Walton David M, Elliott James M, Lee Joshua, Loh Eldon, MacDermid Joy C, Schabrun Siobhan, Siqueira Walter L, Corneil Brian D, Aal Bill, Birmingham Trevor, Brown Amy, Cooper Lynn K, Dickey James P, Dixon S Jeffrey, Fraser Douglas D, Gati Joseph S, Gloor Gregory B, Good Gordon, Holdsworth David, McLean Samuel A, Millard Wanda, Miller Jordan, Sadi Jackie, Seminowicz David A, Shoemaker J Kevin, Siegmund Gunter P, Vertseegh Theodore, Wideman Timothy H
Western University, London, ON, Canada N6G 1H1.
Northwestern University, Chicago, IL 60611, USA.
Pain Res Manag. 2016;2016:1859434. doi: 10.1155/2016/1859434. Epub 2016 Jun 14.
Background. Chronic or persistent pain and disability following noncatastrophic "musculoskeletal" (MSK) trauma is a pervasive public health problem. Recent intervention trials have provided little evidence of benefit from several specific treatments for preventing chronic problems. Such findings may appear to argue against formal targeted intervention for MSK traumas. However, these negative findings may reflect a lack of understanding of the causal mechanisms underlying the transition from acute to chronic pain, rendering informed and objective treatment decisions difficult. The Canadian Institutes of Health Research (CIHR) Institute of Musculoskeletal Health and Arthritis (IMHA) has recently identified better understanding of causal mechanisms as one of three priority foci of their most recent strategic plan. Objectives. A 2-day invitation-only active participation workshop was held in March 2015 that included 30 academics, clinicians, and consumers with the purpose of identifying consensus research priorities in the field of trauma-related MSK pain and disability, prediction, and prevention. Methods. Conversations were recorded, explored thematically, and member-checked for accuracy. Results. From the discussions, 13 themes were generated that ranged from a focus on identifying causal mechanisms and models to challenges with funding and patient engagement. Discussion. Novel priorities included the inclusion of consumer groups in research from the early conceptualization and design stages and interdisciplinary longitudinal studies that include evaluation of integrated phenotypes and mechanisms.
背景。非灾难性“肌肉骨骼”（MSK）创伤后的慢性或持续性疼痛及残疾是一个普遍存在的公共卫生问题。近期的干预试验几乎没有提供证据表明几种特定治疗方法对预防慢性问题有益。此类研究结果似乎可能反对对MSK创伤进行正式的针对性干预。然而，这些负面结果可能反映出对急性疼痛向慢性疼痛转变的潜在因果机制缺乏理解，从而难以做出明智且客观的治疗决策。加拿大卫生研究院（CIHR）肌肉骨骼健康与关节炎研究所（IMHA）最近已将更好地理解因果机制确定为其最新战略计划的三个优先重点之一。目标。2015年3月举办了一场为期两天的仅限受邀者积极参与的研讨会，有30位学者、临床医生和消费者参加，目的是确定创伤相关MSK疼痛与残疾、预测及预防领域的共识研究重点。方法。对话被记录下来，进行主题探讨，并对成员进行准确性核对。结果。从讨论中产生了13个主题，范围从关注确定因果机制和模型到资金及患者参与方面的挑战。讨论。新的优先事项包括从早期概念化和设计阶段就让消费者群体参与研究，以及开展跨学科纵向研究，包括对综合表型和机制的评估。
