Researchers from the US have developed a new pain prediction model based on objective vital signs and pain medication use in sickle cell disease. They found that information about medication type and dose, and whether it was given or missed, can significantly improve subjective pain prediction.

The model is valuable as it provides information about how objective vital signs and medication data can be used to help better understand a patient’s pain and design better pain management strategies.

Sickle cell disease patients experience episodes of severe pain, which are repetitive but unpredictable. In order to treat these pain episodes with the right medication at the right dosage, it is important to be able to measure their intensity objectively.

In the present study, which was published JMIR Formative Research, researchers led by Nirmish Shah, MD, from the Division of Hematology, Duke University School of Medicine, in Durham, North Carolina, used the electronic health records of 496 patients over 5 years to build pain prediction models using machine learning algorithms.

Read more about the symptoms of sickle cell disease.

The records contained information about measures for 6 vital signs—peripheral capillary oxygen saturation, systolic and diastolic blood pressure, heart and respiratory rates, and temperature—as well as the self-reported pain score of the patients. The researchers also extracted information about the type of medication given to the patient, its total dosage, and whether or not it was applied or missed. 

The results showed that the model performed better when data about medication use was added to data on vital signs compared to using vital signs only. Moreover, they showed that deep representational learning can improve pain prediction results and improve understanding of the role of medication and physiology on a patient’s response to pain.

“In the future, this study can be extended to further investigate the effect of variation in medication protocols, such as changes in vital signs before and after medication and the time elapsed between medication doses,” the researchers said.

Reference

Padhee S, Nave GK Jr, Banerjee T, Abrams DM, Shah N. Improving pain assessment using vital signs and pain medication for patients with sickle cell disease: retrospective study. JMIR Form Res. 2022; 23;6(6):e36998. doi:10.2196/36998