Work Group Recommendations on Outcome Measures in Clinical Studies on Musculoskeletal Pain

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The use of brief scales with 13 additional items was recommended to evaluate critical secondary domains.
The use of brief scales with 13 additional items was recommended to evaluate critical secondary domains.

A work group appointed by the Veterans Health Administration recommends the use of 2 scales with 8 items as core outcome measures to assess pain intensity and interference in studies examining chronic musculoskeletal pain, according to a systematic review published in Pain Medicine. The use of brief scales with 13 additional items was recommended to evaluate critical secondary domains (eg, physical function, depression).

To inform these recommendations on core and secondary outcome measures for assessing pain intensity and interference in clinical studies on musculoskeletal pain, the work group reviewed the literature, as well as the results of 3 recently completed trials. They also reviewed and compared measures recommended by other expert groups as well as the results of 2 Delphi surveys of work group members.

A single-item numeric rating scale and the 7-item Brief Pain Inventory interference scale were found to be the most recommended measures for assessing pain intensity and interference, respectively. Physical functioning, depression, sleep, anxiety, and patient-reported global impression of change were found to be the secondary domains with the highest ranking. 

The researchers recommended the use of the Patient-Reported Outcome Information System 4-item physical function and sleep scales, the Patient Health Questionnaire 2-item depression scale, the Generalized Anxiety Disorder 2-item anxiety scale, and the single-item patient-reported global impression of change for the assessment of secondary outcomes. To assess the presence of chronic pain, the work group recommended the use of a single-item National Health Interview Survey item.

“At a minimum, the [Pain Measures Work Group] recommends that common measures of pain intensity and interference be used across all prospective clinical studies of [chronic musculoskeletal pain],” the researchers noted.

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Reference

Kroenke K, Krebs EE, Turk D, et al. Core outcome measures for chronic musculoskeletal pain research: recommendations form a Veterans Health Administration work group. [published online January 5, 2019]. Pain Med. doi: 10.1093/pm/pny279

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