AAPT is an evidence-based approach to the diagnosis of major chronic pain conditions.
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AAPT provides a multidimensional framework for diagnosing chronic pain.
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Structured decision rules will enhance diagnostic criteria reliability and validity.
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Signs/symptoms, comorbidities, mechanisms, and consequences are other dimensions.
Abstract
A variety of approaches have been used to develop diagnostic criteria for chronic pain. The published evidence of the reliability and validity of existing diagnostic criteria is limited, and these criteria have typically not been used in clinical practice. The availability of a widely accepted, consistently applied, and evidence-based taxonomy of diagnostic criteria would improve the quality of clinical research on chronic pain and would be of great value in clinical practice. To address the need for evidence-based diagnostic criteria for the major chronic pain conditions, the Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks (ACTTION) public-private partnership with the US Food and Drug Administration and the American Pain Society (APS) have collaborated on the development of the ACTTION-APS Pain Taxonomy (AAPT). AAPT provides a multidimensional framework that is applied systematically in the development of diagnostic criteria. This article (1) describes the background and rationale for AAPT; (2) presents the AAPT taxonomy and the specific conditions for which diagnostic criteria have been developed (to be published separately); (3) briefly reviews the 5 dimensions that constitute the AAPT multidimensional framework and describes the 7 accompanying articles that discuss these dimensions and other important issues involving AAPT; and (4) provides an overview of next steps, specifically, the general processes by which the initial set of diagnostic criteria (for which the evidence base has been drawn from the literature, systematic reviews, and secondary analyses of existing databases) will undergo additional assessments of reliability and validity.
Perspective
To address the need for evidence-based diagnostic criteria for the major chronic pain conditions, the AAPT provides a multidimensional framework that is applied systematically in the development of diagnostic criteria. The long-term objective of AAPT is to advance the scientific understanding of chronic pain and its treatment.
Key words
Chronic pain
diagnostic criteria
taxonomy
classification
Cited by (0)
The views expressed in this article are those of the authors, none of whom has financial conflicts of interest relevant to the specific issues discussed. No official endorsement by the U.S. Food and Drug Administration (FDA) or the pharmaceutical and device companies that have provided unrestricted grants to support the activities of the ACTTION public-private partnership with the FDA should be inferred. Financial support for this supplement and for the development of the AAPT has been provided by the ACTTION public-private partnership, which has received research contracts, grants, or other revenue from the FDA, multiple pharmaceutical and device companies, and other sources. A complete list of current ACTTION sponsors is available at: http://www.acttion.org/partners.
