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Multidimensional Approach to Classifying Chronic Pain Conditions—Less Is More

  • Alexandre Annes Henriques
    Correspondence
    Address reprint requests to Alexandre Annes Henriques, MD, Psychiatry and Pain Program (PRODOR), Pain and Palliative Care Service, Hospital de Clínicas de Porto Alegre (HCPA), Rua Ramiro Barcelos, 2350-CEP 90035-003, Bairro Rio Branco, Porto Alegre, Rio Grande do Sul, Brazil.
    Affiliations
    Psychiatry and Pain Program
    Laboratory of Pain and Neuromodulation
    Pain and Palliative Care Service
    Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
    Post-Graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
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  • Jairo A. Dussán-Sarria
    Affiliations
    Post-Graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
    Laboratory of Pain and Neuromodulation, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
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  • Leonardo M. Botelho
    Affiliations
    Post-Graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
    Laboratory of Pain and Neuromodulation
    Pain and Palliative Care Service Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
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  • Wolnei Caumo
    Affiliations
    Post-Graduate Program in Medical Sciences, School of Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
    Laboratory of Pain and Neuromodulation
    Pain and Palliative Care Service
    Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
    Search for articles by this author
      Our team received with enthusiasm the proposal from the ACTTION-APS Pain Taxonomy (AAPT),
      • Fillingim R.B.
      • Bruehl S.
      • Dworkin R.H.
      • Dworkin S.F.
      • Loeser J.D.
      • Turk D.C.
      • Widerstrom-Noga E.
      • Arnold L.
      • Bennett R.
      • Edwards R.R.
      • Freeman R.
      • Gewandter J.
      • Hertz S.
      • Hochberg M.
      • Krane E.
      • Mantyh P.W.
      • Markman J.
      • Neogi T.
      • Ohrbach R.
      • Paice J.A.
      • Porreca F.
      • Rappaport B.A.
      • Smith S.M.
      • Smith T.J.
      • Sullivan M.D.
      • Verne G.N.
      • Wasan A.D.
      • Wesselmann U.
      The ACTTION-American Pain Society Pain Taxonomy (AAPT): An evidence-based and multidimensional approach to classifying chronic pain conditions.
      which claims an evidence-based and multidimensional approach to classifying chronic pain conditions. Attempting to approach an ideal diagnostic system that aims to systematize, organize, and standardize the biopsychosocial assessment of chronic pain patients, a 5-dimension taxonomy was proposed. This perspective drew inspiration from the Diagnostic and Statistical Manual of Mental Disorders (DSM), Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD), and International Classification of Headache Disorders diagnostic systems.
      • Fillingim R.B.
      • Bruehl S.
      • Dworkin R.H.
      • Dworkin S.F.
      • Loeser J.D.
      • Turk D.C.
      • Widerstrom-Noga E.
      • Arnold L.
      • Bennett R.
      • Edwards R.R.
      • Freeman R.
      • Gewandter J.
      • Hertz S.
      • Hochberg M.
      • Krane E.
      • Mantyh P.W.
      • Markman J.
      • Neogi T.
      • Ohrbach R.
      • Paice J.A.
      • Porreca F.
      • Rappaport B.A.
      • Smith S.M.
      • Smith T.J.
      • Sullivan M.D.
      • Verne G.N.
      • Wasan A.D.
      • Wesselmann U.
      The ACTTION-American Pain Society Pain Taxonomy (AAPT): An evidence-based and multidimensional approach to classifying chronic pain conditions.
      Of these, the DSM is probably the most widely used system in multidisciplinary settings and an essential requirement in the care of pain patients. The evolution of the taxonomies is both necessary and inherent to the progress of science, which develops together with patients', clinicians', researchers', and third-party payers' needs.
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      References

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      Linked Article

      • The ACTTION-American Pain Society Pain Taxonomy (AAPT): An Evidence-Based and Multidimensional Approach to Classifying Chronic Pain Conditions
        The Journal of PainVol. 15Issue 3
        • Preview
          Current approaches to classification of chronic pain conditions suffer from the absence of a systematically implemented and evidence-based taxonomy. Moreover, existing diagnostic approaches typically fail to incorporate available knowledge regarding the biopsychosocial mechanisms contributing to pain conditions. To address these gaps, the Analgesic, Anesthetic, and Addiction Clinical Trial Translations Innovations Opportunities and Networks (ACTTION) public-private partnership with the U.S. Food and Drug Administration and the American Pain Society (APS) have joined together to develop an evidence-based chronic pain classification system called the ACTTION-APS Pain Taxonomy.
        • Full-Text
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      • The ACTTION-APS Pain Taxonomy Initiative: Response to Henriques et al
        The Journal of PainVol. 15Issue 11
        • Preview
          We are grateful to Dr. Henriques and his colleagues for their generally positive comments regarding the ACTTION-APS Pain Taxonomy (AAPT) initiative and interest in our manuscript describing the approach.2 We likewise appreciate their thoughtful comments regarding the challenges of applying a multidimensional classification in both clinical and research settings. Here we offer a few remarks to help clarify the rationale for the multidimensional nature of AAPT. Although we are hopeful that AAPT will evolve to enjoy widespread clinical use, we recognize that the initial application of the new taxonomy will inevitably occur in the context of research.
        • Full-Text
        • PDF