In pain treatment, outcomes are generally defined by researchers and clinicians, predominantly using patient self-report. A large-scale survey of people with chronic pain found a more extensive range of treatment outcomes rated important (Turk et al., ‘‘Identifying important outcome domains for chronic pain clinical trials: an IMMPACT survey of people with pain.’’ Pain 2008;137:276–85) than are conventionally used (Turk et al., ‘‘Core outcome domains for chronic pain clinical trials: IMMPACT recommendations.’’ Pain 2003;106:337–45). We compared outcomes from 60 randomised, controlled trials of cognitive and/or behavioural treatment for persistent pain with the 19 domains rated as most important
in the survey. Only 2 outcomes, physical activities and emotional well-being, were assigned comparable importance by survey respondents and clinician-researchers. Five of the 19 outcomes important to survey respondents were not measured at all, and 8 rarely. There was a positive, although modest, correlation between the methodological quality of trials and their coverage of survey respondents’ outcomes. We lack measures in many areas of outcome valued by people with chronic pain, and we need to extend routine measurement of trial outcomes
The purpose of the study was to raise the level of attention paid to patients’ choice of outcomes in relation to those widely used in treatment studies.
ContributorsBeale M, Cella M, de C. Williams AC
Disease Category: Other
Disease Name: Chronic pain
Age Range: 18
Sex: Either
Nature of Intervention: Psychological & behavioural
- COS uptake study
- Systematic review
Each of the domains identified in the IMMPACT study [22] was mapped against all measures reported in the Methods sections (even if not reported in Results) of 60 trials of cognitive and/or behavioural treatment (CBT) for persistent pain. The sample was drawn unmodified from an update to the systematic review and meta-analysis of CBT for persistent pain (see Appendix A for the full list of trials). The search drew on Medline, Embase, and PsychInfo from their inception to January 2008, subsequently updated to January 2010. The Cochrane Central Register of Controlled Trials (CENTRAL) was also searched, as were reference lists of retrieved articles