A "TNM" classification system for cancer pain: The Edmonton Classification System for Cancer Pain (ECS-CP)
A "TNM" classification system for cancer pain: The Edmonton Classification System for Cancer Pain (ECS-CP)
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DOI：
10.1007/s00520-008-0423-3
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发表时间：
2008-06-01
影响因子：
3.1
通讯作者：
Nekolaichuk, Cheryl L.
中科院分区：
文献类型：
--
作者：
Fainsinger, Robin L.;Nekolaichuk, Cheryl L.
目的 本文的目的是概述针对晚期癌症患者的“TNM”癌痛分类系统，即埃德蒙顿癌痛分类系统（ECS-CP）的发展。在我们拥有讨论癌症疼痛的通用国际语言之前，理解阿片类药物轮换和使用的临床和研究经验差异仍然存在问题。癌症疼痛经历的复杂性对疼痛的分类提出了独特的挑战。迄今为止，还没有普遍接受的疼痛分类措施能够准确预测疼痛管理的复杂性，特别是对于难以治疗的癌痛患者。 材料和方法为了应对临床评估中的这一差距，开发了埃德蒙顿分期系统（ESS），这是一种癌痛分类系统。 ESS 某些方面的定义和解释方面的困难限制了接受和广泛使用。结果构建、评估者间的可靠性和预测有效性证据促进了 ECS-CP 的发展。 ECS-CP 的五个特征——疼痛机制、偶发疼痛、心理困扰、成瘾行为和认知功能——已证明在预测疼痛管理复杂性方面具有价值。 结论 开发一个全面、可预测且易于使用的标准化分类系统可以为癌症疼痛的临床管理和研究提供通用语言。目前正在进行一项评估 ECS-CP 的评估者间可靠性和预测价值的国际研究。
Objective The purpose of this paper is to provide an overview of the development of a "TNM" cancer pain classification system for advanced cancer patients, the Edmonton Classification System for Cancer Pain (ECS-CP). Until we have a common international language to discuss cancer pain, understanding differences in clinical and research experience in opioid rotation and use remains problematic. The complexity of the cancer pain experience presents unique challenges for the classification of pain. To date, no universally accepted pain classification measure can accurately predict the complexity of pain management, particularly for patients with cancer pain that is difficult to treat.Materials and methods In response to this gap in clinical assessment, the Edmonton Staging System (ESS), a classification system for cancer pain, was developed. Difficulties in definitions and interpretation of some aspects of the ESS restricted acceptance and widespread use.Result Construct, inter-rater reliability, and predictive validity evidence have contributed to the development of the ECS-CP. The five features of the ECS-CP-Pain Mechanism, Incident Pain, Psychological Distress, Addictive Behavior and Cognitive Function-have demonstrated value in predicting pain management complexity.Conclusion The development of a standardized classification system that is comprehensive, prognostic and simple to use could provide a common language for clinical management and research of cancer pain. An international study to assess the inter-rater reliability and predictive value of the ECS-CP is currently in progress.