Classification of Qualitative Fieldnotes Collected During Quantitative Sensory Testing: A Step Towards the Development of a New Mixed Methods Approach in Pain Research

Abstract

Martine Bordeleau,1,2 Guillaume Léonard,1,2 Lynn Gauthier,3– 6 Catherine Estelle Ferland,7– 9 Miroslav Backonja,10,11 Jan Vollert,12– 15 Serge Marchand,2,16 Philip Jackson,17– 19 Léo Cantin,20,21 Michel Prud’Homme20,21 1Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada; 2Research Center on Aging, CIUSSS de l’Estrie-CHUS, Sherbrooke, QC, Canada; 3Department of Family and Emergency Medicine, Faculty of Medicine, Université Laval, Quebec City, QC, Canada; 4Équipe de recherche Michel-Sarrazin en oncologie psychosociale et soins palliatifs, Quebec City, QC, Canada; 5Oncology Division, CHU de Québec-Université Laval Research Center, Quebec City, QC, Canada; 6Université Laval Cancer Research Center, Quebec City, QC, Canada; 7Department of Anesthesia, McGill University, Montreal, QC, Canada; 8Integrated Program in Neuroscience, McGill University, Montreal, QC, Canada; 9Shriners Hospitals for Children-Canada, Montreal, QC, Canada; 10Department of Neurology, University of Wisconsin, Madison, WI, USA; 11Department of Neurology, University of Washington, Seattle, WA, USA; 12Pain Research, MSK lab, Department of Surgery and Cancer, Imperial College London, London, UK; 13Division of Neurological Pain Research and Therapy, Department of Neurology, University Hospital of Schleswig-Holstein, Campus Kiel, Kiel, Germany; 14Department of Anaesthesiology, Intensive Care and Pain Medicine, University Hospital Muenster, Münster, Germany; 15Neurophysiology, Mannheim Center of Translational Neuroscience (MCTN), Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany; 16Sherbrooke University Hospital Research Center (CRCHUS), Sherbrooke, QC, Canada; 17CIRRIS, Quebec City, QC, Canada; 18CERVO Brain Research Center, Quebec City, QC, Canada; 19School of Psychology, Laval University, Quebec City, QC, Canada; 20Centre de recherche du CHU de Québec – Université Laval, Axe neurosciences, Quebec City, QC, Canada; 21Department of Surgery, Division of neurosurgery, CHU de Québec – Université Laval, Quebec City, QC, CanadaCorrespondence: Martine Bordeleau Email [email protected]: Quantitative sensory testing (QST) is a standardized method to assess somatosensory function. The collection of qualitative information, during the QST procedure, could be an interesting way to facilitate the characterization of altered sensory perception and the identification of different pain phenotypes. The aims of this study were 1) to classify qualitative fieldnotes of sensory abnormalities collected during an independent QST study, and 2) to generate a qualitative interview guide that could be included in the traditional QST procedure as a step towards the implementation of a mixed methods approach.Patients and Methods: QST data were collected from 48 chronic neuropathic pain patients treated with spinal cord stimulation (SCS). Three body areas, with or without SCS, were tested: the painful limb targeted by SCS, the contralateral area, and the ipsilateral upper limb. After each trial of each QST modality, patients were encouraged to report any sensory abnormalities they could identify with a pain quality scale or using their own words.Results: Qualitative self-reported sensory abnormalities were dichotomized into two groups: altered sensory intensities and altered sensory perceptions. Altered sensory intensities were classified as sensory loss or sensory gain subgroups. Altered sensory perceptions were classified as paresthesia and dysesthesia subgroups Overall, 630 qualitative fieldnotes of altered sensations were collected: 385 on the painful limb, 173 at the contralateral area, and 72 at the ipsilateral upper limb. Based on these qualitative data, we propose a standardized method to collect qualitative data involving 9 open- and close-ended questions and 21 codes.Conclusion: Our findings have highlighted the value of qualitative sensory evaluation during QST and constitute an important milestone in the development of a mixed methods protocol in phenotyping research.Keywords: sensory evaluation, sensory abnormality, qualitative approach, quantitative approach, mixed methods research

Keywords

• sensory evaluation
• sensory abnormality
• qualitative approach
• quantitative approach
• mixed methods research