Adolescent Screener and Opioid Assessment for Patients with Pain (A-SOAPP)

描述(申请人提供)：疼痛治疗，包括阿片类镇痛剂的使用，建议患有与特定病因相关的复发或慢性疼痛的青少年，如癌症、囊性纤维化、镰状细胞贫血、血友病。 或器官移植(见CO-I的支持信中按病因学列出的引文，索洛迪克博士)。预防性筛查工具提供的信息可供提供者用来告知处方选择(阿片类药物与其他药物的使用)和随后的监测(例如尿液筛查、药片计数)，从而实现安全有效的疼痛控制。儿科医院目前正在使用在其他人群中开发和测试的筛查器，因为还没有针对这一特定患者群体的有效工具。该应用程序的主要目的是开始开发一种名为青少年疼痛患者筛查工具(A-SOAPP)，用于患有继发性、复发性或慢性疼痛并伴有癌症等复杂医疗条件的青少年患者。A-SOAPP将填补现有的一个空白，即一种筛查工具，帮助医疗保健提供者在考虑接受间歇性或长期阿片类药物治疗的患者中识别可能面临阿片类药物滥用风险增加的个人，包括癌症患者和镰状细胞疾病患者。类似于成人版的开发，将采用严格的方法来开发具有稳定、高预测效度的筛选器。这种筛查器的青少年版本提出了重大的心理测量挑战，包括适合年龄的项目内容，说明照顾者在管理和监测药物使用方面的作用，以及在操作上定义异常药物相关行为的指标和指示这一人群可能上瘾的迹象。因此，除了满足重要的临床需求外，适合年龄和人群的阿片类药物风险筛查是该领域的一项重大创新。在我们看来，要实现这一目标，将需要“筛查者”的概念，使之偏离通常用于检测或预测的自我报告行为筛查者 物质使用问题。相反，这个筛选器将努力利用来自各种来源的数据的预测关系(例如，提供者观察、人口统计信息、病史以及患者自我报告)，以最佳地建模和预测感兴趣的结果，即 与药物有关的异常行为。

DESCRIPTION (provided by applicant): Pain management including the use of opioid analgesics is recommended for adolescents who are suffering from recurrent or chronic pain associated with a specific etiology such as cancer, cystic fibrosis, sickle cell anemia, hemophilia or organ transplants (see citations by etiology in letter of support from CO-I, Dr. Solodiuk). Preventive screening tools provide information that can be used by the provider to inform prescription choices (use of opioid versus another medication) and subsequent monitoring (e.g., urine screens, pill counts), resulting in safe and effective pain management. Pediatric hospitals are currently using screeners developed and tested with other populations because there is no validated tool for this specific patient population. The primary aim of this application is to begi development of a screening tool called the Adolescent Screener and Opioid Assessment for Patients with Pain (A-SOAPP) for use with adolescent-aged patients with secondary, recurrent or chronic pain accompanying complex medical conditions like cancer. The A-SOAPP will fill a void that exists for a screening tool to help healthcare providers identify individuals who may be at increased risk for opioid misuse among those patients being considered for episodic or long-term opioid therapy, including cancer patients and patients with sickle cell disease. Similar to development of the adult version, a rigorous methodical approach will be employed to develop a screener with stable, high predictive validity. An adolescent version of such a screener presents significant psychometric challenges including item content that is age-appropriate, accounting for the role of caregivers in the administration and monitoring of medication use, and operationally defining indicators of aberrant medication-related behaviors and signs indicating possible addiction in this population. Thus, in addition to meeting an important clinical need, an age-appropriate, population-appropriate screener for opioid risk represents a significant innovation in the field. In our view, the achievement of this goal will require the concept of a "screener" to deviate from the self-report behavioral screeners typically used to detect or predict substance use problems. Rather, this screener will endeavor to capitalize on predictive relations of data from a variety of sources (e.g., provider observations, demographic information, medical history, as well as patient self-report), to best model and predict the outcome of interest, namely aberrant medication-related behaviors.