[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"health-study-detail:100658150":3},{"organization":4,"outcomesModule":7,"designInfo":40,"detailedDescription":43,"studyPopulation":44,"armGroups":45,"interventions":51,"overallOfficials":39,"centralContacts":57,"locations":63,"responsibleParty":77,"collaborators":39,"id":80,"slug":81,"hasResults":82,"nctId":83,"briefTitle":84,"officialTitle":85,"acronym":39,"eligibilityCriteria":86,"healthyVolunteers":82,"sex":87,"minAge":88,"maxAge":89,"enrollmentInfo":90,"targetDuration":39,"studyType":93,"phases":39,"briefSummary":94,"conditions":95,"keywords":97,"overallStatus":104,"whyStopped":39,"lastUpdateSubmitDate":105,"lastUpdatePostDateStruct":106,"startDateStruct":109,"completionDateStruct":111,"leadSponsor":113,"locationsCount":114},{"fullName":5,"class":6},"First Affiliated Hospital of Chongqing Medical University","OTHER",{"primaryOutcomes":8,"secondaryOutcomes":13,"otherOutcomes":39},[9],{"measure":10,"description":11,"timeFrame":12},"Proportion of Participants With an Adverse Postoperative Pain Trajectory","Participants will be classified as having an adverse or non-adverse postoperative pain trajectory based on pain scores collected during the first 48 hours after surgery and the prespecified, locked trajectory classification and mapping rules. The number and percentage of participants classified as having an adverse postoperative pain trajectory will be reported.","From the end of surgery through 48 hours postoperatively",[14,18,21,24,27,30,33,36],{"measure":15,"description":16,"timeFrame":17},"Area Under the Receiver Operating Characteristic Curve (AUC)","The area under the receiver operating characteristic curve (AUC) will be used to assess the discrimination of the locked prediction model for distinguishing participants with and without an adverse postoperative pain trajectory. The AUC ranges from 0.5, indicating no discrimination, to 1.0, indicating perfect discrimination. The AUC and its 95% confidence interval will be reported.","Through 48 hours postoperatively",{"measure":19,"description":20,"timeFrame":17},"Brier Score","The Brier score will be used to evaluate the overall predictive performance of the locked prediction model by comparing predicted probabilities with the observed binary adverse postoperative pain trajectory outcome. Lower values indicate better overall predictive performance. The Brier score and its 95% confidence interval will be reported.",{"measure":22,"description":23,"timeFrame":17},"Calibration Intercept","Calibration intercept will be used to assess systematic overestimation or underestimation of predicted risk by the locked prediction model. A value of 0 indicates ideal calibration. The calibration intercept and its 95% confidence interval will be reported.",{"measure":25,"description":26,"timeFrame":17},"Calibration Slope","Calibration slope will be used to assess the agreement between the spread of predicted probabilities and observed outcomes. A value of 1 indicates ideal calibration. The calibration slope and its 95% confidence interval will be reported.",{"measure":28,"description":29,"timeFrame":17},"Calibration Curve","A calibration curve will be used to visually assess agreement between predicted probabilities of an adverse postoperative pain trajectory and observed outcome frequencies across the range of predicted risk. The calibration curve and its 95% confidence interval will be presented.",{"measure":31,"description":32,"timeFrame":17},"Classification Performance at the Prespecified Risk Threshold","Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the locked prediction model will be evaluated at the prespecified risk threshold and reported with 95% confidence intervals where applicable. The threshold will not be selected or optimized using the external validation cohort.",{"measure":34,"description":35,"timeFrame":17},"Decision Curve Analysis","Decision curve analysis will be used to evaluate the clinical net benefit of the locked prediction model across a prespecified range of clinically relevant risk thresholds, compared with strategies of treating all participants or treating no participants as being at increased risk.",{"measure":37,"description":38,"timeFrame":12},"Distribution and Characteristics of Postoperative Pain Trajectory Classes","The number and percentage of participants assigned to each prespecified postoperative pain trajectory class will be described. Class-specific mean pain trajectories over the first 48 postoperative hours and prespecified indicators of classification uncertainty will also be summarized.",null,{"allocation":39,"interventionModel":39,"interventionModelDescription":39,"primaryPurpose":39,"observationalModel":41,"timePerspective":42,"maskingInfo":39},"COHORT","PROSPECTIVE","This is a single-center, prospective, observational external validation study of an early prediction model for adverse postoperative pain trajectories in adult patients undergoing elective orthopedic surgery at the First Affiliated Hospital of Chongqing Medical University.\n\nEligible participants will receive routine perioperative care. The study will not assign any experimental treatment or alter the participants' surgical, anesthetic, analgesic, nursing, or rehabilitation management. Study personnel will collect prespecified clinical variables from patient interviews, electronic medical records, anesthesia information systems, nursing records, and standardized postoperative pain assessments.\n\nThe end of surgery will be defined as postoperative hour 0. Postoperative pain intensity will be assessed using the 0-10 Numeric Rating Scale during the first 48 hours after surgery. This period will be divided into eight consecutive 6-hour windows: 0-6, 6-12, 12-18, 18-24, 24-30, 30-36, 36-42, and 42-48 hours. When more than one valid pain score is available within a time window, the median value will be used for the primary analysis.\n\nBefore enrollment of the first participant, the prediction model, prediction time point, predictor definitions, variable coding, data-processing procedures, missing-data handling rules, model structure, model parameters and hyperparameters, and outcome classification rules will be locked. Data from the external validation cohort will not be used to reselect predictors, retune hyperparameters, redefine cutoffs, or otherwise modify the original model.\n\nAfter completion of the 48-hour observation period and data verification, each participant's probability of developing an adverse postoperative pain trajectory will be calculated using the locked model. The observed postoperative pain trajectory will be determined independently according to the prespecified trajectory classification and mapping rules.\n\nExternal model performance will be evaluated using the area under the receiver operating characteristic curve, Brier score, calibration curve, calibration intercept, and calibration slope. Additional analyses will include sensitivity, specificity, positive predictive value, negative predictive value, accuracy, and decision curve analysis at prespecified risk thresholds. Exploratory analyses may describe model performance across major orthopedic surgical categories.\n\nModel predictions will be calculated offline and will not be communicated to participants, surgeons, anesthesiologists, nurses, or other treating clinicians during the study. Prediction results will therefore not influence clinical management.","Adult patients undergoing elective orthopedic surgery at the First Affiliated Hospital of Chongqing Medical University who are expected to remain hospitalized for at least 48 hours after surgery. Eligible procedures include major categories of elective orthopedic surgery, such as spinal surgery, hip or knee arthroplasty, pelvic or extremity fracture fixation, and orthopedic corrective surgery. Participants will be prospectively and consecutively screened and enrolled according to the prespecified eligibility criteria.",[46],{"label":47,"type":39,"description":48,"interventionNames":49},"Prospective External Validation Cohort","Adult patients undergoing elective orthopedic surgery at the First Affiliated Hospital of Chongqing Medical University will be prospectively enrolled and followed for 48 hours after surgery. Postoperative pain scores and prespecified clinical variables will be collected according to the study protocol. All participants will receive routine perioperative care, and no treatment will be assigned or modified by the study investigators. The locked prediction model will be applied offline to evaluate the risk of an adverse postoperative pain trajectory.",[50],"Procedure: Elective Orthopedic Surgery",[52],{"type":53,"name":54,"description":55,"armGroupLabels":56,"otherNames":39},"PROCEDURE","Elective Orthopedic Surgery","Participants will undergo elective orthopedic surgery as part of routine clinical care. The surgical procedure, anesthetic management, postoperative analgesia, nursing care, and rehabilitation plan will be determined by the treating clinical team according to standard practice. The study investigators will not assign, modify, or influence these treatments. The study will prospectively collect prespecified perioperative variables and postoperative pain assessments for external validation of a locked prediction model.",[47],[58],{"name":59,"role":60,"phone":61,"phoneExt":39,"email":62},"Lihua Peng","CONTACT","+86 15823443968","plhcqmu@163.com",[64],{"facility":65,"status":39,"city":66,"state":39,"zip":39,"country":67,"countryCode":68,"cosmosGeoPoint":69,"geoPoint":74,"contacts":75},"The First Affiliated Hospital of Chongqing Medical University","Chongqing","China","CN",{"type":70,"coordinates":71},"Point",[72,73],106.55771,29.56026,{"lat":73,"lon":72},[76],{"name":59,"role":60,"phone":61,"phoneExt":39,"email":62},{"type":78,"investigatorFullName":59,"investigatorTitle":79,"investigatorAffiliation":5,"oldNameTitle":39,"oldOrganization":39},"PRINCIPAL_INVESTIGATOR","Associate Professor and Chief Physician","100658150","prospective-external-validation-of-an-early-prediction-model-for-adverse-postoperative-pain-trajectories-after-orthopedic-surgery-100658150",false,"NCT07846878","Prospective External Validation of an Early Prediction Model for Adverse Postoperative Pain Trajectories After Orthopedic Surgery","Single-Center Prospective External Validation Study of an Early Prediction Model for Adverse Postoperative Pain Trajectories After Orthopedic Surgery","Inclusion Criteria:\n\n1. Aged 18 to 90 years, regardless of sex.\n2. Scheduled to undergo an eligible elective orthopedic surgical procedure at the First Affiliated Hospital of Chongqing Medical University.\n3. Expected to remain hospitalized for at least 48 hours after surgery.\n4. Conscious before surgery, with sufficient understanding and communication ability to understand and complete the 0-10 Numeric Rating Scale for pain.\n5. Able and willing to provide written informed consent before any study-specific data collection.\n\nExclusion Criteria:\n\n1. Younger than 18 years or older than 90 years.\n2. Emergency surgery, unplanned surgery, or a surgical procedure outside the prespecified orthopedic surgical scope of the study.\n3. Unable to reliably understand the study or complete the Numeric Rating （4）Scale because of impaired consciousness, severe cognitive impairment, psychiatric disorder, persistent deep sedation, mechanical ventilation, severe hearing impairment, language or communication difficulties, or similar conditions.\n\n（5）Lacks full capacity to provide valid informed consent. （6）Concurrent participation in another clinical study that may affect pain assessment, analgesic treatment, or study outcomes.\n\n（7）Expected discharge or transfer within 48 hours after surgery, or inability to complete the main study observation because of clinical circumstances.\n\n（8）Any other condition that, in the investigator's judgment, makes the patient unsuitable for participation in the study.","ALL","18 Years","90 Years",{"count":91,"type":92},400,"ESTIMATED","OBSERVATIONAL","This prospective observational study will externally validate a previously developed and locked prediction model for identifying adult patients at risk of adverse postoperative pain trajectories after elective orthopedic surgery. Approximately 400 patients will be consecutively recruited at the First Affiliated Hospital of Chongqing Medical University.\n\nPostoperative pain will be assessed during the first 48 hours after surgery using the 0-10 Numeric Rating Scale. Pain scores will be organized into eight consecutive 6-hour time windows to determine each participant's postoperative pain trajectory according to prespecified rules. Clinical information available at the predefined prediction time point will be entered into the locked prediction model to calculate each participant's predicted probability of an adverse pain trajectory.\n\nThe study will evaluate the model's discrimination, calibration, overall prediction performance, and potential clinical utility. The model will not be modified or retrained using data from this validation cohort. Individual prediction results will not be provided to patients or treating clinicians and will not be used to guide treatment during the study.",[96],"Postoperative Pain",[96,98,99,100,101,102,103],"Pain Trajectory","Orthopedic Surgery","Prediction Model","External Validation","Prospective Cohort","Clinical Prediction Model","NOT_YET_RECRUITING","2026-09-23",{"date":107,"type":108},"2026-09-29","ACTUAL",{"date":110,"type":92},"2026-09",{"date":112,"type":92},"2027-12",{"name":5,"class":6},1]