POS1444 ADOPTION OF DIGITAL MANIKINS TO SELF-REPORT PAIN: A SYSTEMATIC REVIEW
Authors: S. Mustafa Ali, R. Lee, A. Chiarotto, J. Mcbeth, S. Van der Veer, W. Dixon
Journal: Annals of the Rheumatic Diseases (2021)

Background: Chronic pain is common in rheumatic and musculoskeletal conditions, and a major driver of disability worldwide. Knowledge gaps exist with respect to correct estimates of chronic pain [1], what causes it and how best to manage it [2]. To address this, researchers need validated methods to measure pain in large, representative populations. Though many authors have recognised the potential benefits of paper-based and digital pain manikins [3]–[5], it is unknown to what extent studies have adopted digital manikins as a data collection tool. Objectives: The objective of our review was to identify and characterise published studies that have used digital pain manikins as a data collection tool. Methods: We systematically searched six electronic databases, including Medline, CINAHL, Embase, Scopus, IEEE Xplore digital library, ACM Digital Library, on 3-4 of November 2020 by using a pre-defined search strategy. We included a study in our review if it used a digital manikin for self-reporting any pain aspect (e.g., intensity, type) by people suffering from pain, and if its full text was published in English. We conducted this review by following the PRISMA reporting guidelines and conducted a descriptive synthesis of findings, including manikin-derived outcome measures. Results: Our search yielded 4,685 unique studies. After full text screening of 705 articles, we included 14 studies in our review. Most articles were excluded because they used either paper-based manikins or didn’t include enough details to determine that the manikin was digital (n=386). The majority of included studies were published in Europe (n=11). Most studies collected data on a manikin once (n=11); from people with pain conditions (n=9); and in clinical settings (n=9). There was only one study that collected digital pain manikin data in a large sized (i.e., ~20,000) population-based survey. In most studies participants shaded any painful area on manikin (n=9) and did not enable participants to record location-specific pain aspects (n=11). None of the manikins enabled participants to record location-specific pain intensity. Pain distribution (i.e. number or percentage of pre-defined body areas or locations experiencing pain) and pain extent (i.e. number or percentage of shaded pixels) were commonly used manikin-derived outcome measures. In six studies, a heat map was used to summarise the extent of pain across the population. Conclusion: Digital pain manikins have been available since the 1990s but their adoption in research has been slow. Few manikins enabled location-specific pain recording suggesting that the digital nature of the manikin is not yet fully utilised. Future development of a validated digital pain manikin supporting self-reporting of the location and intensity of pain, usable across any device and screen size, may increase uptake and value. References: [1]S. E. E. Mills, K. P. Nicolson, and B. H. Smith, “Chronic pain: a review of its epidemiology and associated factors in population-based studies,” Br. J. Anaesth. , vol. 123, no. 2, pp. e273–e283, Aug. 2019. [2]D. B. Reuben et al. , “National Institutes of Health Pathways to Prevention Workshop: The Role of Opioids in the Treatment of Chronic Pain,” Ann. Intern. Med. , vol. 162, no. 4, p. 295, Feb. 2015. [3]R. Waller, P. Manuel, and L. Williamson, “The Swindon Foot and Ankle Questionnaire: Is a Picture Worth a Thousand Words?,” ISRN Rheumatol. , vol. 2012, pp. 1–8, 2012. [4]M. Barbero et al. , “Clinical Significance and Diagnostic Value of Pain Extent Extracted from Pain Drawings: A Scoping Review,” Diagnostics , vol. 10, no. 8, p. 604, Aug. 2020. [5]S. M. Ali, W. J. Lau, J. McBeth, W. G. Dixon, and S. N. van der Veer, “Digital manikins to self-report pain on a smartphone: A systematic review of mobile apps,” Eur. J. Pain , vol. 25, no. 2, pp. 327–338, Feb. 2021. Disclosure of Interests: None declared