UW-led panel drives new NIH back-pain research standards

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UW-led panel drives new NIH back-pain research standards

Aim is to design study questions, terms more uniformly

Research studies of chronic low-back pain should be more consistent in design, in order to progress faster toward better treatment, the National Institutes of Health (NIH) said today.

Back pain is second only to headaches as the most common neurological ailment in the United States. Each year, low-back pain is estimated to affect approximately 38 percent of people worldwide. In the United States, low-back pain is the most common cause of job-related disability and a leading contributor to missed work.

Samuel Dworkin, left, and Richard Deyo co-chaired the NIH task force.
pictures of Samuel Dworkin and Richard Deyo

The NIH's new standards, published in six peer-reviewed journals (identified below), emerged from a 16-member task force that included four University of Washington faculty members. The NIH calls for researchers to use the recommended definitions of chronic pain, methods of assessment and, most importantly, a recommended minimal data set for inclusion in relevant NIH-funded research grants. 

“The aim is to bring needed standardization of terms and measures to the most basic aspects of back pain research,” said co-chair Samuel Dworkin, emeritus professor in both the School of Dentistry and the School of Medicine. His orofacial pain research interests have long extended to biobehavioral aspects of all chronic pain.

Researchers of low-back pain therapies have faced challenges including difficulties comparing the results of previous studies due to inconsistent terminology and outcome measures and other issues. In 2012, the NIH Pain Consortium recognized these barriers and commissioned a task force of experts to recommend solutions.

The results center on a standard set of data-collection questions, or a uniform minimal dataset. The questions include assessing how long a patient has experienced low-back pain, asking about functional limitations, use of various treatment approaches, and impact on mood, sleep and other factors.

“We encourage all researchers who study low-back pain to utilize these standards in their research efforts,” said Stephen I. Katz, director of the National Institute of Arthritis and Musculoskeletal and Skin Diseases. “With the adoption of a more uniform research approach, we hope to see greater and faster progress for preventing and treating this condition.”

Dworkin's co-chair was Richard Deyo, an affiliate faculty member and chronic-pain epidemiologist in UW's School of Public Health; his primary academic affiliation is at Oregon Health Sciences University. The task force also included UW Medicine pain-care specialists John Loeser and Dennis Turk. The new standards were published in The Journal of Pain (which led the peer-review process), The Clinical Journal of Pain, European Spine Journal, Journal of Manipulative and Physiological Therapeutics, Pain Medicine, Spine and The Spine Journal.