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tools (pain assessment tools and psychological screening questionnaires). Neverthe-
less, the various studies that have been performed on the reliability of pain drawings
have also identified that they have one major disadvantage that is worth mentioning.
Pain Drawings-Conclusions
To this end, the biggest disadvantage of pain drawings, concerns their ability when it
comes to visualizing a patient's pain descriptions, which is considered to be their
main purpose. Over the years there have moreover been a number of research studies
to continue and extend research in respect to pain drawings. All of the studies [16],
[27], [32], [37] had slight variations but were conceptually the same, using the same
2-dimensional approach. Notwithstanding their advantages, 2-D pain drawings have
their limitations, as they do not capture the 3-D nature of the human body. Thus, pa-
tients are unable to visually express the pain that they are experiencing, as statements
of the form “ I have a pain on the inside of my thigh ” are not easily captured in a 2-D
pain drawing, constituting a limited dimension representation of the medical informa-
tion, potentially resulting in a time-consuming process with possible irrelevant medi-
cal data collected that can lead to a report that obscures important information.
In back pain terms, in an experimental study performed by [12], 3D virtual images
were constructed from performing computerized medical scans, in their attempt to
reconstruct spinal cord injuries, with the results indicating that in this case 3D images
were extremely beneficial as the models could be observed from many different
viewpoints. Moreover, while recent inventions of medical imaging techniques such as
computerized tomography and magnetic resonance imaging have revolutionized radi-
ology, the development of 3-D imaging has not yet been ported across the world of
pain drawings. To this end, the same feature benefit just described could be antici-
pated from devising a 3-D adaptation of pain drawings.
Subjective Phase-Conclusions. Finally, based on the discussion so far we can con-
clude that the pain tools mentioned are the standard techniques for assessing back
pain, and have been proven through studies to be of a great value and use in the proc-
ess. However, the consensus of the literature indicates that these pain tools are usually
stored in a paper format something that makes the recording, assessment, and evalua-
tion of the data that is stored upon it, such as areas of pain, an impractical and some-
times an arduous subject to error task. [18] argue in their study that despite the ease of
administration and use of such paper-based assessment techniques, practically, they
have several drawbacks. First of all, use of such tools can lead to “noncompliance,
missing data, and fabrication of information if the respondents have not completed the
requested information at the designated times”. Moreover, the process of transferring
the information from paper forms to the computer for analysis and evaluation is also a
potential source of error.
Last, the paper-based solution of existing methods makes it impractical to record
pain variations over time, in spite of the time-dependent nature of pain in chronic
sufferers [47].
To compound the issue, the need for digitized computer applications emerged that
would be able to describe the painful areas more accurately, compared with the paper-
based tools, and would allow easier storing and recreating capabilities that could show
changes over time using different shades, marks, and colors to identify different pain
types [19]. Similarly to paper-based tools, computer-based tools have both many
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