Deyo Richard A, Dworkin Samuel F, Amtmann Dagmar, Andersson Gunnar, Borenstein David, Carragee Eugene, Carrino John, Chou Roger, Cook Karon, DeLitto Anthony, Goertz Christine, Khalsa Partap, Loeser John, Mackey Sean, Panagis James, Rainville James, Tosteson Tor, Turk Dennis, Von Korff Michael, Weiner Debra K
*Oregon Health & Science University, Portland, OR †University of Washington, Seattle, WA ‡Rush University Medical Center, Chicago, IL §The George Washington University, Washington, DC ¶Stanford University, Stanford, CA ‖Johns Hopkins University, Baltimore, MD **Northwestern University, Evanston, IL ††VA Pittsburgh Healthcare System and University of Pittsburgh, Pittsburgh, PA ‡‡Palmer College of Chiropractic, Davenport, IA §§National Center for Complementary and Alternative Medicine, Bethesda, MD ¶¶National Institute for Arthritis and Musculoskeletal and Skin Diseases, Bethesda, MD ‖‖New England Baptist Hospital, Roxbury Crossing, MA ***Dartmouth University, Hanover, NH; and †††Group Health Research Institute, Seattle, WA.
Spine (Phila Pa 1976). 2014 Jun 15;39(14):1128-43. doi: 10.1097/BRS.0000000000000434.
Despite rapidly increasing intervention, functional disability due to chronic low back pain (cLBP) has increased in recent decades. We often cannot identify mechanisms to explain the major negative impact cLBP has on patients' lives. Such cLBP is often termed nonspecific and may be due to multiple biologic and behavioral etiologies. Researchers use varied inclusion criteria, definitions, baseline assessments, and outcome measures, which impede comparisons and consensus. Therefore, NIH Pain Consortium charged a research task force to draft standards for research on cLBP. The resulting multidisciplinary panel recommended using 2 questions to define cLBP; classifying cLBP by its impact (defined by pain intensity, pain interference, and physical function); use of a minimum data set to describe research participants (drawing heavily on the Patient Reported Outcomes Measurement Information System methodology); reporting "responder analyses" in addition to mean outcome scores; and suggestions for future research and dissemination. The Pain Consortium has approved the recommendations, which investigators should incorporate into NIH grant proposals. The research task force believes that these recommendations will advance the field, help resolve controversies, and facilitate future research addressing the genomic, neurological, and other mechanistic substrates of cLBP. We expect that the research task force recommendations will become a dynamic document and undergo continual improvement.
A task force was convened by the NIH Pain Consortium with the goal of developing research standards for cLBP. The results included recommendations for definitions, a minimum data set, reporting outcomes, and future research. Greater consistency in reporting should facilitate comparisons among studies and the development of phenotypes.
尽管干预措施迅速增加，但近几十年来，慢性下腰痛（cLBP）导致的功能残疾却有所增加。我们常常无法确定能够解释cLBP对患者生活产生重大负面影响的机制。这种cLBP通常被称为非特异性的，可能由多种生物学和行为学病因引起。研究人员使用的纳入标准、定义、基线评估和结果测量方法各不相同，这阻碍了比较和达成共识。因此，美国国立卫生研究院疼痛研究联盟责成一个研究特别工作组起草cLBP的研究标准。由此产生的多学科小组建议使用两个问题来定义cLBP；根据其影响（由疼痛强度、疼痛干扰和身体功能定义）对cLBP进行分类；使用最小数据集来描述研究参与者（大量借鉴患者报告结局测量信息系统方法）；除了平均结局分数外，还报告“应答者分析”；以及对未来研究和传播的建议。疼痛研究联盟已批准这些建议，研究人员应将其纳入美国国立卫生研究院的资助申请中。研究特别工作组认为，这些建议将推动该领域的发展，有助于解决争议，并促进未来针对cLBP的基因组、神经学和其他机制基础的研究。我们预计，研究特别工作组的建议将成为一份动态文件，并不断完善。
美国国立卫生研究院疼痛研究联盟召集了一个特别工作组，目标是制定cLBP的研究标准。结果包括对定义、最小数据集、报告结局和未来研究的建议。报告的更大一致性应有助于研究之间的比较和表型的发展。
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