# Healthcare professionals’ perspectives on the utility of chronic postsurgical pain prediction profiles in perioperative care: a qualitative study

## TL;DR

This study explores how healthcare professionals view the usefulness of predicting chronic postsurgical pain in patients, highlighting both skepticism and potential benefits.

## Contribution

The study provides insights into healthcare professionals' perceptions of implementing a machine learning-based chronic pain risk assessment system in clinical practice.

## Key findings

- Healthcare professionals questioned the applicability of chronic pain predictions in in-hospital settings due to role boundaries and time constraints.
- Participants identified benefits such as improved clinical reflection and individualized treatment when aware of risk profiles.
- Effective implementation requires predictive validity, guidance, collaboration, and clinician training.

## Abstract

Chronic postsurgical pain affects surgical patients with a mean incidence of approximately 20%, posing a major public health concern with substantial implications for patients and healthcare systems. Despite increasing knowledge of risk factors, the incidence of chronic postsurgical pain remains high. Hence, there is growing interest in developing individualised pain management strategies using predictive risk. A novel chronic postsurgical pain risk assessment system using machine learning is under development in Western Norway. As a first step in implementing the risk assessment system, this study explored how in-hospital healthcare professionals perceive the potential utility of access to individualised chronic postsurgical pain risk profiles for clinical practice.

This qualitative study included seven focus groups with 39 healthcare professionals from postanaesthesia care units, surgical units and orthopaedic wards across two hospitals in Norway. Data were analysed inductively using reflexive thematic analysis.

Our analyses yielded two overarching themes: (1) Lack of fit of risk predictions and (2) potentials of knowing risk profiles. Participants questioned the applicability of chronic postsurgical pain predictions in the in-hospital settings, highlighting role boundaries, time constraints, and limited influence over long-term outcomes. However, they also identified the benefits of risk awareness, including improved clinical reflection, more cautious decision-making, and an enhanced potential for individualised treatment and care.

Healthcare professionals expressed a balanced view of chronic postsurgical pain risk profiles, recognising both scepticism about them and their potential benefits. Effective implementation will require predictive validity, clear guidance, and cross-disciplinary collaboration. Education and training will be essential to support clinicians in interpreting and acting on risk information.