Screening for Behavioral Risks: A Precision Healthcare Driven Approach for Chronic Pain Evaluation in Pediatric...

Area of Science:

• Pediatric Rheumatology
• Clinical Informatics
• Pain Management

Background:

• Automated screening tools can improve identification of risk factors for chronic pain in pediatric populations.
• Previous work introduced PROBE (Program for Risk Observation and Behavioral Evaluation) for behavioral risk screening.
• Pediatric specialty care settings present unique challenges for comprehensive patient assessment.

Purpose of the Study:

• To evaluate the effectiveness of the PROBE informatics tool in a pediatric rheumatology outpatient practice.
• To assess patient self-report of pain, chronic disease activity, and associated behavioral risks.
• To identify specific behavioral factors correlating with chronic pain reporting in pediatric patients.

Main Methods:

• The PROBE tool was deployed for a one-year pilot study in a busy pediatric rheumatology clinic.
• 109 patients seeking routine care were assessed for pain, disease activity, and behavioral risks.
• Statistical analysis was performed to determine the odds of reporting chronic pain based on self-reported factors.

Main Results:

• Patients reporting poorer self-efficacy had 8 times higher odds of reporting chronic pain.
• Patients reporting poorer coping skills had 5 times higher odds of reporting chronic pain.
• Night-time awakenings were also significantly associated with increased odds of reporting chronic pain.

Conclusions:

• Automated screening via tools like PROBE can identify previously unknown patient risks in specialty care waiting rooms.
• Identifying behavioral risks such as low self-efficacy and poor coping is crucial for managing pediatric chronic pain.
• This approach can guide precision healthcare resource allocation, including interventions like cognitive behavioral therapy.