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Paediatric anaesthesia
Published in Daniel Cottle, Shondipon Laha, Peter Nightingale, Anaesthetics for Junior Doctors and Allied Professionals, 2018
Pain is assessed using verbal rating scales (e.g. hurts a lot, hurts, hurts a little, doesn’t hurt) or faces scales such as the Wong–Baker FACES Pain Rating Scale. Surrogate markers of pain can also be used such as grimacing and positional changes (e.g. guarding). Intravenous morphine may be prescribed for recovery (0.1 mg/kg), but it cannot always be administered on the ward.
Pediatric techniques
Published in Harald Breivik, William I Campbell, Michael K Nicholas, Clinical Pain Management, 2008
Nancy F Bandstra, Christine T Chambers
The Wong-Baker FACES Pain Rating Scale is composed of six hand-drawn faces.14 The faces range from smiling (representing “no hurt”) to crying (representing “hurts worst”). The scale itself is scored from 0 to 5 (see Figure 38.2). The measure has established adequate responsivity to procedural21,22,23,24,25 and postoperative pain.26 Although often preferred by children relative to other assessment measures14,22,27,28 the Wong-Baker FACES Pain Rating Scale’s use of smiling/crying anchors has been identified as problematic. Scales that begin with neutral faces (such as the FPS-R) are considered a more valid measure of pain intensity because scales with tears or smiles are generally more tied to an emotional component29 and may be more likely to confound more general negative emotions and distress with pain intensity.30
Estimation of the utilities of attributes of intravenous iron infusion treatment for patients with iron-deficiency anemia: a conjoint analysis in Japan
Published in Journal of Medical Economics, 2023
Tomomi Takeshima, Chise Ha, Kosuke Iwasaki
The conjoint analysis survey was conducted to estimate the utility values for factors associated with IV iron infusion. To ensure that the attributes follow current standard of care, we selected attributes and levels of each attribute used in the conjoint cards utilized in the survey (Table 1) mainly based on information from clinicians with expert knowledge of IV iron in Japan. We also referred to information about treatment status with IV iron infusion used in Japan from literature. The seven attributes included waiting time before receiving an IV infusion, pain due to IV infusion, the time required for IV infusion, the number of IV infusions required to achieve treatment effect, frequency of hypophosphatemia as a side effect after the IV infusion, frequency of skin discoloration by the drug solution, and out-of-pocket cost for one IV infusion. The six-level Wong-Baker FACES Pain Rating Scale (0–10) was used for pain evaluation. While there are 17,280 level combinations, the types of combinations were limited in this study according to orthogonal programming using “conjoint” package in R to reduce the survey burden for respondents. Each respondent was provided with question sentences and two different conjoint cards, and then asked to select the preferable one (an example of the options is shown in Figure 1).
Cinnarizine as an alternative recommendation for migraine prophylaxis: a narrative review
Published in Expert Review of Neurotherapeutics, 2020
Mansoureh Togha, Fahime Martami, Mohammad Abdollahi, Mohammad Mozafari, Hamed Cheraghali, Pegah Rafiee, Maryam Shafaei
Migraine intensity was another variable that reduced significantly through CIN consumption (Figure 3). The intensity of migraine was defined as the severity of attacks. This qualitative variable was assessed using the visual analog scale (VAS) scoring system in all studies, except two. VAS scale consists of a 10 cm line that is divided into 10 parts which zero indicates no pain and 10 indicates the worst pain imaginable. Another two studies were used the Wong–Baker Faces Pain Rating Scale and a 3-point verbal pain scale (mild, moderate, severe). Ashrafi et al. [21] conducted a study to compare the efficacy and safety of CIN in comparison to topiramate in the prevention of migraine among children and adolescents. The intensity of headaches significantly dropped in both groups at the end of 12 weeks of therapy. However, CIN’s effect in reducing the intensity of migraine was remarkably more than topiramate. The effects of CIN on migraine prophylaxis compared to placebo were investigated in another study. At the end of the fourth month, it was indicated that CIN was more effective than placebo in terms of reducing headache severity [25]. Interestingly, the protective effects of CIN were not just limited to migraine. A significant beneficial impact was reported on combined migraine-vertigo conditions by Taghdiri et al. [24]. They explored the possible prophylactic effects of CIN on migraine-associated vertigo among patients who suffered from vestibular migraine and migraine with brainstem aura. Following 90 days of treatment with 75 mg/day CIN, in addition to a notable reduction of vertigo frequency, migraine intensity was substantially reduced (median visual analog scale (VAS) score reduced from 8 to 3).
Cost-effectiveness analysis of intradiscal condoliase injection vs. surgical or conservative treatment for lumbar disc herniation
Published in Journal of Medical Economics, 2023
Shu Takaki, Hiroshi Miyama, Motoki Iwasaki
Conjoint cards with one-to-one comparisons were then presented to respondents. The attributes and levels of conjoint cards are listed in Table 1. The six attributes included wound size, treatment-associated pain duration, treatment-associated pain level, anesthesia method, response rate, and co-payment based on interviews with a medical specialist. We used the six-level Wong-Baker FACES Pain Rating Scale (0–5) for the pain evaluation. The response rate was defined as the percentage of back or leg pain due to hernia that improved by more than half after treatment, which is the same definition as responder rate in Table 2 of9.