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
R.A. Deyo, MD, MPH, Oregon Health and Sciences University, 3181 SW Sam Jackson Park Rd, Mail Code FM, Portland, Oregon.
S.F. Dworkin, University of Washington, Seattle, Washington.
Phys Ther. 2015 Feb;95(2):e1-e18. doi: 10.2522/ptj.2015.95.2.e1.
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 non-specific 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 (RTF) 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 dataset to describe research participants (drawing heavily on the PROMIS 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 RTF believes that these recommendations will advance the field, help to resolve controversies, and facilitate future research addressing the genomic, neurologic, and other mechanistic substrates of chronic low back pain. We expect that the RTF 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 chronic low back pain. The results included recommendations for definitions, a minimum dataset, 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)导致的功能障碍却有所增加。我们常常无法确定能解释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,可能是由多种生物学和行为学病因引起的。研究人员使用的纳入标准、定义、基线评估和结果测量各不相同,这妨碍了比较和达成共识。因此,美国国立卫生研究院疼痛协会责成一个研究特别工作组(RTF)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果测量信息系统(PROMIS)方法);除了平均结果分数外,还要报告“反应者分析”;以及对未来研究和传播的建议。疼痛协会已批准这些建议,研究人员应将其纳入美国国立卫生研究院的资助申请中。RTF认为,这些建议将推动该领域的发展,有助于解决争议,并促进未来针对慢性下腰痛的基因组、神经学和其他机制基础的研究。我们预计RTF的建议将成为一份动态文件,并不断改进。
美国国立卫生研究院疼痛协会召集了一个特别工作组,目标是制定慢性下腰痛的研究标准。结果包括对定义、最小数据集、报告结果和未来研究的建议。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。