Design of a XForms based pain assessment 'straw man'

Representing pain assessments is an important part of patient care and is needed for a range of clinical research topics. I am building a standards based pain assessment tool. It will use the W3C XForms to capture several related data elements including:

• The primary pain symptom, e.g. radicular pain in left lower leg
• A pain assessment panel of discrete findings, such as exacerbating and relieving factors, radiation, primary location, quality, duration (of episodes), speed of onset, etc.
• Pain severity, including the FLACC pain assessment score, the Wong-Baker FACES scale, the facial pain scale-revised (FPS-R, an updated version of FACES), 100 mm Visual Analog Scale, and the standard 0-10 ordinal scale

The goal of this is to provide a rich, reusable modular representation which is designed for multiple use and interoperability from the ground up. It is build from a detailed clinical model (DCM), which is a constraint following the HL7 template specification, Using SNOMED CT in HL7 Version 3; Implementation Guide, Release 1.5 (TermInfo), and the Clinical Statement pattern. Once prototyped, this will be submitted to the caDSR, as this approach to common data elements is essential to creation data sets and annotations which can be analyzed, compared and/or aggregated.

This approach builds upon standard terminology systems including SNOMED-CT. It will use a hybrid terminology system, where synonyms in other controlled terminologies, such as the NCI Thesaurus, MedDRA and National Drug File Reference Terminology NDF-RT. Medication use will similarly use a hybrid approach following some of the patterns used by the US FDA, and RxNorm.

A later release will include the executable logic to determine CTCAE.