Every fifth person in Sweden suffers from long-term pain, that is, pain that lasts longer than three months. How it feels varies widely – for example, one patient described it as “an electric shock”, another as “in an anthill” – but the common thread is that it is so painful that it affects quality of life. In more severe cases, it is not uncommon for people to become depressed, have trouble sleeping, and have difficulty participating in social contexts.
Pain can have many causes
Unfortunately, long-term pain is difficult to treat. They can arise for biological, psychological and social reasons, sometimes in combination – but in healthcare, experience has shown that the causes are often difficult to find. When pain causes significant suffering, what is called multimodal rehabilitation, MMR, is usually applied. It is a form of treatment that attacks the problem from several angles by combining, for example, physical exercise, psychotherapy, medications and functional training. Treatments are coordinated by specialists from different care professions who work based on a common plan.
However, recent research shows that the effects of MMR are limited compared to simpler treatments. One reason is thought to be patient selection – healthcare needs to better understand when MMR is a good treatment by identifying patients who can actually be helped by MMR.
Chronic pain is a big problem in Sweden. The feeling varies greatly – but often with long-term pain conditions, the pain is so excruciating that it affects one’s entire existence. Photo: Yeyo Salas/unsplash
Chronic pain – prevalence and costs
- Approximately 4000 to 5000 patients are referred annually to specialized pain clinics in Sweden to be examined for multimodal rehabilitation (MMR). Of these, about half are offered such treatment. However, during the pandemic, fewer patients participated.
- Another number of thousands of people are being treated in primary care.
- Nearly 70 percent of those treated are women, and nearly half of them are in the 30-50 age group. We cannot say with certainty what the long-term pain cost to society will be. But within the EU, the cost was estimated in 2013 at a staggering 5,200 billion Swedish krona.
Source European Parliament
Better tailored pain management
It is believed that another reason why MMR does not give such good results is that the treatments are not individualized enough. Symptoms can change over time for those with chronic pain, requiring frequent evaluations and adjustments.
To address such problems, a research group from Dalarna University, funded by the Forti Research Council, is developing a digital decision support system that combines large amounts of data on, among other things, age, physical function and pain intensity from a number of different patient records using intelligence. Artificial.
“Simply put, we hope the decision support will help the treatment team decide in an instant whether to suggest MMR or not,” says Björn Äng, professor of medical sciences and project leader.
– In the longer term, we also hope to develop decision support that suggests which combination of different efforts and “dose” works best.
Updated data on how pain patients are faring
Decision support must be dynamic, so that new and incoming data constantly evolve it. In the long term, the system’s AI should be able to receive and process information about how the patient is doing, and should be able to provide support when adjusting ongoing treatment.
Bjørn explains that the AI will be gradually trained on data from more than 60,000 patients previously referred to Swedish specialist care for chronic pain. It provides the opportunity to discover hitherto unknown factors and relationships, so that it is easier to determine which treatments are most appropriate and how to design them. In order to evaluate the AI system itself, the researchers plan to conduct a so-called randomized controlled trial in the future, in which one group of patients will be offered regular MMR while the other group of patients will receive the treatment. Designed with the help of decision support.
The project is in the early development phase until 2025, and if all goes as planned, the researchers hope that the decision support can be tested in clinical operations from 2026 onwards.
Text: Anton Delber
One in five Swedes suffers from long-term pain, that is, pain that lasts longer than three months. Photo: Rob Curran/Unsplash
Artificial intelligence can improve diagnosis
- Artificial intelligence (AI) is an umbrella term for computer systems that have the ability to think, learn, plan, and create like we humans do. The computer receives and processes large amounts of collected information and can provide answers to various questions.
- In recent years, there have been major breakthroughs in the field of artificial intelligence thanks to the development of computer performance and access to vast amounts of information and new algorithms (computations). Today, AI is being used in more and more fields, from search engines to drones and cybersecurity.
- In health and healthcare, AI support is becoming increasingly popular, for example, to analyze large amounts of health information and see patterns that can lead to new discoveries in medicine and improved individual diagnosis.
The article is taken from Forte Magasin, a journal of the Forte Research Council, specializing in research on people’s health, work life and well-being. Click here for a free subscription.
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