Health
Exploring objective measures of pain
how much does it hurt? You might think this is one of the simplest questions in health and medicine. In practice, however, it is a very difficult question to answer objectively.
Consider a doctor with two patients who frown and use similar language to describe their pain. Can doctors be sure they are experiencing similar levels of pain? What if you habitually underestimate your suffering? And what if doctors have certain prejudices and are more likely to believe some patients than others?
Pain is a difficult animal to deal with, Difficult to measure and therefore difficult to treatPain can be an important distress signal, and not investigating it can result in missed opportunities to save lives.
“We barely understand it,” says Emma Pearson, a computer scientist who studies pain at Stanford University. “In particular, the fact that human doctors are often puzzled as to why their patients are in pain suggests that our current medical understanding of pain is very poor,” she said.
Currently, the gold standard for pain analysis relies on patients self-reporting how they are feeling, at various locations, either on a numerical scale (0 is no pain, 10 is worst pain), or on a smile. system.
“The first step to properly treating pain is measuring pain accurately. “Today’s standard of care is based on the ‘smiley face’ that traces the ER room. The system can confuse patients, he says, which is especially problematic when treating children or patients who cannot communicate.
Then there is the question of whether patient assessments can be trusted. In one study, People tend to exaggerate the level of pain they feeleven though there is little evidence to suggest that such exaggerations are common.
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Without an objective way to measure pain, there is room for bias in clinician decisions. “Pain affects underserved people particularly hard, and their pain is especially likely to be ignored,” says Pearson.
Unfortunately, there are widespread misconceptions about pain among physicians. In 2016, a study found that: 50% of white U.S. medical students and residents have very dangerous and erroneous ideas about black people and their painful experience. In another study, Nearly half of medical students I heard negative comments about black patients from senior colleagues, and the level of racial prejudice among those students increased significantly during the first four years of medical training.
Such prejudices are A historic attempt to justify slaveryincluding the erroneous claim that blacks have thicker skin and different nerve endings. 40% less likely to seek treatment for pain Hispanic patients, on the other hand, are 25% less likely to receive pain treatment than white patients.
Racism is not the only prejudice affecting pain treatment. “Bias Around”hysterical womanIt is still well known in medicine, especially when it comes to pain. A review of 77 independent research studies Terms such as ‘sensitive’ and ‘complaint’ were more frequently applied to women’s pain reports. study Of the 981 women who came to urgent care for pain, they were less likely to get any relief at all and had to wait 33% longer for treatment than men. Additionally, when men and women reported similar levels of pain, men were given stronger medications to treat it.
Anke Samrowitz, a gender bias researcher at the University of Gothenburg, Sweden, says that societal expectations about what is “normal behavior” for men and women underlie these patterns. These prejudices lead to “medically unwarranted differences in the way men and women are treated in health care.”
She points out that there are sometimes pure reasons why men and women may receive different treatments for particular complaints. It can make all the difference,” she says. “However, all the observed differences in the treatment of painful men and women cannot be explained by biological differences.”
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