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A precision medicine approach to a patient with unresolved pain following orthopedic surgery: a case report

Overview of attention for article published in Journal of Medical Case Reports, February 2017
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About this Attention Score

  • In the top 5% of all research outputs scored by Altmetric
  • One of the highest-scoring outputs from this source (#2 of 2,620)
  • High Attention Score compared to outputs of the same age (99th percentile)

Mentioned by

news
52 news outlets
twitter
5 tweeters

Citations

dimensions_citation
2 Dimensions

Readers on

mendeley
46 Mendeley
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Title
A precision medicine approach to a patient with unresolved pain following orthopedic surgery: a case report
Published in
Journal of Medical Case Reports, February 2017
DOI 10.1186/s13256-017-1207-5
Pubmed ID
Authors

David Gazzaniga, Ashley Brenton, Brian Meshkin

Abstract

Precision medicine is a promising technology in patient care that combines genetic analysis with clinical data, such as health, behavioral, functional, environment, and lifestyle information. Here we present the case of a 54-year old woman who, following an accident, had uncontrolled chronic pain and was subsequently labeled a drug seeker. A 54-year-old white woman who was experiencing severe calf pain was referred for treatment. Her pain was insufficiently controlled immediately following knee arthroplasty with multiple opioid medications, as well as non-opioids. Precision medicine testing was ordered for her so that we could assess her pain sensitivity objectively to determine if the pill seeker designation was correct and to determine the best medications for her. Based on the Proove profiles, we determined that she had moderately low pain sensitivity, which means that clinically she may underreport pain and may have decreased medication needs. This result suggested that her continued reporting of unresolved pain was probably due to a condition unresolved by her right knee arthroplasty. In addition, she was found to be at low risk of opioid addiction, based on the Proove Opioid Risk Profile. Taken together, along with the high levels of pain she described, we determined that her pain was not properly controlled and that the designation of pill seeker was incorrect. The next step was to determine which medications and which doses would result in the most favorable outcomes for our patient. To determine this, we used the results of the Proove Opioid Response, Proove Drug Metabolism, and Proove Non-Opioid Profiles to guide her treatment. We reduced her pain medications to a single opioid, Vicodin (acetaminophen and hydrocodone), which also eliminated the adverse side effects she experienced. Precision medicine offers an important health care decision tool which can reduce emotional and physical costs to patients and may reduce the economic health care burden of unnecessary surgeries and ineffective medication. The information provided by these profiles can be used clinically to guide treatment decisions and evaluate patient pain.

Twitter Demographics

The data shown below were collected from the profiles of 5 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 46 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 46 100%

Demographic breakdown

Readers by professional status Count As %
Student > Bachelor 8 17%
Student > Master 6 13%
Student > Doctoral Student 5 11%
Other 4 9%
Student > Postgraduate 3 7%
Other 9 20%
Unknown 11 24%
Readers by discipline Count As %
Medicine and Dentistry 16 35%
Nursing and Health Professions 6 13%
Pharmacology, Toxicology and Pharmaceutical Science 2 4%
Agricultural and Biological Sciences 2 4%
Computer Science 2 4%
Other 7 15%
Unknown 11 24%

Attention Score in Context

This research output has an Altmetric Attention Score of 409. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 21 July 2017.
All research outputs
#33,824
of 15,920,152 outputs
Outputs from Journal of Medical Case Reports
#2
of 2,620 outputs
Outputs of similar age
#1,418
of 262,617 outputs
Outputs of similar age from Journal of Medical Case Reports
#1
of 1 outputs
Altmetric has tracked 15,920,152 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 99th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 2,620 research outputs from this source. They receive a mean Attention Score of 3.2. This one has done particularly well, scoring higher than 99% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 262,617 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 99% of its contemporaries.
We're also able to compare this research output to 1 others from the same source and published within six weeks on either side of this one. This one has scored higher than all of them