Dataset Information

Pediatric Pain Screening Tool: A Simple 9-Item Questionnaire Predicts Functional and Chronic Postsurgical Pain Outcomes After Major Musculoskeletal Surgeries.

ABSTRACT: Reliable, clinic-friendly screening for Chronic postsurgical pain (CPSP) risk is unavailable. Within a prospective, observational study, we evaluated Pediatric Pain Screening Tool (PPST), a concise 9-item questionnaire, as a preoperative screening tool to identify those at higher risk for CPSP (Numerical Rating Scale > 3/10 beyond 3 months post-surgery) and poor function (disability/Functional Disability Inventory [FDI]/quality of life/ Pediatric Quality of Life) after spine fusion and Nuss procedures. Incidence of CPSP was 34.86% (38/109). We confirmed PPST scale stability, test re-test reliability (ICC = 0.68; P< .001); PPST measures were positively correlated with known CPSP risk factors (P< .001) preoperative pain (Pearson or Spearman Correlation Coefficient [SCC]:0.672), Child anxiety sensitivity index (SCC:0.357), Patient Related Outcome Measures Information System pain interference (SCC:0.569), Patient Related Outcome Measures Information System depression (SCC:0.501), Pediatric Quality of Life (SCC:-0.460) and insomnia severity index (SCC0.567). Preoperative PPST and PPST physical sub-scores (median(IQR) were higher in CPSP (2[0.5,4], 1[0,2]) compared to non-CPSP (1[0,3], 0[0,1.5]) groups (P= .026, P= .029) respectively. PPST scores/sub-scores positively correlated with higher FDI at 6 months but only PPST total and PPST psychosocial subscore correlated with higher FDI at 12 months. Based on ROC, optimal PPST cutoff for CPSP was 2 (63.9% sensitivity, 64.7% specificity). CPSP risk was high (48.94% risk) if PPST ≥ 2 (n = 47) and medium (22.81%) if PPST < 2 (n = 57) after spine/pectus surgery. General and risk-strata specific, targeted psychosocial non-pharmacological interventions, need to be studied. Findings need validation in diverse, larger cohorts. CLINICALTRIALS.GOV IDENTIFIER: NCT02998138. PERSPECTIVE: The article supports Pediatric Pain Screening Tool, a simple 9-item questionnaire, as a preoperative screening tool for CPSP and function 6-12 months after spine/pectus surgeries. PPST measures correlate with known risk factors for CPSP. Risk stratification and targeted preventive interventions in high-risk subjects are proposed.

SUBMITTER: Narayanasamy S

PROVIDER: S-EPMC8783955 | biostudies-literature | 2022 Jan

REPOSITORIES: biostudies-literature

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Pediatric Pain Screening Tool: A Simple 9-Item Questionnaire Predicts Functional and Chronic Postsurgical Pain Outcomes After Major Musculoskeletal Surgeries.

Narayanasamy Suryakumar S Yang Fang F Ding Lili L Geisler Kristie K Glynn Susan S Ganesh Arjunan A Sathyamoorthy Madhankumar M Garcia Victor V Sturm Peter P Chidambaran Vidya V

The journal of pain 20210717 1

Reliable, clinic-friendly screening for Chronic postsurgical pain (CPSP) risk is unavailable. Within a prospective, observational study, we evaluated Pediatric Pain Screening Tool (PPST), a concise 9-item questionnaire, as a preoperative screening tool to identify those at higher risk for CPSP (Numerical Rating Scale > 3/10 beyond 3 months post-surgery) and poor function (disability/Functional Disability Inventory [FDI]/quality of life/ Pediatric Quality of Life) after spine fusion and Nuss proc ...[more]

PMID: 34280572

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Project description:Study objectiveTo determine if baseline cytokines and their changes over postoperative days 0-2 (POD0-2) predict acute and chronic postsurgical pain (CPSP) after major surgery.DesignProspective, observational, longitudinal nested study.SettingUniversity-affiliated quaternary children's hospital.PatientsSubjects (≥8 years old) with idiopathic scoliosis undergoing spine fusion or pectus excavatum undergoing Nuss procedure.MeasurementsDemographics, surgical, psychosocial measures, pain scores, and opioid use over POD0-2 were collected. Cytokine concentrations were analyzed in serial blood samples collected before and after (up to two weeks) surgery, using Luminex bead arrays. After data preparation, relationships between pre- and post-surgical cytokine concentrations with acute (% time in moderate-severe pain over POD0-2) and chronic (pain score>3/10 beyond 3 months post-surgery) pain were analyzed. After adjusting for covariates, univariate/multivariate regression analyses were conducted to associate baseline cytokine concentrations with postoperative pain, and mixed effects models were used to associate longitudinal cytokine concentrations with pain outcomes.Main resultsAnalyses included 3,164 measures of 16 cytokines from 112 subjects (median age 15.3, IQR 13.5-17.0, 54.5% female, 59.8% pectus). Acute postsurgical pain was associated with higher baseline concentrations of GM-CSF (β=0.95, SE 0.31; p=.003), IL-1β (β=0.84, SE 0.36; p=.02), IL-2 (β=0.78, SE 0.34; p=.03), and IL-12 p70 (β=0.88, SE 0.40; p=.03) and longitudinal postoperative elevations in GM-CSF (β=1.38, SE 0.57; p=.03), IFNγ (β=1.36, SE 0.6; p=.03), IL-1β (β=1.25, SE 0.59; p=.03), IL-7 (β=1.65, SE 0.7, p=.02), and IL-12 p70 (β=1.17, SE 0.58; p=.04). In contrast, CPSP was associated with lower baseline concentration of IL-8 (β= -0.39, SE 0.17; p=.02), and the risk of developing CPSP was elevated in patients with lower longitudinal postoperative concentrations of IL-6 (β= -0.57, SE 0.26; p=.03), IL-8 (β= -0.68, SE 0.24; p=.006), and IL-13 (β= -0.48, SE 0.22; p=.03). Furthermore, higher odds for CPSP were found for females (vs. males) for IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, and TNFα, and for pectus (vs. spine) surgery for IL-8 and IL-10.ConclusionWe identified pro-inflammatory cytokines associated with increased acute postoperative pain and anti-inflammatory cytokines associated with lower CPSP risk, with potential to serve as predictive and prognostic biomarkers.

Project description:BackgroundThe Mystical Experience Questionnaire (MEQ-30) and Challenging Effects Questionnaire (CEQ) are two of the most widely used, validated instruments to probe subjective effects of psychedelic drugs. However, these assessments are lengthy and can be a burden to study participants or patients if administered during acute psychedelic effects, after resolution of psychedelic effects when participants are often fatigued, or in studies with multiple other assessments. The development of briefer measures can advance research and patient assessment.Methods and materialsThis study developed and assessed the validity of brief versions of the MEQ-30 and CEQ (MEQ-4 and CEQ-7) using data collected online from individuals reporting psychedelic use with therapeutic intent in nonstudy settings (N = 1160). Respondents completed full and brief versions as well as mood questionnaires indexing mental health symptoms before their psychedelic experience and now.ResultsFull and brief version total scores showed strong correspondence for the MEQ (r = 0.89) and CEQ (r = 0.90). Brief versions also showed strong correspondence to full-scale subscale scores. MEQ and CEQ scores were higher for classic psychedelics (e.g., lysergic acid diethylamide, psilocybin) than for 3,4-Methylene-dioxymethamphetamine in this sample with both full and brief versions, consistent with previous full-version findings showing drug and dose-related differences using the MEQ. Also consistent with prior findings, higher mystical experience scores on both full and brief MEQ versions were associated with greater reductions in depression and anxiety, whereas challenging experiences on both full and brief CEQ versions showed limited association with changes in mental health variables.ConclusionThe notably strong association of brief scales with full versions combined with associations with therapeutic outcomes provide initial support for the MEQ-4 and CEQ-7. These findings, combined with substantial reductions in participant/patient burden, support the use of the MEQ-4 and CEQ-7 for a wide variety of research and patient treatment settings.

Project description:The musculoskeletal disorders (MSDs) severity and frequency questionnaire (MSFQ) has been used with agriculturists. Although it frequently appears in the literature, it does not periodically reflect the levels of MSDs. This study aimed to develop a MSDs assessment tool for agriculturists via an online database. The four hospitals that were assigned to the development and tryout group received a random selection of participants from 33 health promoting hospitals. In the development phase, 55 agriculturists (from two hospitals) completed the structured interview questionnaire. The MSFQ document for the analysis of MSDs symptoms among agriculturists was concentrated on the frequency and severity of symptoms. The online MSFQ was checked by using intraclass correlation coefficients (ICC) in a one-way random-effects model. In the tryout phase, a group of 44 agriculturists (from another two hospitals) completed a similar online MSFQ. Cronbach's alpha was used to test the reliability of the online self-reported MSDs questionnaires. A Likert rating scale, used to measure the satisfaction of users, was divided into three categories: information, program design, and benefits. The development phase showed an ICC = 0.99 with a 95% CI = 0.98-0.99. More than 65 percent of agriculturists were female, aged from 41-50 years old. A large number of them were engaged in self-cultivation. Their main crops were rice and cassava. In total, 50% reported that they had experienced mild MSDs levels. The shoulder, knee-calf, and hip-thigh areas were the top three parts of the body where agriculturists had experienced MSDs from cultivation. Excellent reliability of online MSFQ was found after the tryout. The agriculturists were very satisfied overall (information, program design, and benefits). Developments to the MSFQ and online administration did not diminish its reliability for obtaining information about the level of MSDs of agriculturists' musculoskeletal symptoms. This self-reported MSDs questionnaire was appropriate to be used among agriculturists.

Project description:BackgroundPatients with back and neck pain are often seen in primary care and it is important to provide them with tailored interventions based on risk stratification/triage. The STarT Back Screening Tool (SBT) is a widely used screening questionnaire which has not yet been validated for a population with back and/or neck pain with short duration. Our aim was to compare the concurrent validity of the SBT and the short form of the ÖMPSQ including psychometric properties and clinical utility in a primary care setting.MethodsPatients who applied for physiotherapy by direct access (January 2013 to January 2014) at 35 primary care centers in south Sweden, with acute or subacute back and/or neck pain, aged 18-67 years, who were not currently on sick leave or had been on sick leave less than 60 days were asked to complete the SBT and ÖMPSQ-short questionnaire (n = 329). We used the Spearman's rank correlations to study correlations, cross tabulation and Cohen's kappa to analyze agreement of patient classification. Clinical utility was described as clinician scoring miscalculations and misclassifications of total and/or subscale scores.ResultsCompleted SBT (9-items) and ÖMPSQ-short (10-items) data were available for 315/329 patients respectively. The statistical correlation for SBT and ÖMPSQ-short total scores was moderately strong (0.62, p < 0.01). In subgroup analyses, the correlations were 0.69 (p < 0.01) for males and 0.57 (p < 0.01) for females. The correlations were lower among older age groups, especially females over 50 years (0.21, p = 0.11). Classification to high or low risk for long-term pain and disability had moderate agreement (κ = 0.42). Observed classification agreement was 70.2%. The SBT had fewer miscalculations (13/315) than the ÖMPSQ-short (54/315).ConclusionsThe correlation between the SBT and the ÖMPSQ-short scores were moderately strong for individuals with acute or subacute back and/or neck pain. SBT seemed to be clinically feasible to use in clinical practice. We therefore suggest that SBT can be used for individuals with both BP and/or NP in primary care settings but it is important to be aware of that SBT's agreement with the ÖMPSQ-short was poor among females aged over 50 years.Trial registrationClinicalTrials.gov ID: NCT02609750 Registered: November 18, 2015.

Dataset Information

Pediatric Pain Screening Tool: A Simple 9-Item Questionnaire Predicts Functional and Chronic Postsurgical Pain Outcomes After Major Musculoskeletal Surgeries.

Publications

Pediatric Pain Screening Tool: A Simple 9-Item Questionnaire Predicts Functional and Chronic Postsurgical Pain Outcomes After Major Musculoskeletal Surgeries.

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