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Khan MA, Koh RGL, Rashidiani S, Liu T, Tucci V, Kumbhare D, Doyle TE. Cracking the Chronic Pain code: A scoping review of Artificial Intelligence in Chronic Pain research. Artif Intell Med 2024; 151:102849. [PMID: 38574636 DOI: 10.1016/j.artmed.2024.102849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 03/15/2024] [Accepted: 03/19/2024] [Indexed: 04/06/2024]
Abstract
OBJECTIVE The aim of this review is to identify gaps and provide a direction for future research in the utilization of Artificial Intelligence (AI) in chronic pain (CP) management. METHODS A comprehensive literature search was conducted using various databases, including Ovid MEDLINE, Web of Science Core Collection, IEEE Xplore, and ACM Digital Library. The search was limited to studies on AI in CP research, focusing on diagnosis, prognosis, clinical decision support, self-management, and rehabilitation. The studies were evaluated based on predefined inclusion criteria, including the reporting quality of AI algorithms used. RESULTS After the screening process, 60 studies were reviewed, highlighting AI's effectiveness in diagnosing and classifying CP while revealing gaps in the attention given to treatment and rehabilitation. It was found that the most commonly used algorithms in CP research were support vector machines, logistic regression and random forest classifiers. The review also pointed out that attention to CP mechanisms is negligible despite being the most effective way to treat CP. CONCLUSION The review concludes that to achieve more effective outcomes in CP management, future research should prioritize identifying CP mechanisms, CP management, and rehabilitation while leveraging a wider range of algorithms and architectures. SIGNIFICANCE This review highlights the potential of AI in improving the management of CP, which is a significant personal and economic burden affecting more than 30% of the world's population. The identified gaps and future research directions provide valuable insights to researchers and practitioners in the field, with the potential to improve healthcare utilization.
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Affiliation(s)
- Md Asif Khan
- Department of Electrical and Computer Engineering at McMaster University, Hamilton, ON L8S 4K1, Canada
| | - Ryan G L Koh
- KITE Research Institute, Toronto Rehabilitation Institute - University Health Network, Toronto, ON M5G 2A2, Canada
| | - Sajjad Rashidiani
- Department of Electrical and Computer Engineering at McMaster University, Hamilton, ON L8S 4K1, Canada
| | - Theodore Liu
- Department of Electrical and Computer Engineering at McMaster University, Hamilton, ON L8S 4K1, Canada
| | - Victoria Tucci
- Faculty of Health Sciences at McMaster University, Hamilton, ON L8S 4K1, Canada
| | - Dinesh Kumbhare
- KITE Research Institute, Toronto Rehabilitation Institute - University Health Network, Toronto, ON M5G 2A2, Canada
| | - Thomas E Doyle
- Department of Electrical and Computer Engineering at McMaster University, Hamilton, ON L8S 4K1, Canada.
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Raudenská J, Šteinerová V, Vodičková Š, Raudenský M, Fulková M, Urits I, Viswanath O, Varrassi G, Javůrková A. Arts Therapy and Its Implications in Chronic Pain Management: A Narrative Review. Pain Ther 2023; 12:1309-1337. [PMID: 37733173 PMCID: PMC10616022 DOI: 10.1007/s40122-023-00542-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 07/11/2023] [Indexed: 09/22/2023] Open
Abstract
Chronic nonmalignant pain is recognized as a complex, dynamic, phenomenological interplay between biological, psychological, and social factors that are individual to the person suffering from it. Therefore, its management and treatment ought to entail the individual's biopsychosocial aspects that are often addressed by collaborative, inter/multidisciplinary multimodal care, as there is no biologic treatment. In an effort to enhance inter/multidisciplinary multimodal care, a narrative review of arts therapy as a mind-body intervention and its efficacy in chronic pain populations has been conducted. Changes in emotional and physical symptoms, especially pain intensity, during arts therapy sessions have also been discussed in in the context of attention distraction strategy. Arts therapy (visual art, music, dance/movement therapy, etc.) have been investigated to summarize relevant findings and to highlight further potential benefits, limitations, and future directions in this area. We reviewed 16 studies of different design, and the majority reported beneficial effects of art therapy in patients' management of chronic pain and improvement in pain, mood, stress, and quality of life. However, the results are inconsistent and unclear. It was discovered that there is a limited amount of high-quality research available on the implications of arts therapy in chronic nonmalignant pain management. Due to the reported limitations, low effectiveness, and inconclusive findings of arts therapy in the studies conducted so far, further research with improved methodological standards is required.
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Affiliation(s)
- Jaroslava Raudenská
- Department of Nursing, 2nd Medical School and University Hospital Motol, Charles University, Prague, Czech Republic
| | - Veronika Šteinerová
- Amsterdam Emotional Memory Lab, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Martin Raudenský
- Department of Art Education, Faculty of Education, Charles University, Prague, Czech Republic
| | - Marie Fulková
- Department of Art Education, Faculty of Education, Charles University, Prague, Czech Republic
| | - Ivan Urits
- Southcoast Physicians Group Pain Medicine, Southcoast Health, Wareham, MA, USA
- Department of Anesthesiology, Louisiana State University Shreveport, Shreveport, LA, USA
| | - Omar Viswanath
- Department of Anesthesiology, Louisiana State University Shreveport, Shreveport, LA, USA
- Department of Anesthesiology, University of Arizona College of Medicine-Phoenix, Phoenix, AZ, USA
- Valley Anesthesiology and Pain Consultants-Envision Physician Services, Phoenix, AZ, USA
- Department of Anesthesiology, Creighton University School of Medicine, Omaha, NE, USA
| | | | - Alena Javůrková
- Department of Nursing, 2nd Medical School and University Hospital Motol, Charles University, Prague, Czech Republic
- Department of Clinical Psychology, 3rd Medical Faculty, University Hospital KV, Prague, Czech Republic
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Antonucci LA, Pergola G, Rampino A, Rocca P, Rossi A, Amore M, Aguglia E, Bellomo A, Bianchini V, Brasso C, Bucci P, Carpiniello B, Dell'Osso L, di Fabio F, di Giannantonio M, Fagiolini A, Giordano GM, Marcatilli M, Marchesi C, Meneguzzo P, Monteleone P, Pompili M, Rossi R, Siracusano A, Vita A, Zeppegno P, Galderisi S, Bertolino A, Maj M. Clinical and psychological factors associated with resilience in patients with schizophrenia: data from the Italian network for research on psychoses using machine learning. Psychol Med 2023; 53:5717-5728. [PMID: 36217912 DOI: 10.1017/s003329172200294x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Resilience is defined as the ability to modify thoughts to cope with stressful events. Patients with schizophrenia (SCZ) having higher resilience (HR) levels show less severe symptoms and better real-life functioning. However, the clinical factors contributing to determine resilience levels in patients remain unclear. Thus, based on psychological, historical, clinical and environmental variables, we built a supervised machine learning algorithm to classify patients with HR or lower resilience (LR). METHODS SCZ from the Italian Network for Research on Psychoses (N = 598 in the Discovery sample, N = 298 in the Validation sample) underwent historical, clinical, psychological, environmental and resilience assessments. A Support Vector Machine algorithm (based on 85 variables extracted from the above-mentioned assessments) was built in the Discovery sample, and replicated in the Validation sample, to classify between HR and LR patients, within a nested, Leave-Site-Out Cross-Validation framework. We then investigated whether algorithm decision scores were associated with the cognitive and clinical characteristics of patients. RESULTS The algorithm classified patients as HR or LR with a Balanced Accuracy of 74.5% (p < 0.0001) in the Discovery sample, and 80.2% in the Validation sample. Higher self-esteem, larger social network and use of adaptive coping strategies were the variables most frequently chosen by the algorithm to generate decisions. Correlations between algorithm decision scores, socio-cognitive abilities, and symptom severity were significant (pFDR < 0.05). CONCLUSIONS We identified an accurate, meaningful and generalizable clinical-psychological signature associated with resilience in SCZ. This study delivers relevant information regarding psychological and clinical factors that non-pharmacological interventions could target in schizophrenia.
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Affiliation(s)
- Linda A Antonucci
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Giulio Pergola
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Antonio Rampino
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Paola Rocca
- Department of Neuroscience, Section of Psychiatry, University of Turin, Turin, Italy
| | - Alessandro Rossi
- Section of Psychiatry, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Mario Amore
- Section of Psychiatry, Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Maternal and Child Health, University of Genoa, Genoa, Italy
| | - Eugenio Aguglia
- Department of Clinical and Molecular Biomedicine, Psychiatry Unit, University of Catania, Catania, Italy
| | - Antonello Bellomo
- Psychiatry Unit, Department of Medical Sciences, University of Foggia, Foggia, Italy
| | - Valeria Bianchini
- Unit of Psychiatry, Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Claudio Brasso
- Department of Neuroscience, Section of Psychiatry, University of Turin, Turin, Italy
| | - Paola Bucci
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Bernardo Carpiniello
- Section of Psychiatry, Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
| | - Liliana Dell'Osso
- Section of Psychiatry, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Fabio di Fabio
- Department of Neurology and Psychiatry, "La Sapienza" University of Rome, Rome, Italy
| | | | - Andrea Fagiolini
- Department of Molecular Medicine and Clinical Department of Mental Health, University of Siena, Siena, Italy
| | | | | | - Carlo Marchesi
- Department of Neuroscience, Psychiatry Unit, University of Parma, Parma, Italy
| | - Paolo Meneguzzo
- Psychiatric Clinic, Department of Neurosciences, University of Padua, Padua, Italy
| | - Palmiero Monteleone
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana" Section of Neuroscience, University of Salerno, Salerno, Italy
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, S. Andrea Hospital, "La Sapienza" University of Rome, Rome, Italy
| | - Rodolfo Rossi
- Section of Psychiatry, Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Alberto Siracusano
- Department of Systems Medicine, Psychiatry and Clinical Psychology Unit, "Tor Vergata" University of Rome, Rome, Italy
| | - Antonio Vita
- Psychiatric Unit, School of Medicine, University of Brescia, Brescia, Italy
- Department of Mental Health, Spedali Civili Hospital, Brescia, Italy
| | - Patrizia Zeppegno
- Department of Translational Medicine, Psychiatric Unit, University of Eastern Piedmont, Novara, Italy
| | - Silvana Galderisi
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Alessandro Bertolino
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Mario Maj
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
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Sankaran R, Kumar A, Parasuram H. Role of Artificial Intelligence and Machine Learning in the prediction of the pain: A scoping systematic review. Proc Inst Mech Eng H 2022; 236:1478-1491. [DOI: 10.1177/09544119221122012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Artificial Intelligence in healthcare is growing quickly in diagnostics and treatment management. Despite the quantity and variety of studies its role in clinical care is not clear. To identify the evidence gaps and characteristics of the Artificial Intelligence and Machine Learning techniques in predicting/diagnosing the pain? Pubmed/Embase were searched from the inception to October 2021 for articles without any language restrictions specifically addressing the following: the accuracy of AI in pain considering Brain Imaging, Patient-reported measures, and Electrophysiology, the ability of AI to differentiate stratify severity/types of pain, the ability of AI to predict pain and lastly the most accurate AI technique for given inputs. All the included studies were on humans. Eight hundred forty abstracts were reviewed, and 23 articles were finally included. Identified records were independently screened and relevant data was extracted. We performed conceptual synthesis by grouping the studies using available concepts of AL/ML techniques in diagnosing pain. Then we summarized the number of features/physiological measurements. Structured tabulation synthesis was used to show patterns predictions along with a narrative commentary. A total of 23 articles, published between 2015 and 2020 from 12 countries were included. Most studies were experimental in design. The most common design was cross sectional. Chronic or acute pains were predicted more often. Compared to control, the pain prediction was in the range of 57%–96% by AI techniques. Support Vector Machine and deep learning showed higher accuracy for classifying pain. From this study, it can be inferred that AI/ML can be used to differentiate healthy controls from patients. It can also facilitate categorizing them into new and different clinical subgroups. Lastly, it can predict future pain. The limitations are with respect to studies done after the search period. AL/ ML has a supportive role in pain diagnostics.
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Affiliation(s)
- Ravi Sankaran
- Department of Physical Medicine and Rehabilitation, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | - Anand Kumar
- Department of Neurology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | - Harilal Parasuram
- Department of Neurology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
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You DS, Ziadni MS, Hettie G, Darnall BD, Cook KF, Von Korff MR, Mackey SC. Comparing Perceived Pain Impact Between Younger and Older Adults With High Impact Chronic Pain: A Cross-Sectional Qualitative and Quantitative Survey. FRONTIERS IN PAIN RESEARCH (LAUSANNE, SWITZERLAND) 2022; 3:850713. [PMID: 35465295 PMCID: PMC9030949 DOI: 10.3389/fpain.2022.850713] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 03/07/2022] [Indexed: 01/19/2023]
Abstract
High impact chronic pain (HICP) is a recently proposed concept for treatment stratifying patients with chronic pain and monitoring their progress. The goal is to reduce the impact of chronic pain on the individual, their family, and society. The US National Pain Strategy defined HICP as the chronic pain associated with substantial restrictions on participation in work, social, and self-care activities for at least 6 months. To understand the meaning and characteristics of HICP from the younger (<65 years old) and older adults (≥65 years old) with chronic pain, our study examined patients' perceived pain impact between the two age groups. We also characterize the degree of pain impact, assessed with the Patient-Reported Outcomes Measurement Information System (PROMIS) pain interference (PI), between adults and older adults with HICP. We recruited patients at a tertiary pain clinic. The survey included open-ended questions about pain impact, the Graded Chronic Pain Scale-Revised to identify patients' meeting criteria for HICP, and the Patient-Reported Outcomes Measurement Information System (PROMIS®) 8-item PI short form (v.8a). A total of 55 younger adults (65.5% women, 72.7% HICP, mean age = 55.0 with SD of 16.2) and 28 older adults (53.6% women, 64.3% HICP, mean age = 72.6 with SD of 5.4) with chronic pain participated in this study. In response to an open-ended question in which participants were asked to list out the areas of major impact pain, those with HICP in the younger group most commonly listed work, social activity, and basic physical activity (e.g., walking and standing); for those in the older group, basic physical activity, instrumental activity of daily living (e.g., housework, grocery shopping), and participating in social or fun activity for older adults with HICP were the most common. A 2 × 2 ANOVA was conducted using age (younger adults vs. older adults) and HICP classification (HICP vs. No HICP). A statistically significant difference was found in the PROMIS-PI T-scores by HICP status (HICP: M = 58.4, SD = 6.3; No HICP: M = 67.8, SD = 6.3), but not by age groups with HICP. In conclusion, perceived pain impacts were qualitatively, but not quantitatively different between younger and older adults with HICP. We discuss limitations and offer recommendations for future research.
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Affiliation(s)
- Dokyoung S. You
- Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA, United States
| | - Maisa S. Ziadni
- Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA, United States
| | - Gabrielle Hettie
- Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA, United States
| | - Beth D. Darnall
- Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA, United States
| | | | - Michael R. Von Korff
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, United States
| | - Sean C. Mackey
- Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, Palo Alto, CA, United States,*Correspondence: Sean C. Mackey
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Myrcik D, Statowski W, Trzepizur M, Paladini A, Corli O, Varrassi G. Influence of Physical Activity on Pain, Depression and Quality of Life of Patients in Palliative Care: A Proof-of-Concept Study. J Clin Med 2021; 10:jcm10051012. [PMID: 33801357 PMCID: PMC7958598 DOI: 10.3390/jcm10051012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 02/18/2021] [Accepted: 02/22/2021] [Indexed: 12/26/2022] Open
Abstract
Introduction: Palliative care not only focuses on physical ailments associated with the disease, but also considers the psychological, social and spiritual needs of the patients. The aim of this study is to assess the impact of physical activity on palliative care patients, with special regard to the subjective assessment of severity of total pain and quality of life. Materials and methods: The study was conducted on 92 palliative care patients either in a hospice or at home. The tool used to assess the patients was an original questionnaire focusing on the area of their independence and motor abilities. The study attempted to understand whether an appropriate physical activity and the instruction of palliative care patients and their families in the field of independence would improve the quality of life and reduce the intensity of total pain in the patients. Results: All of the patients were at an advanced stage of cancer. The survey at time “0”, conducted before the start of the instructions for patients and their relatives, showed that a majority of patients (47, 51.09%) often experienced limitations during the performance of daily activities. In the fourth visit, conducted one week after the fourth educational session, there was a significant increase in patients who did not experience any limitations in performing their daily activities or experienced them just sometimes. Conclusions: The ultimate effect of the proposed educational program on physical activity was an increase in the quality of life, a reduction in pain and a mood improvement. These results would need confirmation with more extensive studies.
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Affiliation(s)
- Dariusz Myrcik
- Emergency Medicine, Department of Internal Medicine, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, Piekarska 18, 42-600 Bytom, Poland; (D.M.); (M.T.)
| | - Wojciech Statowski
- Chair and Department of Medical and Molecular Biology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Jordana 19, 41-808 Zabrze, Poland;
- Faculty of Health Sciences, Jan Długosz University in Częstochowa, Armii Krajowej 13/15, 42-200 Częstochowa, Poland
| | - Magdalena Trzepizur
- Emergency Medicine, Department of Internal Medicine, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, Piekarska 18, 42-600 Bytom, Poland; (D.M.); (M.T.)
| | | | - Oscar Corli
- Mario Negri Institute for Pharmacological Research IRCCS, 20156 Milano, Italy;
| | - Giustino Varrassi
- Paolo Procacci Foundation, Via Tacito 7, 00193 Roma, Italy
- Correspondence: ; Tel.: +39-3486068472
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