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Cited by 88Digital Mental Health InterventionsMusculoskeletal pain and rehabilitationPediatric Pain Management Techniques

Tailored web-based interventions for pain: Systematic review and meta-analysis

Open access
Martorella, Geraldine, Boitor, Madalina, Berube, Melanie, Fredericks, Suzanne, Le May, Sylvie, Gélinas, Céline·2017·Journal of Medical Internet Research
DOI 10.2196/jmir.8826PMC PMC5701966
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Abstract

BACKGROUND: Efforts have multiplied in the past decade to underline the importance of pain management. For both acute and chronic pain management, various barriers generate considerable treatment accessibility issues, thereby providing an opportunity for alternative intervention formats to be implemented. Several systematic reviews on Web-based interventions with a large emphasis on chronic pain and cognitive behavioral therapy have been recently conducted to explore the influence of these interventions on pain management However, to our knowledge, the specific contribution of tailored Web-based interventions for pain management has not been described and their effect on pain has not been evaluated. OBJECTIVE: The primary aim of this systematic review was to answer the following research question: What is the effect of tailored Web-based pain management interventions for adults on pain intensity compared with usual care, face-to-face interventions, and standardized Web-based interventions? A secondary aim was to examine the effects of these interventions on physical and psychological functions. METHODS: We conducted a systematic review of articles published from January 2000 to December 2015. We used the DerSimonian-Laird random effects models with 95% confidence intervals to calculate effect estimates for all analyses. We calculated standardized mean differences from extracted means and standard deviations, as outcome variables were measured on different continuous scales. We evaluated 5 different outcomes: pain intensity (primary outcome), pain-related disability, anxiety, depression, and pain catastrophizing. We assessed effects according to 3 time intervals: short term (<1 month), medium term (1-6 months), and long term (6-12 months). RESULTS: After full-text review, we excluded 31 articles, resulting in 17 eligible studies. Only 1 study concerned acute pain and was removed from the meta-analysis, resulting in 16 studies available for quantitative assessment. Compared with standard care or a waiting list, tailored Web-based intervention showed benefits immediately after, with small effect sizes (<0.40) for pain intensity (10 randomized controlled trials [RCTs], n=1310, P=.003) and pain-related disability (6 RCTs, n=953, P<.001). No other improvements were observed at follow-up in the medium and long terms. Compared with the active control group, no improvements were found for the primary outcome (pain intensity) or any of the outcomes except for a small effect size on pain catastrophizing (2 RCTs, n=333, P<.001) immediately after the intervention. CONCLUSIONS: Tailored Web-based interventions did not prove to be more efficacious than standardized Web-based interventions in terms of pain intensity, pain-related disability, anxiety, and depression. An interesting finding was that some efficacy was shown on pain catastrophizing compared with active control interventions. Considering the diversity of approaches used in tailored Web-based interventions for chronic pain management, their efficacy is yet to be explored. Moreover, their contribution to acute pain management is embryonic. TRIAL REGISTRATION: International prospective register of systematic reviews (PROSPERO): CRD42015027669; http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42015027669 (Archived by WebCite at http://www. webcitation.org/6uneWAuyR).

AI snapshot

Written from the paper’s full text.

TL;DR

This systematic review and meta-analysis found that tailored Web-based pain interventions produced small short-term improvements in pain intensity and pain-related disability versus standard care or waitlist, but not versus active controls except for pain catastrophizing. Evidence was limited by few active-control studies, heterogeneous intervention approaches, and only one acute pain trial.

Key findings

  • Versus standard care or waitlist, tailored Web-based interventions showed small short-term benefits for pain intensity (10 RCTs, n=1310, SMD –0.21, 95% CI –0.34 to –0.07, P=.003; I²=29%) and pain-related disability (6 RCTs, n=953, SMD –0.38, 95% CI –0.59 to –0.16, P<.001; I²=58%); no significant medium- or long-term improvements were observed.
  • Versus active control, no significant improvements were found for pain intensity short term (4 RCTs, n=543, SMD –0.09, P=.32) or medium term (4 RCTs, n=630, SMD –0.14, P=.09), nor for pain-related disability, anxiety, or depression; the only significant effect was short-term pain catastrophizing (2 RCTs, n=333, SMD –0.46, 95% CI –0.67 to –0.24, P<.001; I²=0%).
  • The review included 17 studies; 16 chronic pain studies entered meta-analysis, and the single acute pain study after cardiac surgery was removed. Mean completion rate was 77.6%, attrition ranged from 5% to 56% (average 22%), mean age was 48.2 years, and 71% of participants were female.
  • Feedback was used in every intervention, content matching in half of studies, and personalization was difficult to assess because of limited intervention descriptions.

Methods

  • Systematic review and meta-analysis of RCTs in adults with any pain, published January 2000 to December 2015, searched in MEDLINE, Embase, CINAHL, PsycINFO, Web of Science, and the Cochrane Library; protocol registered as PROSPERO CRD42015027669.
  • Eligible studies involved tailored Web-based pain management with at least one tailoring strategy (personalization, feedback, or adaptation/content matching), compared with passive control (usual care or waitlist) or active control (face-to-face or standardized Web-based intervention); pain intensity was a mandatory outcome.
  • DerSimonian-Laird random effects models calculated standardized mean differences with 95% CIs for pain intensity, pain-related disability, anxiety, depression, and pain catastrophizing at short term (<1 month), medium term (1-6 months), and long term (6-12 months); heterogeneity was assessed with I².

Limitations

  • Stated in the paper: only 5 studies were included in the active-control meta-analysis, so those results should be interpreted with caution; intervention approaches and dosage varied widely, preventing clear conclusions about efficacy; only half used content matching; attrition and fidelity were challenges; only one acute pain study was found; most participants were women and sex differences were not considered; focusing on the Roland Morris Disability Questionnaire and Brief Pain Inventory may have influenced disability results.
  • Evident from the text: most studies had high risk of bias for blinding of participants/personnel and outcome assessment, and many had unclear risk for random sequence generation or allocation concealment; small numbers of studies per analysis limited funnel plot assessment and subgroup analyses.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.2196/jmir.8826

Cites

67 of 67 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 62 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    Compared with active control, tailored Web-based interventions showed no improvement in pain intensity immediately after the intervention.

    “Compared with the active control group, no improvements were found for the primary outcome (pain intensity) or any of the outcomes except for a small effect size on pain catastrophizing (2 RCTs, n=333, P<.001) immediately after the intervention.”
    Quote in the paperSubstantial claim
  • Findingown data

    No significant short-term reductions in depression were found with tailored Web-based interventions compared with standard care or waitlist control (7 RCTs, n=635, SMD -0.33, 95% CI -0.66 to 0.00, P=.05).

    “or depression (7 RCTs, n=635, SMD –0.33, 95% CI –0.66 to 0.00, P=.05; I2=73%)”
    Quote in the paperSubstantial claim
  • Findingown data

    The beneficial short-term effect of tailored Web-based interventions on pain intensity was not sustained at long term (5 RCTs, n=1909, SMD -0.09, 95% CI -0.18 to 0.00, P=.05).

    “and long term (5 RCTs, n=1909, SMD –0.09, 95% CI –0.18 to 0.00, P=.05; I2=0%)”
    Quote in the paperSubstantial claim
  • Findingown data

    The beneficial short-term effect of tailored Web-based interventions on pain intensity was not sustained at medium term (4 RCTs, n=987, SMD -0.08, 95% CI -0.30 to 0.13, P=.45).

    “The beneficial pain relief effect was not sustained at medium term (4 RCTs, n=987, SMD –0.08, 95% CI –0.30 to 0.13, P=.45; I2=48%)”
    Quote in the paperSubstantial claim
  • Findingown data

    Compared with active control, tailored Web-based interventions produced a small effect on pain catastrophizing immediately after the intervention (2 RCTs, n=333, P<.001).

    “except for a small effect size on pain catastrophizing (2 RCTs, n=333, P<.001) immediately after the intervention.”
    Quote in the paperSubstantial claim
  • May combine two claims. 20
  • The quote only partly states this claim. 2
  • Classified as probably not a substantial claim. 16

  • May combine two claims.

    Findingown data

    Only 1 of the 17 eligible studies concerned acute pain; it was removed from the meta-analysis, leaving 16 studies for quantitative assessment.

    “Only 1 study concerned acute pain and was removed from the meta-analysis, resulting in 16 studies available for quantitative assessment.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The systematic review excluded 31 articles after full-text review and included 17 eligible studies.

    “After full-text review, we excluded 31 articles, resulting in 17 eligible studies.”
    Quote in the paperNot a substantial claim

  • The quote only partly states this claim.

    Findingown data

    In adults with chronic pain, tailored Web-based interventions compared with standard care or waitlist control produced a small beneficial short-term effect on pain intensity (10 RCTs, n=1310, SMD -0.21, 95% CI -0.34 to -0.00, P=.003).

    “We entered 10 studies (n=1310) into an analysis of the short-term effect of Web-based tailored interventions on pain intensity. The overall effect of Web-based tailored interventions on pain intensity was beneficial, with a small effect size and no significant heterogeneity (SMD –0.21, 95% CI –0.34 to –0.0, P=.003; I2=29%).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    When comparing the active control group, no improvements were found for the primary outcome (pain intensity) or any of the outcomes except for a small effect size on pain catastrophizing immediately after the intervention.

    “When comparing the active control group, we found no improvements for the primary outcome (pain intensity) or any of the outcomes except for a small effect size on pain catastrophizing (2 RCTs, n=333) immediately after the intervention.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    The 2 studies both used content matching but used different format and different approach.

    “Although they both used content matching, they used different format (hybrid vs not), and a different approach (CBT and motivational vs CBT, acceptance and commitment therapy, and mindfulness).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    Funnel plot asymmetry was observed at the bottom, possibly reflecting moderate heterogeneity due to the inclusion of small studies.

    “We observed some asymmetry at the bottom, possibly reflecting moderate heterogeneity due to the inclusion of small studies.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Only 1 study concerned acute pain, which was removed from the meta-analysis, resulting in 16 studies available for quantitative assessment.

    “Only 1 study concerned acute pain, which we removed from the meta-analysis, resulting in 16 studies available for quantitative assessment.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingnone given

    The levels of catastrophizing recorded were high.

    “Nonetheless, it is important to underline that the levels of catastrophizing recorded were high.”
    Quote in the paperNot a substantial claim

  • The quote only partly states this claim.

    Findingown data

    The tailored Web-based intervention did not relieve pain-related disability significantly better than active control in the short term (2 RCTs, n=426, SMD -0.09, 95% CI -0.28 to 0.10, P=.37; I2=0%).

    “The tailored Web-based intervention did not relieve pain significantly better than the active control in the short term (2 RCTs, n=426, SMD –0.09, 95% CI –0.28 to 0.10, P=.37; I2=0%)”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Selected studies included interventions profoundly influenced by CBT, but approaches were oftentimes multimodal and varied.

    “Selected studies included interventions profoundly influenced by CBT, but approaches were oftentimes multimodal and varied from wearing a pedometer and physical activity coaching to relaxation and mindfulness.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Feedback was used in all studies but content matching was used in only half of the studies.

    “Feedback was used in all studies but content matching, the most important tailoring ingredient, was used in only half of the studies.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingnone given

    Many of the interventions included an educational aspect related to management of a specific chronic disease and wellness.

    “Many of the interventions also included an educational aspect related to management of a specific chronic disease and wellness.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductcitation

    The detailed protocol was published and registered with PROSPERO (CRD42015027669).

    “The detailed protocol was published [34] and registered with the international prospective register of systematic reviews (no CRD42015027669).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [34] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    Data were extracted independently by 2 teams of 2 reviewers using DistillerSR, and disagreements were resolved by discussion until 100% agreement.

    “Data were extracted independently by 2 teams of 2 reviewers (GM and MaB; CG and MeB) composed of 1 doctoral student and 1 researcher using the software DistillerSR v2 (Evidence Partners Inc).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    Risk of bias for the 17 selected studies was assessed by 2 teams of reviewers using the Cochrane Collaboration tool, and discrepancies were discussed between the teams.

    “Risk of bias for the 17 selected studies was assessed by the 2 teams of reviewers using the Cochrane Collaboration tool [41-43], and any discrepancies between reviewers were discussed between the 2 teams.”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [41] source

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    • cites [42] Higgins, JPT, 2011, BMJ source

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    • cites [43] source

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  • May combine two claims.

    Study design and conductown data

    Selective reporting was judged low risk except in 4 studies, where it was unclear.

    “We judged selective reporting as low risk except in 4 studies (unclear) [39,59].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [39] source

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    • cites [59] source

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Funnel plots were constructed for only 1 analysis because fewer than 10 studies were included in each analysis.

    “We constructed funnel plots for only 1 analysis due to the small number of studies included in each analysis (n<10) [63,64].”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [63] Sterne, J, 2008, Cochrane Handbook for Systematic Reviews of Interventions: Cochrane Book Series

      Not checked in the free run.

    • cites [64] Sterne, JAC, 2011, BMJ source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S4 (based).

    Interpretationnone given

    The contribution of tailored Web-based interventions to acute pain management is embryonic.

    “Moreover, their contribution to acute pain management is embryonic.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    The systematic review protocol was developed based on PRISMA guidelines for reporting systematic reviews evaluating health care interventions.

    “This systematic review protocol has been developed based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for reporting systematic reviews evaluating health care interventions [31-33].”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites [31] Shamseer, L, 2015, BMJ source

      Not checked in the free run.

    • cites [32] Liberati, A, 2009, BMJ source

      Not checked in the free run.

    • cites [33] source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Interpretationreasoning

    The efficacy of tailored Web-based interventions for chronic pain management is yet to be explored.

    “Considering the diversity of approaches used in tailored Web-based interventions for chronic pain management, their efficacy is yet to be explored.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    Eligibility was assessed independently in an unblinded standardized manner by 2 team members, and results were compared.

    “Eligibility was assessed independently in an unblinded standardized manner by 2 team members (GM, CG) and results were then compared.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductown data

    All included studies except 2 presented a high risk of performance bias regarding blinding of participants, and the same was the case for detection bias.

    “In terms of performance bias, all studies except for 2 (low and unclear risks) [48,52] presented a high risk in regard to blinding of participants, which was also the case for detection bias.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [48] Andersson, G, 2003, Headache source

      Not checked in the free run.

    • cites [52] source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    One meta-analysis on Web-based CBT found a small effect on pain catastrophizing posttreatment, but reported high heterogeneity and used standard care or waiting list as comparator.

    “One meta-analysis on Web-based CBT found a small effect on pain catastrophizing posttreatment [19]. However, a high heterogeneity was reported and the comparator was standard care or waiting list.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [19] source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    Variations in samples coming from the general population as opposed to outpatients from a clinic could be a potential explanation for the funnel plot asymmetry.

    “Variations in samples coming from the general population as opposed to outpatients from a clinic could also be a potential explanation.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    Previous systematic reviews on Web-based interventions for pain concluded that results were promising in terms of pain reduction and improvement of functional and emotional well-being.

    “Overall, their authors concluded that results were promising in terms of pain reduction, and improvement of functional and emotional well-being.”
    Quote in the paperSubstantial claim0 of 6 sources checked
    • cites [14] source

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    • cites [15] source

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    • cites [16] source

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    • cites [17] source

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    • cites [18] source

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    • cites [19] source

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  • May combine two claims.

    Premisecitation

    Another meta-analysis found a small effect on depression posttreatment compared with standard care, but that analysis merged both depression and anxiety outcomes.

    “Another meta-analysis found a small effect on depression posttreatment compared with standard care. However, that analysis merged both depression and anxiety outcomes [19].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [19] source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    This attrition rate is similar to the rate found in another meta-analysis, underlining that there was no difference in attrition even when participants received more guidance as opposed to no reminders or feedback.

    “This rate is similar to the rate found in another meta-analysis, underlining that there was no difference in attrition even when participants received more guidance as opposed to no reminders or feedback [19].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [19] source

      Not checked in the free run.

  • May combine two claims.

    Interpretationnone given

    This is, to our knowledge, the first review examining tailored Web-based interventions and using active control groups as a comparator.

    “Although several meta-analyses and systematic reviews of Web-based interventions for pain management have been conducted, this is, to our knowledge, the first examining tailored Web-based interventions and using active control groups as a comparator.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning

    Similar findings to other meta-analyses on Web-based interventions for pain management were generated, meaning that these interventions may have a short-term effect on pain intensity and disability compared with usual care.

    “Similar findings to other meta-analyses on Web-based interventions for pain management were generated, meaning that these interventions may have a short-term effect on pain intensity and disability compared with usual care.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    A recent study (n=1371) in the context of a rehabilitation program found that women have better activity level, pain acceptance, and social support, while men report more fear of movement and mood disturbances.

    “A recent study (n=1371) in the context of a rehabilitation program found that women have better activity level, pain acceptance, and social support, while men report more fear of movement and mood disturbances [70].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [70] source

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Content matching is thought to be the essence of tailored approaches.

    “which is thought to be the essence of tailored approaches [21]”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [21] source

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  • Classified as probably not a substantial claim.

    Study design and conductreasoning

    Focusing on the Roland Morris Disability Questionnaire and the Brief Pain Inventory as the 2 most commonly used measures for pain-related disability could have influenced our results.

    “In an effort to decrease heterogeneity in measures and their involved concepts when looking at pain-related disability, we focused on the 2 most commonly used measures: the Roland Morris Disability Questionnaire and the Brief Pain Inventory. This could have influenced our results.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    A meta-analysis on tailored Web-based interventions in general found that expert input does not necessarily mean more efficacy.

    “A meta-analysis on tailored Web-based interventions in general found that expert input does not necessarily mean more efficacy [30].”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [30] source

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33 of 33

  • The paper relies on this without support.

    The specific contribution of tailored Web-based interventions for pain management has not been described and their effect on pain has not been evaluated.

    “However, to our knowledge, the specific contribution of tailored Web-based interventions for pain management has not been described and their effect on pain has not been evaluated.”

  • The paper relies on this without support.

    The active control groups in the included studies are equivalent to standardized Web-based interventions.

    “Tailored Web-based interventions did not prove to be more efficacious than standardized Web-based interventions in terms of pain intensity, pain-related disability, anxiety, and depression.”
2 of 2

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Internet-based CBT interventions for chronic somatic (pain) conditions are more effective than passive control conditions for outcomes such as pain intensity, fatigue, pain-related interference/disability, pain acceptance, health-related quality of life, distress, depression, anxiety, and catastrophizing.

    “Specifically, internet-based (CBT) interventions for chronic somatic (pain) conditions are found to be more effective than passive control conditions for outcomes such as pain intensity, fatigue, pain-related interference/disability, pain acceptance, health-related quality of life, distress, depression, anxiety, and catastrophizing (van Beugen et al., 2014; Buhrman et al., 2016; Martorella et al.,”

    From Guided internet-based cognitive-behavioral therapy for patients with chronic pain: A meta-analytic review (2022) · cites this paper as Martorella et al., 2017

    The Discussion (Principal Findings; page unavailable) reports small, immediate improvements in pain intensity and pain-related disability versus standard care or a waiting list. It reports no statistically significant benefit for anxiety or depression; its finding for catastrophizing is against an active control, not a passive one. The cited results do not establish the claimed benefits for fatigue, pain acceptance, quality of life, or distress. (LLM, conf=0.91)

    Experimental — accuracy not yet measured

  • The first three IMMPACT outcome domains (pain, physical functioning, emotional functioning) appear frequently reported in meta-analyses on internet-based interventions in chronic pain, whereas the last three (global improvement/satisfaction, disposition/dropout, adverse events) are often not or only partly reported.

    “The first three outcome domains appear to be frequently reported in meta-analyses on internet-based interventions in chronic pain, whereas the last three domains related to participant experience and safety of the treatment are often not or only partly reported (Buhrman et al., 2016; Martorella et al., 2017; Vugts et al., 2018).”

    From Guided internet-based cognitive-behavioral therapy for patients with chronic pain: A meta-analytic review (2022) · cites this paper as Martorella et al., 2017

    The Discussion’s Principal Findings (page not supplied) say the review evaluated pain intensity, pain-related disability, anxiety, depression, and pain catastrophizing, supporting the claim about the first three domains. The Discussion’s Limitations and Future Research section reports attrition rates, so dropout was not wholly unreported; the review does not establish a general reporting pattern across meta-analyses for satisfaction, dropout, and adverse events. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

  • Existing eHealth and mHealth solutions in pain settings have focused mostly on self-administered treatments, mostly psychological or physical therapy.

    “To date, the focus of existing eHealth and mHealth solutions in pain settings has been mostly placed on self-administered treatments, mostly of psychological or alternatively of physical therapy nature [64,65,66].”

    From Telemonitoring in Chronic Pain Management Using Smartphone Apps: A Randomized Controlled Trial Comparing Usual Assessment against App-Based Monitoring with and without Clinical Alarms (2020) · cites this paper as [65]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Study [39] has conflicting publication years

    Minor

    Table 2 labels Moessner study [39] as 2012, while Table 1 labels the same study as 2014.

  • Studies called higher-dropout have rates above the stated cutoff

    Minor

    The discussion labels the cited studies as having higher dropout rates of less than 20%, but Table 1 reports 40% for Kristjánsdóttir, 25% for Lorig 2008, and 44% for Moessner 2012.

  • Stated maximum session count is below a listed intervention

    Minor

    The text says interventions had at most 18 sessions, but Table 2 lists 20 sessions for Kristjánsdóttir.

  • Short-term pain confidence interval differs from Table 5

    Minor

    The text gives an upper confidence limit of -0.0, whereas the corresponding Table 5 total gives -0.07.

4 of 4

Cites

Flagged first, then by citations

Research works printed but not linked: 3

  1. 2011, Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education and Research
  2. The Cochrane CollaborationRevMan: computer program version 5.320142017-08-30Copenhagen, DenmarkThe Nordic Cochrane Centrehttp://community.cochrane.org/tools/review-production-tools/revman-5
  3. Sterne, J, 2008, Cochrane Handbook for Systematic Reviews of Interventions: Cochrane Book Series

Cited by

Sorted by citations

Related

Authors
Martorella, G., Boitor, M., Berube, M., Fredericks, S., Le May, S., & Gélinas, C.
Affiliations
  • Toronto Metropolitan University (CA)
  • Jewish General Hospital (CA)
ORCID
Venue
Journal of Medical Internet Research
Publisher
JMIR Publications Inc.
Published
2017-11-10
Volume
19
Issue
11
Pages
e385
ISSN
1438-8871 (ISSN-L)
DOI
10.2196/jmir.8826
PMC
PMC5701966
OpenAlex
W2767214959
Semantic Scholar
7c0046537c030c80c9c4c3fd55fd61289c8bc204
Cited by
88
References
67
Citations by year
2026: 5 · 2025: 10 · 2024: 16 · 2023: 9 · 2022: 8 · 2021: 13 · 2020: 11 · 2019: 8 · 2018: 8
FWCI
0.86
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Journal of Medical Internet Research (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
  • Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pediatric Pain Management Techniques
Keywords
pain management, chronic pain, pain intensity, pain-related disability, pain catastrophizing, anxiety, depression, physical function, psychological functioning, e-health, personalized interventions
MeSH terms
Adult, Female, Humans, Male, Internet, Pain Management

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-09.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-09.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

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