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Fig. 10.
The Grid method
Having said that, several studies exist in literature regarding the usefulness
of the grid method in identifying various back pain patterns. [49] cite in
their work results of [6] study that demonstrate the ability of grid method to
differentiate of localized, mechanical and radicular or referred patterns of
pain. On the other hand though, [46] found that when used grid assessment
before operation in patients with spinal stenosis, the results showed a nega-
tive correlation between the outcomes of operation with the area of the body
covered with symbols.
Moreover, in reality most of the pain drawing methods described can be and are
used in conjunction with
sensation types,
which as has been described before, they
allow for both the location of pain, as well as the type of pain to be recorded on the
drawing. This is usually achieved by assigning a symbol or a color to each sensation
type (e.g. yellow for pins and needles), and then mapping it on the pain drawing.
Finally, so far most of the pain drawings scoring methods were performed manu-
ally by a clinician based on his or her experience. However, various studies have
taken a different approach and adopted the use of automated computer scoring by,
mainly, artificial intelligence methods. To this end, [44] used artificial neural net-
works to assess pain drawings, whereas [18] used a computerized decision model to
score them in order to identify real or imagined pain. In overall, as cited by [44] after
comparing the results of the automated computer techniques to the results of experi-
enced clinicians, generally they found that these techniques were able to classify pain
drawings almost as well as physician experts.
However, based on the pain drawings discussion so far, the consensus of the litera-
ture seems to indicate that they are considered to be a valuable and useful tool in
identifying pain location and sensation type, as well as identifying psychological
disturbances, in both cases always when combined with the appropriate additional
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