可以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）确定和完善疼痛评估的领域 对于老年肿瘤学人群，使用生物心理社会医学的现有理论框架， 2）编制多维疼痛项目库的项目，从 现有的疼痛问卷，并补充新编写的项目; 3）经验性地开发一个疼痛 建立适用于老年肿瘤学人群的试题库; 4）对计算机化自适应测验进行试点测试 (CAT)在临床环境中管理个性化疼痛评估的平台。 在这个R21项目结束时，我们期望（1）老年肿瘤学疼痛的概念模型 （2）可以构造疼痛项目的初始集合;（3）项目显示 差异项目功能（DIP）可以识别和修改;（4）CAT原型将展示 如何在临床环境中实施和测试该系统。

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 (DIP) can be identified and revised; and (4) the CAT prototype will demonstrate how the system should be implemented and tested in clinical settings.