Communication of pain by school-age children with cancer using a game-based symptom assessment app: A secondary analysis.

The study included only 19 children from one hospital, and it was a feasibility study, so it cannot show how common these pain patterns are in other pediatric oncology groups. The sample size was set for feasibility, not for pain outcomes. Only 13 children recorded app information for at least four days, and many pain reports were missing severity or bother details. The app did not require children to report pain attributes, which may have caused missing data and made some reports incomplete. Researchers could not verify that the enrolled child personally completed each daily entry. Children's prior pain history was not formally assessed, so acute and persistent pain could not be separated. No member checking was done, so the categories used to describe pain-related statements may not fully match what the children meant. The free-text questions were not designed to elicit pain, so pain statements captured there may not represent all pain experiences. Only children who could use English and complete study procedures were included. Some children may have had parent support in reading items, which could influence responses.

The authors declared no conflicts of interest.

Do not read this as evidence that the app improves pain assessment or pain control. It describes 19 children's reports in a small single-site feasibility study, and the free-text questions were not designed to capture pain.