Protocol for Development and Validation of Multivariable Prediction Models for Chronic Postsurgical Pain Following Video-Assisted Thoracic Surgery

Abstract

Purpose

Chronic postsurgical pain (CPSP) is a common complication after thoracic surgery and associated with long-term adverse outcomes. This study aims to develop two prediction models for CPSP after video-assisted thoracic surgery (VATS).

Methods and Analysis

This single-center prospective cohort study will include a total of 500 adult patients undergoing VATS lung resection (n = 350 for development and n = 150 for external validation). Patients will be enrolled continuously at The First Affiliated Hospital of Soochow University in Suzhou, China. The cohort for external validation will be recruited in another time period. The outcome is CPSP, which is defined as pain with the numerical rating scale score of 1 or higher 3 months after VATS. Univariate and multivariable logistic regression analyses will be performed to develop two CPSP prediction models based on patients’ data of postoperative day 1 and day 14, respectively. For internal validation, we will use the bootstrapping validation technique. For external validation, the discrimination capability of the models will be assessed using the area under the receiver operating characteristic curve, and the calibration will be evaluated using the calibration curve and Hosmer–Lemeshow goodness-of-fit statistic. The results will be presented in model formulas and nomograms.

Conclusion

Based on the development and validation of the prediction models, our results contribute to early prediction and treatment of CPSP after VATS.

Trial Registration

Chinese Clinical Trial Register (ChiCTR2200066122).

Keywords:

• chronic postsurgical pain
• prediction
• video-assisted thoracoscopic surgery

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

This study is supported by the Jiangsu Medical Association Anaesthesia Research Project (SYH-32021-0036 (2021031) to KP), Suzhou Medical Health Science and Technology Innovation Project (SKY2022136 to KP), and National Natural Science Foundation of China (82072130 to FHJ).