Assessment of Quality of Life by Patients in Pain

DESCRIPTION (provided by investigator): The prevalence of untreated moderate to severe pain may be as high as 25% in the United States. In order to measure the effectiveness of treatment, outcome measures of patient perceptions have become increasingly important in hospital and health settings. Questionnaires are the only instruments presently used to assess Quality of Life (QOL) from the standpoint of the patient. The objective of this Phase II application is to further develop a computerized judgment method, not based on a questionnaire format, allowing health professionals to quickly determine perceived QOL of patients entering a hospital or clinic for treatment. Patients use numerical visual analogue scales (NVAS) and adjust the length of bars on the computer screen to indicate satisfaction or dissatisfaction with overall QOL and with QOL for each of 20 variables. The approach is referred to as the "Interactive Computer method for rating Quality of Life" (ICQOL). The user actively creates a profile representing the positive or negative salience of variables such as health status, energy level, and home life. In Year 1 the method will be tested with a culturally diverse group of patients diagnosed with different types of pain. A Spanish version will also be tested. Results will be compared with the same patients' ratings of absolute pain intensity along a NVAS. In Year 2 the method will be compared with the commonly used SF-36 questionnaire to determine how well scores of QOL from both methods track relief from pain, as measured along a NVAS, before and after epidural steroid injection. The main advantages of this new assessment method are (a) quantitative interval scale measures are obtained, (b) ratings of items are given in the context of other items, (c) dynamic adjustments in ratings are possible, and (d) data collection and analysis is efficient and inexpensive. PROPOSED COMMERCIAL APPLICATION. The commercial goal is to replace paper-and-pencil surveys with a computer-administered method that allows dynamic ratings of QOL variables considered in the context of other variables. The software will be available for the two major computer platforms (Windows & Macintosh). As marketed in Phase III, physicians, pain clinics and hospitals throughout the world will purchase the computer software package.