Journal article
AAAPT: Assessment of the Acute Pain Trajectory
Pain medicine (Malden, Mass.), Vol.22(3), pp.533-547
03/18/2021
DOI: 10.1093/pm/pnaa440
PMCID: PMC7971475
PMID: 33735384
Abstract
Abstract Objective Define and contrast acute pain trajectories vs. the aggregate pain measurements, summarize appropriate linear and nonlinear statistical analyses for pain trajectories at the patient level, and present methods to classify individual pain trajectories. Clinical applications of acute pain trajectories are also discussed. Setting In 2016, an expert panel involving the Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks (ACTTION), American Pain Society (APS), and American Academy of Pain Medicine (AAPM) established an initiative to create a pain taxonomy, named the ACTTION-APS-AAPM Pain Taxonomy (AAAPT), for the multidimensional classification of acute pain. The AAAPT panel commissioned the present report to provide further details on analysis of the individual acute pain trajectory as an important component of comprehensive pain assessment. Methods Linear mixed models and nonlinear models (e.g., regression splines and polynomial models) can be applied to analyze the acute pain trajectory. Alternatively, methods for classifying individual pain trajectories (e.g., using the 50% confidence interval of the random slope approach or using latent class analyses) can be applied in the clinical context to identify different trajectories of resolving pain (e.g., rapid reduction or slow reduction) or persisting pain. Each approach has advantages and disadvantages that may guide selection. Assessment of the acute pain trajectory may guide treatment and tailoring to anticipated symptom recovery. The acute pain trajectory can also serve as a treatment outcome measure, informing further management. Conclusions Application of trajectory approaches to acute pain assessments enables more comprehensive measurement of acute pain, which forms the cornerstone of accurate classification and treatment of pain.
Details
- Title: Subtitle
- AAAPT: Assessment of the Acute Pain Trajectory
- Creators
- Emine O Bayman - Department of Biostatistics, University of Iowa College of Public Health, Iowa City, Iowa, USA, Department of Anesthesia, University of Iowa, Iowa City, Iowa, USAJacob J Oleson - Department of Biostatistics, University of Iowa College of Public Health, Iowa City, Iowa, USAJennifer A Rabbitts - Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, Washington, USA, Center for Clinical and Translational Research, Seattle Children’s Hospital, Seattle, Washington, USA
- Resource Type
- Journal article
- Publication Details
- Pain medicine (Malden, Mass.), Vol.22(3), pp.533-547
- DOI
- 10.1093/pm/pnaa440
- PMID
- 33735384
- PMCID
- PMC7971475
- ISSN
- 1526-2375
- eISSN
- 1526-4637
- Language
- English
- Date published
- 03/18/2021
- Academic Unit
- Biostatistics; Anesthesia
- Record Identifier
- 9984214711302771
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