The Problem of Pain in Rheumatology : Variations in Case Definitions Derived From Chronic Pain Phenotyping Algorithms Using Electronic Health Records
Copyright © 2024 by the Journal of Rheumatology..
OBJECTIVE: The aim of this study was to investigate and compare different case definitions for chronic pain to provide estimates of possible misclassification when researchers are limited by available electronic health record and administrative claims data, allowing for greater precision in case definitions.
METHODS: We compared the prevalence of different case definitions for chronic pain (N = 3042) in patients with autoimmune rheumatic diseases. We estimated the prevalence of chronic pain based on 15 unique combinations of pain scores, diagnostic codes, analgesic medications, and pain interventions.
RESULTS: Chronic pain prevalence was lowest in unimodal pain phenotyping algorithms: 15% using analgesic medications, 18% using pain scores, 21% using pain diagnostic codes, and 22% using pain interventions. In comparison, the prevalence using a well-validated phenotyping algorithm was 37%. The prevalence of chronic pain also increased with the increasing number (bimodal to quadrimodal) of phenotyping algorithms that comprised the multimodal phenotyping algorithms. The highest estimated chronic pain prevalence (47%) was the multimodal phenotyping algorithm that combined pain scores, diagnostic codes, analgesic medications, and pain interventions. However, this quadrimodal phenotyping algorithm yielded a 10% overestimation of chronic pain compared to the well-validated algorithm.
CONCLUSION: This is the first empirical study to our knowledge that shows that established common modes of phenotyping chronic pain can lead to substantially varying estimates of the number of patients with chronic pain. These findings can be a reference for biases in case definitions for chronic pain and could be used to estimate the extent of possible misclassifications or corrections in using datasets that cannot include specific data elements.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:51 |
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| Enthalten in: |
The Journal of rheumatology - 51(2024), 3 vom: 01. März, Seite 297-304 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Falasinnu, Titilola [VerfasserIn] |
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| Links: |
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| Themen: |
Analgesics |
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| Anmerkungen: |
Date Completed 04.03.2024 Date Revised 10.03.2024 published: Electronic Citation Status MEDLINE |
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| doi: |
10.3899/jrheum.2023-0416 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM365926086 |
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| 245 | 1 | 4 | |a The Problem of Pain in Rheumatology |b Variations in Case Definitions Derived From Chronic Pain Phenotyping Algorithms Using Electronic Health Records |
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| 500 | |a published: Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2024 by the Journal of Rheumatology. | ||
| 520 | |a OBJECTIVE: The aim of this study was to investigate and compare different case definitions for chronic pain to provide estimates of possible misclassification when researchers are limited by available electronic health record and administrative claims data, allowing for greater precision in case definitions | ||
| 520 | |a METHODS: We compared the prevalence of different case definitions for chronic pain (N = 3042) in patients with autoimmune rheumatic diseases. We estimated the prevalence of chronic pain based on 15 unique combinations of pain scores, diagnostic codes, analgesic medications, and pain interventions | ||
| 520 | |a RESULTS: Chronic pain prevalence was lowest in unimodal pain phenotyping algorithms: 15% using analgesic medications, 18% using pain scores, 21% using pain diagnostic codes, and 22% using pain interventions. In comparison, the prevalence using a well-validated phenotyping algorithm was 37%. The prevalence of chronic pain also increased with the increasing number (bimodal to quadrimodal) of phenotyping algorithms that comprised the multimodal phenotyping algorithms. The highest estimated chronic pain prevalence (47%) was the multimodal phenotyping algorithm that combined pain scores, diagnostic codes, analgesic medications, and pain interventions. However, this quadrimodal phenotyping algorithm yielded a 10% overestimation of chronic pain compared to the well-validated algorithm | ||
| 520 | |a CONCLUSION: This is the first empirical study to our knowledge that shows that established common modes of phenotyping chronic pain can lead to substantially varying estimates of the number of patients with chronic pain. These findings can be a reference for biases in case definitions for chronic pain and could be used to estimate the extent of possible misclassifications or corrections in using datasets that cannot include specific data elements | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a autoimmune diseases | |
| 650 | 4 | |a pain | |
| 650 | 4 | |a rheumatic diseases | |
| 650 | 4 | |a rheumatoid arthritis | |
| 650 | 4 | |a systemic lupus erythematosus | |
| 650 | 7 | |a Analgesics |2 NLM | |
| 700 | 1 | |a Nguyen, Thy |e verfasserin |4 aut | |
| 700 | 1 | |a Jiang, Tiffany En |e verfasserin |4 aut | |
| 700 | 1 | |a Tamang, Suzanne |e verfasserin |4 aut | |
| 700 | 1 | |a Chaichian, Yashaar |e verfasserin |4 aut | |
| 700 | 1 | |a Darnall, Beth D |e verfasserin |4 aut | |
| 700 | 1 | |a Mackey, Sean |e verfasserin |4 aut | |
| 700 | 1 | |a Simard, Julia F |e verfasserin |4 aut | |
| 700 | 1 | |a Chen, Jonathan H |e verfasserin |4 aut | |
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