Evidence map›Paper›PMID 40304934›Full record

ArticleJournal of patient-reported outcomes2025

Development of patient reported outcome measures assessing tumor pain intensity and tumor pain interference for individuals with neurofibromatosis type 1 and plexiform neurofibromas: qualitative findings.

Nour Al Ghriwati, Kari Struemph, Staci Martin, Paige Little, Melissa Baker, Jason Levine, Cynthia MacKenzie, James Tonsgard, Elizabeth K Schorry, Karin S Walsh and 1 more

Abstract readMulticenter Study
In one paragraph

Article in Journal of patient-reported outcomes, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Trial
  2. Article
  3. Caregiver Interviews Regarding Health in Down Syndrome.American journal of medical genetics. Part A · 2026
    Observational
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Nour Al Ghriwati *Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
Kari Struemph *Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
Staci MartinPediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
Paige LittlePediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
Melissa BakerPediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
Jason LevinePediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA.
Cynthia MacKenzieUniversity of Chicago Pritzker School of Medicine, Chicago, IL, USA.
James TonsgardUniversity of Chicago Pritzker School of Medicine, Chicago, IL, USA.
Elizabeth K SchorryCincinnati Children's Hospital and Medical Center, Cincinnati, OH, USA.
Karin S WalshChildren's National Hospital, The George Washington University School of Medicine, Washington, DC, USA.
Pamela L WoltersPediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA. woltersp@mail.nih.gov.ORCID http://orcid.org/0000-0001-9319-6281

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPain is a common symptom in individuals with neurofibromatosis type 1 (NF1) that often is associated with plexiform neurofibroma (pNF) tumors. To date, no patient-reported outcome measures have been validated specifically to assess pNF-related pain intensity or pain interference in this population. Such measures are sorely needed since pain is being considered as an outcome in clinical trials targeting reduction of pNF. The study aims were to: (1) obtain qualitative information from individuals with NF1 and pNFs about their pain and its measurement and (2) modify existing scales to assess pNF-related pain intensity and pain interference for NF1 clinical trials.

methodsFor this multi-site, qualitative study, 56 individuals (26 children, 6-16 years; 30 adults, 18-68 years) with NF1 and pNF participated in a focus group and/or individual interview about pain intensity and pain interference (concept elicitation) and also provided feedback about existing pain measures (Numeric Rating Scale-11 and Pain Interference Index) assessing these domains (cognitive debriefing). Four additional waves of cognitive debriefing interviews further refined the measures. Qualitative concept elicitation data from transcripts were coded, analyzed using NVivo software, and thematic analysis was conducted using both deductive and inductive techniques. Additional themes and systematic problems and suggestions regarding the measures were gleaned from reviewing the field notes and interview transcriptions generated by the cognitive debriefing sessions.

resultsConcept elicitation themes included descriptions of two types of pNF-related pain (chronic and episodic), variability of pain over time, varying ability to recall pain, lack of knowledge of pNFs, and the ways pain interferes with daily activities. Cognitive debriefing themes included information on how to rate pNF-related pain intensity apart from other pain; problems and suggestions regarding the measures included difficulty comprehending some items and preferences for alternative wording and formatting. Based on these qualitative results, the measures' instructions, items, and formatting were modified to create the PAin INtensity Scale for plexiform neurofibromas (PAINS-pNF) and the Pain Interference Index for plexiform neurofibromas (PII-pNF) for administration on a mobile app or web-based platform.

conclusionsThe PAINS-pNF and PII-pNF are promising self-report measures developed using patient engagement to evaluate tumor pain intensity and pain interference in NF1 clinical trials. The second phase of the study to provide reliability, validity, and normative data for individuals with NF1 and pNFs ages 8 years and older is underway.

Indexed as

Cancer PainNeurofibroma, PlexiformNeurofibromatosis 1Pain MeasurementPatient Reported Outcome MeasuresAdolescentAdultAgedChildFemaleFocus GroupsHumansMaleMiddle AgedQualitative ResearchYoung AdultMeasure developmentNeurofibromatosis type 1Pain assessmentPain intensityPain interferencePatient-reported outcomesPlexiform neurofibromasQualitative

Identifiers

PMID40304934
PMCPMC12044096

What Socratic holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.