CORE/EBOH Seminar Series - November 24, 2025 - Dr. Karen Brown

Value of the Information & Strength of the Argument

The value of the information is high, as it provides novel insights into postoperative pain trajectories and their association with sleep apnea severity, which can inform clinical management. The argumentation is solid, based on a well-designed prospective cohort study with appropriate statistical methods. The speaker transparently discusses limitations, such as missing data and lack of standardized analgesic protocols, and addresses reviewer concerns. The use of multiple imputation and sensitivity analyses strengthens the validity of the findings. The clinical implications, such as early prediction of pain trajectory and potential for personalized analgesic strategies, are clearly articulated.

Scientific Rigor, Source Quality, Title Accuracy

The scientific rigor is evident in the study design, statistical methodology, and peer-review process. The speaker cites relevant literature, including the STBUR questionnaire development and the PPPM validation. The study was accepted by the British Journal of Anesthesia, indicating high-quality research. The title accurately reflects the content, focusing on trajectory analysis of pain. The presentation includes a thorough discussion of missing data handling and sensitivity analyses, demonstrating methodological rigor. The speaker also acknowledges collaborations with statisticians and the CORE team, enhancing credibility.

The title accurately reflects the content, which focuses on trajectory analysis of pain following tonsillectomy.

8/10

Presentation of a peer-reviewed prospective cohort study with robust statistical methods (multiple imputation, trajectory modeling) and transparent discussion of limitations. The speaker is a professor with extensive clinical and research experience. The study was accepted by the British Journal of Anesthesia, indicating scientific rigor.

Markers derived by PSI from the transcript: the creator did not define chapters.

• 02:00Introduction and background on sleep apnea and pain
• 10:00Study design and exposure/outcome variables
• 20:00Data collection challenges and missing data handling
• 30:00Trajectory modeling and selection of three groups
• 40:00Results: association with STBUR score and hospital revisits
• 50:00Analgesic effectiveness and clinical implications

• STBUR questionnaire (Tate et al., 2013) — Used to assess severity of obstructive sleep-disordered breathing
• Parents' Postoperative Pain Measure (PPPM) — Validated behavioral pain scale for children
• MICE (Multiple Imputation by Chained Equations) — Statistical method for imputing missing data
• Group-based trajectory modeling (Proc Traj) — Method used to identify pain trajectories

• Pain after tonsillectomy: a systematic review — Supports the finding that pain is common and lasts for several days postoperatively.
• Association between sleep apnea and pain sensitivity — Provides background on the link between sleep apnea and pain modulation.

• No association between oSDB severity and postoperative pain — A different study found no significant association, possibly due to differences in study design or pain measurement.