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美国国立卫生研究院“健康公平促进与疼痛缓解”疼痛通用数据元素(CDE):一个良好的开端,但距离终点仍有很长的路要走。

The NIH HEAL pain common data elements (CDE): a great start but a long way to the finish line.

作者信息

Adams Meredith C B, Hassett Afton L, Clauw Daniel J, Hurley Robert W

机构信息

Department of Anesthesiology, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, United States.

Center for Artificial Intelligence Research, Wake Forest University School of Medicine, Medical Center Boulevard, Winston-Salem, NC 27157, United States.

出版信息

Pain Med. 2025 Mar 1;26(3):146-155. doi: 10.1093/pm/pnae110.

Abstract

BACKGROUND

The National Institutes of Health (NIH) Pain Common Data Elements (CDEs) provide a standardized framework for pain research, but their implementation and interpretation present challenges.

OBJECTIVES

To review the NIH CDE Program's selected pain domains, provide best practices for implementing required questions, and offer a checklist for appropriate CDE use in clinical trials and secondary data analysis. This work analyzed the 10 core pain research domains selected by the NIH CDE Program and discuss their limitations and considerations for use.

RESULTS

The manuscript provides an overview of the 10 core pain research domains, including pain intensity, interference, physical function, sleep, catastrophizing, depression, anxiety, global impression of change, substance use screening, and quality of life. It offers sample scenarios for implementing required questions and presents a checklist to guide researchers in using pain CDEs effectively for clinical trials and secondary data analysis.

CONCLUSION

Key challenges identified include contextual variability, lack of validation across all pain conditions and populations, and potential misuse or misinterpretation of measures. This work proposes solutions such as supplementary measures, context-specific guidance, comprehensive training programs, and ongoing refinement of the CDE framework. While NIH Pain CDEs are valuable tools for standardizing pain assessment in research, addressing challenges in their implementation and interpretation is crucial for improving the consistency, validity, and interpretability of pain research data, ultimately advancing the field and enhancing patient care.

摘要

背景

美国国立卫生研究院(NIH)疼痛通用数据元素(CDE)为疼痛研究提供了标准化框架,但其实施和解释存在挑战。

目的

回顾NIH CDE计划选定的疼痛领域,提供实施所需问题的最佳实践,并提供一份在临床试验和二次数据分析中正确使用CDE的清单。这项工作分析了NIH CDE计划选定的10个核心疼痛研究领域,并讨论了它们的局限性和使用时的注意事项。

结果

该手稿概述了10个核心疼痛研究领域,包括疼痛强度、干扰、身体功能、睡眠、灾难化、抑郁、焦虑、总体变化印象、物质使用筛查和生活质量。它提供了实施所需问题的示例场景,并给出了一份清单,以指导研究人员在临床试验和二次数据分析中有效使用疼痛CDE。

结论

确定的主要挑战包括背景变异性、缺乏在所有疼痛状况和人群中的验证,以及测量方法可能被滥用或误解。这项工作提出了一些解决方案,如补充措施、针对具体情况的指导、全面的培训计划以及对CDE框架的持续完善。虽然NIH疼痛CDE是研究中标准化疼痛评估的宝贵工具,但应对其实施和解释中的挑战对于提高疼痛研究数据的一致性、有效性和可解释性至关重要,最终推动该领域发展并改善患者护理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/78a0/11879210/70d527d9f3e5/pnae110f1.jpg

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