美国疼痛协会行动疼痛分类法(AAPT):一种基于证据的多维慢性疼痛病症分类方法。

The ACTTION-American Pain Society Pain Taxonomy (AAPT): an evidence-based and multidimensional approach to classifying chronic pain conditions.

作者信息

Fillingim Roger B, Bruehl Stephen, Dworkin Robert H, Dworkin Samuel F, Loeser John D, Turk Dennis C, Widerstrom-Noga Eva, Arnold Lesley, Bennett Robert, Edwards Robert R, Freeman Roy, Gewandter Jennifer, Hertz Sharon, Hochberg Marc, Krane Elliot, Mantyh Patrick W, Markman John, Neogi Tuhina, Ohrbach Richard, Paice Judith A, Porreca Frank, Rappaport Bob A, Smith Shannon M, Smith Thomas J, Sullivan Mark D, Verne G Nicholas, Wasan Ajay D, Wesselmann Ursula

机构信息

Pain Research and Intervention Center of Excellence, Gainesville, Florida.

Department of Anesthesiology, Vanderbilt University School of Medicine, Nashville, Tennessee.

出版信息

J Pain. 2014 Mar;15(3):241-9. doi: 10.1016/j.jpain.2014.01.004.

Abstract

UNLABELLED

Current approaches to classification of chronic pain conditions suffer from the absence of a systematically implemented and evidence-based taxonomy. Moreover, existing diagnostic approaches typically fail to incorporate available knowledge regarding the biopsychosocial mechanisms contributing to pain conditions. To address these gaps, the Analgesic, Anesthetic, and Addiction Clinical Trial Translations Innovations Opportunities and Networks (ACTTION) public-private partnership with the U.S. Food and Drug Administration and the American Pain Society (APS) have joined together to develop an evidence-based chronic pain classification system called the ACTTION-APS Pain Taxonomy. This paper describes the outcome of an ACTTION-APS consensus meeting, at which experts agreed on a structure for this new taxonomy of chronic pain conditions. Several major issues around which discussion revolved are presented and summarized, and the structure of the taxonomy is presented. ACTTION-APS Pain Taxonomy will include the following dimensions: 1) core diagnostic criteria; 2) common features; 3) common medical comorbidities; 4) neurobiological, psychosocial, and functional consequences; and 5) putative neurobiological and psychosocial mechanisms, risk factors, and protective factors. In coming months, expert working groups will apply this taxonomy to clusters of chronic pain conditions, thereby developing a set of diagnostic criteria that have been consistently and systematically implemented across nearly all common chronic pain conditions. It is anticipated that the availability of this evidence-based and mechanistic approach to pain classification will be of substantial benefit to chronic pain research and treatment.

PERSPECTIVE

The ACTTION-APS Pain Taxonomy is an evidence-based chronic pain classification system designed to classify chronic pain along the following dimensions: 1) core diagnostic criteria; 2) common features; 3) common medical comorbidities; 4) neurobiological, psychosocial, and functional consequences; and 5) putative neurobiological and psychosocial mechanisms, risk factors, and protective factors.

摘要

未标注

当前慢性疼痛疾病的分类方法缺乏系统实施且基于证据的分类学。此外,现有的诊断方法通常未能纳入有关导致疼痛疾病的生物心理社会机制的现有知识。为了填补这些空白,镇痛药、麻醉药和成瘾临床试验转化创新机会与网络(ACTTION)与美国食品药品监督管理局及美国疼痛协会(APS)的公私合作共同开发了一种基于证据的慢性疼痛分类系统,称为ACTTION-APS疼痛分类法。本文描述了ACTTION-APS共识会议的成果,专家们在此次会议上就这种新的慢性疼痛疾病分类法的结构达成了一致。围绕其展开讨论的几个主要问题被提出并总结,同时还介绍了该分类法的结构。ACTTION-APS疼痛分类法将包括以下维度:1)核心诊断标准;2)共同特征;3)常见医学合并症;4)神经生物学、心理社会和功能后果;5)假定的神经生物学和心理社会机制、危险因素及保护因素。在未来几个月里,专家工作组将把这种分类法应用于慢性疼痛疾病群组,从而制定出一套在几乎所有常见慢性疼痛疾病中都得到一致且系统实施的诊断标准。预计这种基于证据和机制的疼痛分类方法将对慢性疼痛研究和治疗大有裨益。

观点

ACTTION-APS疼痛分类法是一种基于证据的慢性疼痛分类系统,旨在沿以下维度对慢性疼痛进行分类:1)核心诊断标准;2)共同特征;3)常见医学合并症;4)神经生物学、心理社会和功能后果;5)假定的神经生物学和心理社会机制、危险因素及保护因素。

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