I hear from people all the time who want to know how they can get their doctors to understand just how bad their pain is. Describing your pain to your doctor in a way that accurately communicates its type and severity without sounding like you are exaggerating can be a huge challenge.
Now, Werner Ceusters, MD, professor of psychiatry in the University at Buffalo's School of Medicine and Biomedical Sciences, is attempting to help resolve this communication problem between chronic pain patients and their doctors by using ontology, the branch of philosophy concerned with the nature of being or existence.
"Pain research is very difficult because nothing allows the physician to see the patient's pain directly," says Ceusters. "The patient has to describe what he or she is feeling."
According to Ceusters, that is a serious shortcoming because each patient's subjective experience of pain is different. Descriptions of pain, therefore, lack the precision and specificity that is taken for granted with other disorders, where biomarkers or physiological indicators reveal what health-care providers need in order to assess the severity of a particular disorder.
When it comes to describing pain, there are so many variables involved. Family influences, cultural background, vocabulary, language, gender and individual personal experiences can all play a part in the way a person describes his or her pain. With the help of a grant from the National Institutes of Health, Ceusters plans to combine ontology with technology to develop a vocabulary of pain that will help pain specialists measure their patients' pain more accurately.
Applying Ontology to Pain
"The philosophical definition of ontology is the study of things that exist and how they relate to each other," says Ceusters. While the philosophical approach to ontology has its roots in ancient Greece, a computational approach to ontology began in the latter part of the 20th century, when computer scientists interested in artificial intelligence wanted to create software programs that perform reasoning the way humans do. To do so, they began to draw upon ontology.
In this study Ceusters will combine the philosophical approach with the computational approach. He explains, “These computational approaches allow us to devise systems of communication in which there is a consistent meaning for terms used in different language systems and conceptual frameworks."
With the $793,571 NIH grant, Ceusters and colleagues will study data gathered from thousands of patients in the US, the United Kingdom, Sweden, Israel and Germany who suffer from oral and facial pain, including temporomandibular disorder (TMD).
"The goal is to integrate the data together so that we have a large pool of data that will allow us to obtain better insight into the complexity of pain disorders, specifically the assessment of pain disorders and how they impact mental health and a patients' quality of life," Ceusters says.
"Our goal is to create a software program that will allow all pain specialists to express themselves in crystal clear terms," he says, "We will create a symptom checklist that can be understood by computers. We have to define the terminology of pain.”
Since I know nothing about ontology, it's hard for me to imagine just how this vocabulary of pain might work. But there certainly is a great need for a more accurate and descriptive way for patients to communicate their pain to their doctors than the pain scale currently used. If the use of ontology can help meet that need, I'm all for it. I guess you could describe my feelings about this research as skeptical but hopeful.
To Help Doctors and Patients, UB Researchers Are Developing a "Vocabulary of Pain." University at Buffalo. News Release. July 18, 2011.
Published On: July 20, 2011