JMIR Publications

ABSTRACT

Background:

A digital pain manikin is measurement tool that presents a diagram of the human body where people can mark the location of their pain to produce a pain drawing. Digital pain manikins facilitate collection of more detailed spatial pain data compared to questionnaire-based methods and are an increasingly common method for self-reporting and communicating pain. However, an overview of how digital pain drawings, collected through digital pain manikins, are analysed and summarised is currently missing.

Objective:

To map the ways digital pain drawings were summarised and analysed, and which pain constructs these summaries attempted to measure. Specific objectives were to: 1) identify and characterise studies which used digital pain manikins for data collection; 2) identify (a) which individual drawing-level summary measures they reported, and (b) the methods by which these summaries were calculated; 3) identify if and how multi-drawing (e.g., time series) summary and analysis methods were applied.

Methods:

We conducted a scoping review to systematically identify studies using digital pain manikins for data collection which reported any summary measures or analysis of digital pain drawings. We searched multiple databases using search terms related to “pain” and “manikin”. Two authors independently performed title, abstract and full text screening. We extracted and synthesised data on how studies summarised and analysed digital manikin pain data at the individual pain drawing-level as well as across multiple pain drawings.

Results:

Our search yielded 6,189 studies, of which we included 92. The majority were clinical studies (n=51), and collected data cross-sectionally (n=64). Eighty-seven studies reported at least one individual drawing-level summary measure. We identified individual drawing-level manikin summary measures related to 10 distinct pain constructs, with the most common ones being pain extent (or, pain area) (reported in 53 studies), physical location (n=28), and widespreadness (n=21), with significant methodological variation within constructs. Forty-two studies reported at least one multi-drawing summary method, with five distinct categories. Heatmaps were most common (n=35), followed by the number or proportion of participants reporting pain in a specific location (n=14). Sixteen studies reported multi-drawing analysis methods, with the most common being an assessment of the similarity between pairs of pain drawings intended to represent the same individual at the same moment in time (n=6).

Conclusions:

We found a substantial number of studies which reported manikin summary and analysis methods, with the majority being cross-sectional clinical studies. Studies commonly reported pain extent at the individual pain drawing-level and used heatmaps to summarise data across multiple drawings. Analysis methods which went beyond summarising pain drawings were much rarer. Methodological variation within pain constructs meant a lack of comparability of methods between studies and across manikins. This highlights a need for standardisation of methods to summarise and analyse digital pain drawings, which are applicable across manikins.