Lion's Lair: Hamilton researchers find innovative way to track pain
When Chitra Lalloo presented her PhD research project to a pain support group, they liked what they saw.
"Because they have chronic pain, they have a lot of experience in the health care system and a frustration of being referred to different practitioners," Lalloo said. "They would always have to fill out the same long questionnaire at every clinic they went to."
Lalloo, along with her supervisor, professor emeritus James Henry, have developed the latest version of a web-based tool for patients of chronic pain to track how they feel. A series of icons can be dragged onto the image of a body to represent different pain sensations – a match stick for burning pain, a knife for stabbing pain. Once the patient drags the icon, a scale of 1 - 10 pops up on their screen to track intensity.
"They liked the idea of being able to describe it quickly and empowering them to take control over describing what their pain felt like," Lalloo said of the patients in the support group.
Because it's web-based, their tool, called Pain QuILT (Quality Intensity Location Tracker), can be accessed anywhere by patients to add pain information. Clinicians or hospitals can also always see pain trend information from their patients.
"No other tool can do that," Henry said.
Pain QuILT was originally developed by Henry and a former student at the University of Toronto, where Henry was part of the biomedical communications department for several years and received a research grant.
His student, Emilie McMahon, moved on from working in Henry's lab, but the tool still needed development. When he moved to Hamilton with "an offer [he] couldn't refuse" to be the chair of McMaster's DeGroote Institute for Pain Research and Care about five years ago, he brought the tool with him. Lalloo stepped in when she began her master's degree under Henry's supervision.
She's made a number of improvements, Henry said, like adding more icons to represent varying types of pain. That's come from visiting the support groups and pain clinics in hospitals like Sick Kids and St. Joseph's.
As an example, Lalloo said she added an icon for throbbing pain and asked children at Sick Kids what it should look like.
That icon is now a foot with a throbbing toe a la Fred Flinstone, who commonly stubbed his toe and hopped around with a throbbing pain.
If a patient wants to know how their own pain has been changing, Lalloo said, Pain QuILT will also spit out a graph with this information.
Henry believes that clinical trial is one of the major uses for Pain QuILT.
"Because we own the data, we can provide analytic services for a clinic who wants to know how their patients are doing as a population, so how they are doing in terms of treating neuropathic pain patients versus their low back pain patients versus their migraine patients," Henry said.
The tool also tracks analytics from patients in different cities, like Hamilton versus Toronto, to compare treatment, Henry said. Clinicians can also use analytics to track improvements or resistance to certain medications over time.
The end product, Lalloo and Henry hope, will be a smartphone application. That way, patients can be anywhere – at the gym after a workout, at school or work – and input information about their pain.
Henry has been at McMaster for the past five years, but has since retired. He continues to supervise Lalloo's PhD as professor emeritus.
"So I'm still busy," he laughed.
Prior to that, Henry spent time on faculty at the University of Western Ontario and the University of Toronto, but the bulk of his career happened at McGill University.
"I started research in chronic pain as a post-doc [at McGill]," he said. "My first project was to see if I could find the site of action in morphine... one of the sites of actions is the spinal cord and I stayed with looking at pain mechanisms."
Lalloo, 26, was born and raised in Hamilton and has been at McMaster since her bachelor's degree in health sciences. She "hopefully" has just one year left of her PhD.
Why Pain QuILT should win Lion’s Lair
The reception to the tool, Lalloo and Henry said, has been exceptional. When Lalloo presented at a conference in Sweden, she had doctors from the UK asking her when the tool will be ready for use.
Henry is confident Pain QuILT is unique and fills an important need.
"We hope it will have meaning for people living with chronic pain and using the tool as an expression of their own pain and better understanding on their, part and will better mean pain management programs on the part of the professional, and better outcomes for the patients," Henry said.