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Report of the NIH Task Force on Research Standards for Chronic Low Back Pain

Deyo, Richard A.*; Dworkin, Samuel F.; Amtmann, Dagmar; Andersson, Gunnar; Borenstein, David§; Carragee, Eugene; Carrino, John; Chou, Roger*; Cook, Karon**; DeLitto, Anthony††; Goertz, Christine‡‡; Khalsa, Partap§§; Loeser, John; Mackey, Sean; Panagis, James¶¶; Rainville, James‖‖; Tosteson, Tor***; Turk, Dennis; Von Korff, Michael†††; Weiner, Debra K.††

doi: 10.1097/BRS.0000000000000434
Epidemiology
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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 nonspecific 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. Therefore, NIH Pain Consortium charged a research task force to draft standards for research on cLBP. The resulting multidisciplinary 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 minimum data set to describe research participants (drawing heavily on the Patient Reported Outcomes Measurement Information System 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. The research task force believes that these recommendations will advance the field, help resolve controversies, and facilitate future research addressing the genomic, neurological, and other mechanistic substrates of cLBP. We expect that the research task force recommendations will become 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 cLBP. The results included recommendations for definitions, a minimum data set, reporting outcomes, and future research. Greater consistency in reporting should facilitate comparisons among studies and the development of phenotypes.

Level of Evidence: N/A

Because of inconsistencies among research reports, the NIH Pain Consortium charged a task force to draft research standards for chronic low back pain. The panel recommended a definition of chronic low back pain, stratification by impact score, and a minimum data set. Researchers should incorporate the recommendations into National Institutes of Health grant proposals.

*Oregon Health & Science University, Portland, OR

University of Washington, Seattle, WA

Rush University Medical Center, Chicago, IL

§The George Washington University, Washington, DC

Stanford University, Stanford, CA

Johns Hopkins University, Baltimore, MD

**Northwestern University, Evanston, IL

††VA Pittsburgh Healthcare System and University of Pittsburgh, Pittsburgh, PA

‡‡Palmer College of Chiropractic, Davenport, IA

§§National Center for Complementary and Alternative Medicine, Bethesda, MD

¶¶National Institute for Arthritis and Musculoskeletal and Skin Diseases, Bethesda, MD

‖‖New England Baptist Hospital, Roxbury Crossing, MA

***Dartmouth University, Hanover, NH; and

†††Group Health Research Institute, Seattle, WA.

Address correspondence and reprint requests to Richard A. Deyo, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Mail Code FM, Portland, Oregon 97239; E-mail: deyor@ohsu.edu

This guideline article was first reported in The Journal of Pain, Copyright © 2014 American Pain Society. Deyo RA, Dworkin SF, Amtmann D, Andersson G, Borenstein D, Carragee E, Carrino J, Chou R, Cook K, Delitto A, Goertz C, Khalsa P, Loeser J, Mackey S, Panagis J, Rainville J, Tosteson T, Turk D, Von Korff M, Weiner DK. Report of the NIH Task Force on Research Standards for Chronic Low Back Pain. J Pain. 2014 Apr 28. pii: S1526-5900(14)00680-4. doi: 10.1016/j.jpain.2014.03.005.

Acknowledgment date: May 13, 2014. Acceptance date: May 13, 2014.

Supported by the National Center for Complementary and Alternative Medicine and the National Institute for Arthritis and Musculoskeletal and Skin Diseases.

© 2014 by Lippincott Williams & Wilkins