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App that assesses headache pain inconsistent with ‘gold standard’
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PHILADELPHIA — The “Pediatric Pain Evaluator” app, designed to help users identify and describe their headache pain, disagreed with what a researcher described as the “gold standard,” according to study results presented at the American Headache Society Annual Scientific Meeting.
“Pediatric headache is a clinical challenge since children aged younger than 7 years cannot describe accurately their pain, and the diagnosis is based on the parent´s assumption of the quality of pain and other characteristics,” researchers wrote in the abstract.
“Based on the observation that children at an early age easily learn the use of touch screen electronic devices, we developed an application — the Pediatric Pain Evaluator — that, through animated cartoons, facilitated the identification of some descriptors of the headache, like location, type and intensity of pain,” they continued.
They compared results from 49 patients (mean age, 10.7 years) who underwent a physical exam and neurologic and pediatric headache histories — which she called the “gold standard” — and who also used the app.
Researchers reported that the gold standard led to a migraine without aura diagnosis in 53.06% of patients, of whom 42.6% identified the front of the head as pain’s location and 26.5% of patients said the pain lasted an hour. These variables’ Kappa score for pain type was 0.217, location of pain was 0.24 and intensity of pain 0.219.
In addition, children aged 6 to 11 years had kappa values of 0.317 for pain localization; 0.345 for type of pain and pain intensity’s value could not be calculated. Conversely, in children aged 12 to 15 years, kappa value for pain localization was 0.104 with slight concordance, type of pain could not be calculated and intensity of pain was 0.396.
“The agreement was fair or low, which indicates that our app disagrees with our gold standard. This can be explained because our method doesn´t work or because it works better than our gold standard. To dilucidate this issue, we are currently working on app improvements,” researchers concluded. – by Janel Miller
Reference: An app to help children describe their headache. Results of the first clinical trial. Presented at: American Headache Society Annual Scientific Meeting; July 11-14, 2019; Philadelphia. Submission ID: 680825
Disclosures : Healio Primary Care was unable to determine Rodríguez’s relevant financial disclosures prior to publication.