Department of Medicine, Tulane University School of Medicine, New Orleans, Louisiana; Department of Veteran Affairs, Malcom Randall VAMC, Gainesville, Florida.
University of Alabama at Birmingham (UAB), Department of Anesthesiology and Perioperative Medicine (Division of Pain Medicine), Neurology and Psychology, Birmingham, Alabama.
J Pain. 2018 Mar;19(3):257-263. doi: 10.1016/j.jpain.2017.10.002. Epub 2017 Oct 24.
In conjunction with the Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks public-private partnership with the U.S. Food and Drug Administration and the American Pain Society, the Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks-American Pain Society Pain Taxonomy (AAPT) initiative strove to develop the characteristics of a diagnostic system useful for clinical and research purposes across disciplines and types of chronic pain conditions. After the establishment of these characteristics, a working group of clinicians and clinical and basic scientists with expertise in abdominal, pelvic, and urogenital pain began generating core diagnostic criteria and defining the related extraintestinal somatic pain and other symptoms experienced by patients. Systematic diagnostic criteria for several common abdominal, pelvic, and urogenital pain conditions are in development. In this report, we present the proposed AAPT criteria for irritable bowel syndrome (IBS), the most common chronic, noncancer abdominal pain condition. A systematic review and synthesis was conducted to complement the Rome IV Diagnostic Criteria for IBS. Future efforts will subject these proposed AAPT criteria to systematic empirical evaluation of their feasibility, reliability, and validity. The AAPT IBS criteria are part of an evidence-based classification system that provides a consistent vocabulary regarding diagnostic criteria, common features, comorbidities, consequences, and putative mechanisms of the disorder. A similar approach is being applied to other chronic and often debilitating abdominal, pelvic, and urogenital pain conditions.
The AAPT's goal is to develop an evidence-based taxonomy for chronic pain on the basis of a consistently applied multidimensional framework, and encourage experts to apply this taxonomy to specific chronic pain conditions. In this report, the taxonomy is applied to IBS, a chronic abdominal pain condition.
与美国食品和药物管理局及美国疼痛学会的公私合作伙伴关系——镇痛、麻醉和成瘾临床试验转化、创新、机遇和网络(Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks,简称 AATCTN)共同努力,制定出一个适用于跨学科和各类慢性疼痛病症的临床和研究目的的诊断系统特征。在这些特征建立之后,一个由具有腹部、盆腔和泌尿生殖疼痛专业知识的临床医生和临床及基础科学家组成的工作组开始制定核心诊断标准,并定义患者经历的相关肠外躯体疼痛和其他症状。几种常见的腹部、盆腔和泌尿生殖疼痛病症的系统性诊断标准正在制定中。在本报告中,我们提出了用于肠易激综合征(irritable bowel syndrome,IBS)的 AAPT 标准,IBS 是最常见的慢性非癌性腹部疼痛病症。我们进行了系统的综述和综合,以补充罗马 IV 肠易激综合征诊断标准。未来的工作将对这些拟议的 AAPT 标准进行系统的实证评估,以检验其可行性、可靠性和有效性。AAPT IBS 标准是一个基于证据的分类系统的一部分,该系统就诊断标准、常见特征、共病、后果和该疾病的假定机制提供了一个一致的词汇。正在对其他慢性且常常使人衰弱的腹部、盆腔和泌尿生殖疼痛病症应用类似的方法。
AAPT 的目标是基于一致应用的多维框架制定一个基于证据的慢性疼痛分类系统,并鼓励专家将该分类系统应用于特定的慢性疼痛病症。在本报告中,该分类系统应用于 IBS,一种慢性腹部疼痛病症。