Chronic pain produces the largest non-fatal burden of disease, yet our understanding
of factors that contribute to the transition from acute chronic pain are poorly understood.
The Acute to Chronic Pain Signatures Program (A2CPS) is a longitudinal, multi-site
observational study to identify biomarkers (individual or biosignature combinations)
that predict susceptibility or resilience to the development of chronic pain after
surgery (knee replacement or thoracotomy). Due to the COVID-19 pandemic, however,
travel between sites was restricted just as the study was preparing to begin enrollment.
Here, we present multiple training protocol adaptations that were successfully implemented
to facilitate remote research-related training. The A2CPS consortium includes 2 Multisite
Clinical Centers (MCCs, 10 recruitment sites), a Clinical Coordinating Center (CCC),
a Data Integration and Resource Center (DIRC), 3 Omics Data Generation Centers, and
representation from the NIH Pain Consortium, Common Fund, and National Institute of
Drug Abuse. The A2CPS is collecting candidate and exploratory biomarkers including
pain, fatigue, function, sleep, psychosocial factors, quantitative sensory testing
(QST), genomics, proteomics, metabolomics, lipidomics, and brain imaging. The CCC
adapted the A2CPS training and evaluation techniques for certifying the MCCs to ensure
competency with recruitment, assessments (surveys, QST, function), and data entry
across clinical sites using a combination of virtual training sessions, standardized
quantitative measurements, video demonstrations, and reliability assessments. Staff
at data collection sites have been successfully certified in all psychophysical assessments
(QST, function). This included use of stop watches and metronomes to ensure standard
application rates, completion of application-rate and inter-rater-reliability worksheets
at each clinical site, designation of site-specific master examiners, training rubrics
and video demonstration to verify competency was harmonized across sites. Adaptation
of training protocols to a remote format enabled initiation of subject enrollment
while maintaining documented standards with high data completion rates for surveys
and assessments. The A2CPS Consortium is supported by the National Institutes of Health
Common Fund, which is managed by the OD/Office of Strategic Coordination (OSC). Consortium
components include: Clinical Coordinating Center (UO1NS077179), Data Integration and
Resource Center (UO1NS077352), Omics Data Generation Centers (U54DA049116, U54DA049115,
U54DA09113), and Multisite Clinical Centers: MCC 1 (UM1NS112874) and MCC 2 (UM1NS118922).
Postdoctoral support for GB provided by the National Institutes of Neurological Disease
and Stroke (NINDS) of the NIH under Award Number U24NS112873-03S2.