Pain Assessment and Treatment Decisions for Virtual Human Patients

Abstract

Laypeople and healthcare professionals use demographic cues when making pain management decisions. These decisions can negatively affect patient outcomes. This study examined whether laypeople base their pain management decisions in part on pain-related postures and demographic cues. Virtual human (VH) technology was used to research whether sex and race, as well as body posture, influenced pain management decisions. Ninety-seven laypersons examined VH patients exhibiting low back pain related body postures whose demographic cues varied by VH sex and VH race. T tests validated that participants were able to distinguish between high pain related body postures and low pain related body postures. The participants assessed male VH patients to be experiencing more pain than female VH patients. This study suggests that participants use sex as a cue when assessing pain. Participants may perceive VH male patients as experiencing high pain intensity if the participants are willing to counter male stereotypes and acknowledge that the male VH patients display pain behaviors.

<p>The influence of patient race, sex, pain-related body postures, and anxiety status on pain management: a virtual human technology investigation</p>

“…To our knowledge, there is one study examining the influence of pain-related body postures on pain management decisions for chronic pain patients. From this study, researchers26 found men were rated by laypeople as experiencing more pain than females exhibiting the same pain-related body postures. Additionally, these findings have not yet been generalized to clinical settings.…”

“…Regarding sex disparities, studies have reported that women are more likely to receive psychotropic medication for pain,14,21 less likely to receive opioid analgesia,22,23 and more likely to have pain attributed to emotional/psychological factors when compared to men 24,25. Relatedly, previous studies using virtual human technology found that participants rated male virtual human patients as having higher pain than female virtual human patients even though all patients presented the same pain behaviors 26. Male virtual human patients were also more likely to have their pain treated more aggressively than female virtual human patients 27.…”

The influence of sex, race, and age on pain assessment and treatment decisions using virtual human technology: a cross-national comparison

“…Findings from previous research have consistently demonstrated the advantage of VH technology in capturing pain assessment and treatment decisions in both community and health care populations 8–15,43. Although a verbal report is often one of the most effective ways of assessing pain, nonverbal facial expressions (eg, grimacing, brow lowering, nose wrinkling, eye closure, guarded movement, bracing, rubbing, touching painful areas, sighing, etc) also provide a quantifiable measure of pain-related behavior.…”

The Influence of Health Care Professional Characteristics on Pain Management Decisions

“…Independent variables included practitioner sex, race, age, and duration of professional experience, while dependent variables included ratings of 1) pain intensity, 2) pain unpleasantness, 3) willingness to prescribe a non‐opioid analgesic, and 4) willingness to prescribe an opioid analgesic. Type of professional (dentists vs physicians) was used as a covariate in all analyses due to differences among these groups in pain management ratings (data reported elsewhere) [22,24,25]. For practitioner sex, race, age, and duration of experience, a series of repeated measures analysis of covariance were conducted in separate models for each independent variable with VH sex (male vs female), race (white vs black), and age (younger adult vs older adult) as the within‐subject variables.…”

“…Results from our previous studies have found practitioner assessment and treatment decisions to be influenced by patient sex, race, and age [2,3,20–23]. Furthermore, type of medical profession differentially affects these decisions [22,24], as dentists have been found to rate pain higher and exhibit greater willingness to prescribe opioid analgesics to VH patients, relative to physicians [22,25]. Given this, it is conceivable that provider demographic characteristics also may influence pain management decisions.…”