A basic struggle for individuals living with chronic pain is communicating how they feel to doctors and healt hcare providers trying to understand and treat them.
New research seeks to find common ground as researchers seek to develop a consistent approach to dealing with pain, a path that begins with aggregating experiences and pooling data.
“Pain research is very difficult because nothing allows the physician to see the patient’s pain directly,” said Werner Ceusters, M.D., principal investigator. “The patient has to describe what he or she is feeling.”
Unfortunately, this is where current medical practice comes up short because each patient’s subjective experience of pain is different.
Descriptions of pain consequently lack the precision and specificity that is taken for granted with other disorders, where biomarkers or physiological indicators reveal what health care providers need in order to assess the severity of a particular disorder.
“If we want to more effectively help people suffering from chronic pain, we need to study a population that is consistent, patients who have features in common,” Ceusters said.
“The problem with pain is, it’s very hard to build up a group with the same sort of pain. People don’t have the same vocabulary or linguistic capabilities or even the same cultural backgrounds. It’s something pain researchers have struggled with for decades. We need to develop a vocabulary of pain.”
That’s where ontology comes in.
“The philosophical definition of ontology is the study of things that exist and how they relate to each other,” said Ceusters.
“I am a person and you are a person so we share something. Suppose I drop dead. What lies on the floor? Is that still a person? If it is no longer a person, is it still the very same thing that was sitting here as a person but now is a corpse?”
Ceusters said that in much the same way, definitions of pain and especially of chronic pain need to be much more precise; ontology provides methods of distinguishing among categories and describing data in uniform and formal ways.
Researchers believe information technology can lead the way to recognize commonalities, perform analysis, and expand reasoning a la artificial intelligence.
“Here at the University at Buffalo, we excel at combining the two approaches; we have a very strong foundation in the philosophical approach to ontology with Barry Smith, who is a pioneer in contemporary ontology, especially related to biomedical applications,” said Ceusters, “while we also have a very strong presence in computational approaches, especially to biomedical ontology.
These computational approaches allow us to devise systems of communication in which there is a consistent meaning for terms used in different language systems and conceptual frameworks.”
A NIH grant will allow Ceusters and colleagues to study data gathered from thousands of patients in the U.S., the United Kingdom, Sweden, Israel and Germany who suffer from oral and facial pain, including temporomandibular disorder (TMD).
Ceusters will work with his colleagues, to develop an ontology that allows the data to be described in a much more uniform way.
“The goal is to integrate the data together so that we have a large pool of data that will allow us to obtain better insight into the complexity of pain disorders, specifically the assessment of pain disorders and how they impact mental health and a patients’ quality of life,” Ceusters said.
Clusters said his research team hopes to build ontology so that it could represent what pain is and how it relates to body parts and their activities and functions.
“Our goal is to create a software program that will allow all pain specialists to express themselves in crystal clear terms,” he said, “We will create a symptom checklist that can be understood by computers. We have to define the terminology of pain.”
Source: University of Buffalo