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Fung Ping Wong, from Toronto Western Hospital, and colleagues compared the outcomes of neuromodulation trials and implants in patients who bypassed an in-person psychological assessment (fast-track cohort; 57 participants) versus those who had the assessment (114 participants). The fast-track protocol incorporates a short mental health checklist and predefined cutoffs for validated questionnaires, with patients screening positive for unresolved psychological conditions undergoing an in-person psychological assessment.

The researchers found that 72 percent of patients having the psychological assessment and 70 percent in the fast-track group had a successful spinal cord stimulation trial. At six to 12 months following the implant (78 patients with follow-up data), 48.15 percent of patients in the fast-track group and 47.06 percent of patients receiving the psychological assessment had ≥30 percent reduction in pain scores from preimplant levels.

“An algorithm incorporating predefined thresholds on validated questionnaires and a mental health checklist can be used to identify patients who do not need a formal in-person psychological assessment without a negative impact on outcomes of neuromodulation therapies for pain,” the authors write. “This can help reduce wait times and optimize utilization of health care resources.”