Report of the NIH Task Force on Research Standards for Chronic Low Back Pain
Report of the NIH Task Force on Research Standards for Chronic Low Back Pain
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DOI：
10.1111/pme.12538
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发表时间：
2014-08-01
期刊：
影响因子：
3.1
通讯作者：
Weiner, Debra K.
中科院分区：
文献类型：
--
作者：
Deyo, Richard A.;Dworkin, Samuel F.;Weiner, Debra K.
目标。尽管干预措施迅速增加，但近几十年来，慢性腰痛（cLBP）导致的功能障碍有所增加。我们通常无法确定解释cLBP对患者生活的主要负面影响的机制。这种cLBP通常被称为非特异性，可能是由多种生物和行为病因引起的。研究人员使用不同的纳入标准、定义、基线评估和结果测量，这阻碍了比较和共识。关键建议的专家小组和初步评价。方法。美国国立卫生研究院疼痛联盟委托一个研究工作组（RTF）起草cLBP研究标准。由此产生的多学科小组制定了一个分三个阶段的过程，每个阶段有一个为期两天的会议。专家组建议使用2个问题来定义cLBP；根据其影响（疼痛强度、疼痛干扰和身体功能）对cLBP进行分类；使用最小数据集来描述研究主题（大量借鉴PROMIS方法）；除平均结果分数外，报告“应答者分析”；以及对未来研究和传播的建议。Pain Consortium已经批准了这些建议，研究人员应该将其纳入NIH的拨款提案中。RTF相信这些建议将推动该领域的发展，有助于解决争议，并促进未来对慢性腰痛的基因组学、神经学和其他机制基础的研究。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。我们期望RTF的建议将成为一份动态的文件，并不断改进。美国国立卫生研究院疼痛联盟召集了一个工作组，目的是制定慢性腰痛的研究标准。结果包括对定义的建议、最小数据集、报告结果和未来研究。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。
Objective. 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.Design. Expert panel and preliminary evaluation of key recommendations.Methods. The NIH Pain Consortium charged a Research Task Force (RTF) to draft standards for research on cLBP. The resulting multidisciplinary panel developed a 3-stage process, each with a 2-day meeting.Results. The 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 minimal data set to describe research subjects (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.Conclusion. The RTF believes 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. Greater consistency in reporting should facilitate comparisons among studies and the development of phenotypes. We expect the RTF recommendations will be come a dynamic document, and undergo continual improvement.Perspective. 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.