Schrepf Andrew, Phan Vy, Clemens J Quentin, Maixner William, Hanauer David, Williams David A
Chronic Pain and Fatigue Research Center, Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, Michigan.
Trinity College-Hartford, Hartford, Connecticut.
J Pain. 2020 Jan-Feb;21(1-2):59-70. doi: 10.1016/j.jpain.2019.05.007. Epub 2019 May 30.
Chronic overlapping pain conditions (COPCs) are a set of painful chronic conditions characterized by high levels of co-occurrence. It has been hypothesized that COPCs co-occur in many cases because of common neurobiological vulnerabilities. In practice, most research on COPCs has focused upon a single index condition with little effort to assess comorbid painful conditions. This likely means that important phenotypic differences within a sample are obscured. The International Classification of Diseases (ICD) coding system contains many diagnostic classifications that may be applied to individual COPCs, but there is currently no agreed upon set of codes for identifying and studying each of the COPCs. Here we seek to address this issue through three related projects 1) we first compile a set of ICD-10 codes from expert panels for ten common COPCs, 2) we then use natural language searches of medical records to validate the presence of COPCs in association with the proposed expert codes, 3) finally, we apply the resulting codes to a large administrative medical database to derive estimates of overlap between the ten conditions as a demonstration project. The codes presented can facilitate administrative database research on COPCs. PERSPECTIVE: This article presents a set of ICD-10 codes that researchers can use to explore the presence and overlap of COPCs in administrative databases. This may serve as a tool for estimating samples for research, exploring comorbidities, and treatments for individual COPCs, and identifying mechanisms associated with their overlap.
慢性重叠性疼痛病症（COPCs）是一组以高共现率为特征的慢性疼痛病症。据推测，许多情况下COPCs会共现是因为存在共同的神经生物学易损性。在实际中，大多数关于COPCs的研究都集中在单一指标病症上，几乎没有努力评估共病性疼痛病症。这可能意味着样本中的重要表型差异被掩盖了。国际疾病分类（ICD）编码系统包含许多可应用于个体COPCs的诊断分类，但目前尚无一套商定的用于识别和研究每种COPCs的编码。在此，我们试图通过三个相关项目来解决这个问题：1）我们首先从专家小组那里汇编了一套针对十种常见COPCs的ICD - 10编码；2）然后我们使用病历的自然语言搜索来验证与提议的专家编码相关的COPCs的存在情况；3）最后，我们将所得编码应用于一个大型行政医疗数据库，以得出这十种病症之间重叠情况的估计值，作为一个示范项目。所呈现的编码能够促进对COPCs的行政数据库研究。观点：本文提出了一组ICD - 10编码，研究人员可用于探索行政数据库中COPCs的存在情况和重叠情况。这可作为一种工具，用于估计研究样本、探索共病情况以及针对个体COPCs的治疗方法，并识别与其重叠相关的机制。
