Report of the NIH Task Force on Research Standards for Chronic Low Back Pain

Abstract

Note fr'5ym PTJ's Editor in Chief: Both investigators and readers get frustrated reading research on low back pain because of different definitions of “chronic” and different outcome measures. Lack of consensus on study methods makes it difficult to determine if contradictory findings are based on different methods or different interventions; lack of consensus also prevents synthesis across studies. Dr. Partap Khalsa, Deputy Director, National Center for Complementary and Integrative Health, announced the release of Research Standards for Chronic Low Pain, and the hope is that future investigations will adopt them and reduce variability in research reporting. The task force on research standards was an international, multidisciplinary team including Anthony Delitto, PT, PhD, FAPTA. Its findings have been published in leading pain journals. PTJ is among the first professional journals to share the report with its readers. Despite rapidly increasing intervention, functional disability due to chronic low back pain (cLBP) has increased in recent decades. We often cannot identify mechanisms to explain the major negative impact cLBP has on patients' lives. Such cLBP is often termed non-specific and may be due to multiple biologic and behavioral etiologies. Researchers use varied inclusion criteria, definitions, baseline assessments, and outcome measures, which impede comparisons and consensus. Therefore, NIH Pain Consortium charged a Research Task Force (RTF) to draft standards for research on cLBP. The resulting multidisciplinary panel recommended using 2 questions to define cLBP; classifying cLBP by its impact (defined by pain intensity, pain interference, and physical function); use of a minimum dataset to describe research participants (drawing heavily on the PROMIS methodology); reporting “responder analyses” in addition to mean outcome scores; and suggestions for future research and dissemination. The Pain Consortium has approved the recommendations, which investigators should incorporate into NIH grant proposals. The RTF believes that these recommendations will advance the field, help to resolve controversies, and facilitate future research addressing the genomic, neurologic, and other mechanistic substrates of chronic low back pain. We expect that the RTF recommendations will become a dynamic document and undergo continual improvement. Perspective: A task force was convened by the NIH Pain Consortium with the goal of developing research standards for chronic low back pain. The results included recommendations for definitions, a minimum dataset, reporting outcomes, and future research. Greater consistency in reporting should facilitate comparisons among studies and the development of phenotypes.