Design, construction, and technical implementation of a web-based interdisciplinary symptom evaluation (WISE) - a heuristic proposal for orofacial pain and temporomandibular disorders

Dominik A Ettlin, Isabelle Sommer, Ben Brönnimann, Sergio Maffioletti, Jörg Scheidt, Mei-Yin Hou, Nenad Lukic, Beat Steiger, Dominik A Ettlin, Isabelle Sommer, Ben Brönnimann, Sergio Maffioletti, Jörg Scheidt, Mei-Yin Hou, Nenad Lukic, Beat Steiger

Abstract

Background: Medical symptoms independent of body location burden individuals to varying degrees and may require care by more than one expert. Various paper and computer-based tools exist that aim to comprehensively capture data for optimal clinical management and research.

Methods: A web-based interdisciplinary symptom evaluation (WISE) was newly designed, constructed, and technically implemented. For worldwide applicability and to avoid copyright infringements, open source software tools and free validated questionnaires available in multiple languages were used. Highly secure data storage limits access strictly to those who use the tool for collecting, storing, and evaluating their data. Concept and implementation is illustrated by a WISE sample tailored for the requirements of a single center in Switzerland providing interdisciplinary care to orofacial pain and temporomandibular disorder patients.

Results: By combining a symptom- burden checklist with in-depth questionnaires serving as case-finding instruments, an algorithm was developed that assists in clarifying case complexity and need for targeted expert evaluation. This novel modular approach provides a personalized, response-tailored instrument for the time- and cost-effective collection of symptom-burden focused quantitative data. The tool includes body drawing options and instructional videos. It is applicable for biopsychosocial evaluation in a variety of clinical settings and offers direct feedback by a case report summary.

Conclusions: In clinical practice, the new instrument assists in clarifying case complexity and referral need, based on symptom burden and response -tailored case finding. It provides single-case summary reports from a biopsychosocial perspective and includes graphical symptom maps. Secure, centrally stored data collection of anonymous data is possible. The tool enables personalized medicine, facilitates interprofessional education and collaboration, and allows for multicenter patient-reported outcomes research.

Keywords: Orofacial pain; Patient-reported outcome measures; Personalized medicine; Questionnaire; Temporomandibular disorders.

Figures

Fig. 1
Fig. 1
Overview of data exchange options between multiple patient management centers and a secure central data collection server. For clinical practice, customized single case reports available only to the supplying clinic are generated from centrally stored data that are linked by a unique identification number (ID). For research purposes, anonymized data clusters can be merged, thus enabling multicenter research projects
Fig. 2
Fig. 2
Pain drawing. The predefined areas are marked with green dotted lines. Pain intensity of selected regions is represented by gradients of red. Darker red indicates more intense pain
Fig. 3
Fig. 3
Time pattern of pain. Patients can select one of four different patterns
Fig. 4
Fig. 4
Example of a possible diurnal pain course. Each bar represents a 3-h time period during the day and a 6-hour period at night. Most frequent pain intensity from 0 to 10 is indicated by moving the bars accordingly
Fig. 5
Fig. 5
Example of a single case summary report
Fig. 6
Fig. 6
Example of a single case summary report

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