A new multidimensional clinical response index to assess the overall health status of chronic pain patients: a multicenter study.

PubMed Article

Introduction: Chronic postoperative lumbo-radicular pain (LRPO), described as an unpleasant sensory and emotional experience, results in multidimensional alterations at biological, psychological and social levels [1-3]. Despite the constant innovation of digital technology and artificial intelligence, pain is still assessed by "reference tools" such as the visual analog pain scale (VAS) [4]. The main limitation of this tool is that it does not take into account the many dimensions of pain, such as functional disability, psychological distress, quality of life or the location and extent of pain on the body [3]. In practice, assessments of these dimensions are considered independently, even though clinical experience underlines the interweaving of these dimensions with each other.

Material and methods: The MCRI was developed through the prospective, multicenter study (PREDIBACK) including 200 patients with LRPO with a 12-month follow-up. Measures of pain intensity, body pain area (in cm2 via a tactile interface), functional disability, anxiety/depression and quality of life were combined using statistical learning tools to create the MCRI composite index. The MCRI was compared with other measures.

Results: The MCRI represented all dimensions of pain more accurately than other conventional scores. Furthermore, compared with other criteria, the MCRI showed the highest sensitivity and specificity for detecting patient satisfaction after pain therapy, compared with other scores.

Discussion / conclusion: This new MCRI composite index can help refine the assessment of the general health status of the chronic pain patient on the basis of objective parameters. This new MCRI index needs to be tested in a clinical setting, in order to assess the effectiveness of the different therapies encountered by patients.

Digital interface used to assess the patient’s overall health status before (left) and after (right) surgery. The MCRI includes pain intensity, functional disability, quality of life, anxiety and depression, and pain surface related to pain intensity. The MCRI is a score ranging from 0 (worst overall health) to 10 (best overall health).

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