The ACTTION-APS Pain Taxonomy Initiative: Response to Henriques et al

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. 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. Indeed, we hope that AAPT will actually serve to promote new research to validate, extend, and potentially contribute to revision of the classification criteria as they are published. Thus, we opted for a more comprehensive dimensional approach, which would allow (and even encourage) investigators to design studies to address biopsychosocial consequences of painful conditions as well as neurobiological and psychosocial mechanisms, risk factors, and protective factors. Henriques and colleagues note that the multidimensional approach may be difficult to apply in acute pain settings, which is an important consideration. Although the initial focus of AAPT is classification of chronic pain, we intend to extend this initiative to acute pain, which may require modifications to the framework to avoid such difficulties.