Validating a home based quantitative sensory testing (QST) paradigm for two pediatric/young adult patient groups: I. Orthopedic surgery with regional anesthesia, and II. Sickle cell disease
OA Version
Citation
Abstract
Pain assessment and management in pediatric patients is crucial for improving health outcomes and quality of life. Quantitative Sensory Testing (QST) is a valuable tool for evaluating sensory function and pain processing, but traditional laboratory-based QST (L-QST) is often limited by its cost, complexity, and accessibility. This study aimed to validate the feasibility, safety, and effectiveness of proxy- or self-administered QST (P/SA-QST) for remote pain assessment in pediatric patients with sickle cell disease (SCD) and those undergoing orthopedic surgery with regional anesthesia.Two independent studies were conducted at Boston Children’s Hospital, enrolling patients aged 6–18 years with SCD and patients aged 8–25 years undergoing orthopedic procedures with regional anesthesia. P/SA-QST assessed mechanical and thermal detection and pain thresholds, and results were compared to L-QST. Statistical analyses, including correlation coefficients and Bland-Altman plots, were used to evaluate agreement between P/SA-QST and L-QST. Additionally, participants and caregivers completed a questionnaire on P/SA-QST’s acceptability and safety.
Results demonstrated significant weak-to-moderate associations between P/SA-QST and L-QST in assessing vibration detection, pressure pain threshold, and pinprick sensitivity. The P/SA-QST tool-kit successfully detected changes in sensory function following regional anesthesia, with significant alterations in mechanical and vibratory sensitivity across postoperative time points. High participant acceptability was observed, with no adverse events reported. Identified challenges included minor usability concerns related to certain tools and the need for clearer instructional materials.
Findings demonstrated strong agreement between P/SA-QST and L-QST, supporting its potential of P/SA-QST as a cost-effective, accessible alternative to L-QST for pediatric pain assessment. Further research should explore its long-term reliability and applicability across broader patient populations.
Description
2025
License
Attribution-NonCommercial-ShareAlike 4.0 International