Wednesday, July 27, 2011

Bad News For MDs. Researchers Work on Vocabulary for Chronic Pain

Just released on Science Daily is the news that psychiatrists in Buffalo are working on a project to enable chronic pain sufferers to better describe what they are feeling. The docs are using ontology, the branch of metaphysics that studies the nature of existence or being as such. Metaphysics is sometimes called philosophy, especially in its more abstruse branches. [Definitions are from]

Here is a quote from the Science Daily article:

"The philosophical definition of ontology is the study of things that exist and how they relate to each other," says [Werner] Ceusters, who also is director of the Ontology Research Group of UB's New York State Center of Excellence in Bioinformatics and Life Sciences. "I am a person and you are a person so we share something. Suppose I drop dead. What lies on the floor? Is that still a person? If it is no longer a person, is it still the very same thing that was sitting here as a person but now is a corpse?"

If you can explain that quote to me, I would certainly appreciate it.

Someone must understand it because the group has received an NIH grant of $793,571 to study the subject.

You may have no idea how many chronic pain sufferers there are. I do. For fibromyalgia [also known as chronic widespread pain syndrome] alone, 17% of a population in a published study from England had it. In my blog on the paper, I pointed out that at the rate people were developing the syndrome, 50% will have it by the year 2033.

Honestly, I do not see standardizing a vocabulary for pain based on ontology leading to anything good.


Gurdur said...

Can you please detail WHY you don't see it as good?

Skeptical Scalpel said...

1. If the vocabulary that is eventually produced is as confusing as the "dead person" quote, it will make matters worse.

2. How can you standardize terminology of something that is intangible and perceived differently in just about every person?

3. The simple attempt to categorize the intensity of pain on a scale of 1 to 10 does not work. Ask any nurse.

4. It is very difficult to sort out the drug seekers from those who are truly in pain. Give the drug seekers a vocabulary and see what happens.

Patricia said...

I see a problem in equating people with genuine pain with 'drug seekers'. This can be as subjective a process as trying to find an universal argot able to aptly describe the pain one feels.

Why not separate the two groups from each other as they are almost completely dissimilar except for one superficial behavior (getting drugs that alleviate pain). The damage done to those who legitimately have pain, especially chronic pain by associating them with drug seekers is incalculable. Something a physician is probably tempted to ignore.

Skeptical Scalpel said...

@Patricia-Thanks for your comment. I wish it was easy to separate the drug seekers from the people who really have pain. That is indeed the problem. MDs are in a "Catch-22" situation. We are criticized if we don't alleviate suffering in the true pain sufferers and lose our licenses if we give addicts narcotic prescriptions.

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