title: Application of a psychological decision algorithm for the selection of patients susceptible to implantation of neuromodulation systems for the treatment of chronic pain. A proposal.
abstract: Objective. The application of a decision algorithm is described here for the inclusion of patients in a protocol of therapeutic intervention by the use of an implantable neuromodulation system. This algorithm is based on the assessment of the psychological profiles of the patients and their environment. Materials and methods. This algorithm was applied to patients in the Multidisciplinary Unit for Pain Treatment at the General University Hospital of Valencia (Spain) by means of a clinical interview performed by the Psychology Department prior to the therapeutic decision. It was applied to two samples. The first sample was made up of patients psychologically assessed prior to implantation; the second sample was made up of implanted patients to whom the algorithm was applied retrospectively, by reviewing their clinical medical history. Results. In the first sample, pain relief of 50% or higher was obtained by 80% of the subjects studied, while in the second the percentage decreased to 63%. While the rate of implants removed in sample 1 was 4.2%, the rate of implants removed in sample 2 was 7.5% due to lack of efficacy. In a third sample, made up of implanted patients from sample 1 and sample 2, a discriminant analysis was performed using a pooled variable. Conclusion. The results of the application of the pooled analysis confirm the need for considering the psychological profile as a variable predicting an optimum result in the therapeutic treatment of chronic pain.
authors.affiliation: Multidisciplinary Unit for Pain Treatment, General University Hospital of Valencia, Valencia, Spain.
authors.forename: V
authors.initials: V
authors.lastname: Monsalve
authors.forename: J A
authors.initials: JA
authors.lastname: de Andres
authors.forename: J C
authors.initials: JC
authors.lastname: Valia