Evaluation of Patients Undergoing Spinal Cord Stimulation Using the e-Health Tool

Abstract

Objectives: The aim of the study is to evaluate patients undergoing spinal cord stimulation (SCS) using an online decision support system (SCS e-health tool). Materials and Methods: In this study, data of patients who underwent SCS between 2005 and 2023 at the Department of Algology, Ankara University Faculty of Medicine, were retrospectively analyzed. The clinical characteristics of the patients were assessed using an e-health tool scoring system proposed by the panel and presented online. Furthermore, the alignment of the implanted SCS devices with the recommendations of this scoring system was evaluated. Results: It was determined that the median SCS appropriateness score for the 117 patients who underwent SCS implantation was 7, and only 3 patients had the SCS removed during the trial period. All the patients who underwent SCS implantation in our study met the eligibility criteria for SCS according to the e-health tool algorithm. Conclusion: We observed a much lower rate of SCS removal during the trial period compared to the literature. We believe this is attributable to the multidisciplinary evaluation conducted at our hospital by highly competent specialists from various fields who assess patients for SCS suitability. Keywords: Spinal cord stimulation, health information systems, decision support systems, chronic pain

Keywords

• Spinal cord stimulation
• health information systems
• decision support systems
• chronic pain

Spinal Kord Stimülasyonu Uygulanan Hastaların e-Health Tool ile Değerlendirilmesi

Abstract

Objectives: The aim of the study is to evaluate patients undergoing spinal cord stimulation (SCS) using an online decision support system (SCS e-health tool). Materials and Methods: In this study, data of patients who underwent SCS between 2005 and 2023 at the Department of Algology, Ankara University Faculty of Medicine, were retrospectively analyzed. The clinical characteristics of the patients were assessed using an e-health tool scoring system proposed by the panel and presented online. Furthermore, the alignment of the implanted SCS devices with the recommendations of this scoring system was evaluated. Results: It was determined that the median SCS appropriateness score for the 117 patients who underwent SCS implantation was 7, and only 3 patients had the SCS removed during the trial period. All the patients who underwent SCS implantation in our study met the eligibility criteria for SCS according to the e-health tool algorithm. Conclusion: We observed a much lower rate of SCS removal during the trial period compared to the literature. We believe this is attributable to the multidisciplinary evaluation conducted at our hospital by highly competent specialists from various fields who assess patients for SCS suitability. Keywords: Spinal cord stimulation, health information systems, decision support systems, chronic pain

Keywords

• Spinal kord stimülasyonu
• sağlık bilgi sistemleri
• klinik karar destek sistemleri
• kronik ağrı

References

1. 1. Manchikanti L, Derby R, Wolfer L, et al. Evidence-based medicine ,systematic reviews, and guidelines in interventional pain management: Part 7: systematic reviews and meta-analyses of diagnostic accuracy studies. Pain Physician. 2009;12:929-963.
2. 2. Campbell CM, Buenaver LF, Raja SN, et al. Dynamic pain phenotypes are associated with spinal cord stimulation-induced reduction in pain: a repeated measures observational pilot study. Pain Med. 2015;16:1349-1360.
3. 3. Malinowski MN, Jain S, Jassal N, et al. Spinal cord stimulation for the treatment of neuropathic pain: expert opinion and 5-year outlook. Expert Rev Med Devices. 2020;17:1293-1302.
4. 4. Atkinson L, Sundaraj SR, Brooker C, et al. Recommendations for patient selection in spinal cord stimulation. J Clin Neurosci. 2011;18:1295-1302.
5. 5. Thomson S, Helsen N, Prangnell S, et al. Patient selection for spinal cord stimulation: The importance of an integrated assessment of clinical and psychosocial factors. Eur J Pain. 2022;26:1873-1881.
6. 6. Davanzo J, Brandmeir NJ. surgical technique and patient selection for spinal cord stimulation for chronic pain. Neurol India. 2020;68:S213-S217.
7. 7. Thomson S, Huygen F, Prangnell S, et al. Appropriate referral and selection of patients with chronic pain for spinal cord stimulation: European consensus recommendations and e-health tool. Eur J Pain. 2020;24:1169-1181.
8. 8. Brook RH, Chassin MR, Fink A, et al. A method for the detailed assessment of the appropriateness of medical technologies. Int J Technol Assess Health Care. 1986;2:53-63.

9. 9. Thomson S, Huygen F, Prangnell S, et al. Applicability and validity of an e-health tool for the appropriate referral and selection of patients with chronic pain for spinal cord stimulation: results from a european retrospective study. Neuromodulation. 2023;26:164-171.
10. 10. Jeon YH. Spinal cord stimulation in pain management: a review. Korean J Pain. 2012;25:143-150.
11. 11. Shanthanna H, Eldabe S, Provenzano DA, et al. Evidence-based consensus guidelines on patient selection and trial stimulation for spinal cord stimulation therapy for chronic non-cancer pain. Reg Anesth Pain Med. 2023;48:273-287.
12. 12. Shanthanna H, Eldabe S, Provenzano DA, et al. Role of patient selection and trial stimulation for spinal cord stimulation therapy for chronic noncancer pain: a comprehensive narrative review. Reg Anesth Pain Med. 2023;48:251-272.
13. 13. Campbell CM, Jamison RN, Edwards RR. Psychological screening phenotyping as predictors for spinal cord stimulation. Curr Pain Headache Rep. 2013;17:307.