The ACTTION-American Pain Society Pain Taxonomy (AAPT): An evidence-based and multidimensional approach to classifying chronic pain conditions

Roger B. Fillingim, Stephen Bruehl, Robert H. Dworkin, Samuel F. Dworkin, John D. Loeser, Dennis C. Turk, Eva Widerstrom-Noga, Lesley Arnold, Robert Bennett, Robert R. Edwards, Roy Freeman, Jennifer Gewandter, Sharon Hertz, Marc Hochberg, Elliot Krane, Patrick W Mantyh, John Markman, Tuhina Neogi, Richard Ohrbach, Judith A. PaiceFrank Porreca, Bob A. Rappaport, Shannon M. Smith, Thomas J. Smith, Mark D. Sullivan, G. Nicholas Verne, Ajay D. Wasan, Ursula Wesselmann

Research output: Contribution to journalArticle

74 Citations (Scopus)

Abstract

Current approaches to classification of chronic pain conditions suffer from the absence of a systematically implemented and evidence-based taxonomy. Moreover, existing diagnostic approaches typically fail to incorporate available knowledge regarding the biopsychosocial mechanisms contributing to pain conditions. To address these gaps, the Analgesic, Anesthetic, and Addiction Clinical Trial Translations Innovations Opportunities and Networks (ACTTION) public-private partnership with the U.S. Food and Drug Administration and the American Pain Society (APS) have joined together to develop an evidence-based chronic pain classification system called the ACTTION-APS Pain Taxonomy. This paper describes the outcome of an ACTTION-APS consensus meeting, at which experts agreed on a structure for this new taxonomy of chronic pain conditions. Several major issues around which discussion revolved are presented and summarized, and the structure of the taxonomy is presented. ACTTION-APS Pain Taxonomy will include the following dimensions: 1) core diagnostic criteria; 2) common features; 3) common medical comorbidities; 4) neurobiological, psychosocial, and functional consequences; and 5) putative neurobiological and psychosocial mechanisms, risk factors, and protective factors. In coming months, expert working groups will apply this taxonomy to clusters of chronic pain conditions, thereby developing a set of diagnostic criteria that have been consistently and systematically implemented across nearly all common chronic pain conditions. It is anticipated that the availability of this evidence-based and mechanistic approach to pain classification will be of substantial benefit to chronic pain research and treatment. Perspective The ACTTION-APS Pain Taxonomy is an evidence-based chronic pain classification system designed to classify chronic pain along the following dimensions: 1) core diagnostic criteria; 2) common features; 3) common medical comorbidities; 4) neurobiological, psychosocial, and functional consequences; and 5) putative neurobiological and psychosocial mechanisms, risk factors, and protective factors.

Original languageEnglish (US)
Pages (from-to)241-249
Number of pages9
JournalJournal of Pain
Volume15
Issue number3
DOIs
StatePublished - Mar 2014

Fingerprint

Chronic Pain
Clinical Trials
Pain
Comorbidity
Public-Private Sector Partnerships
United States Food and Drug Administration
Analgesics
Anesthetics
Consensus

Keywords

  • biopsychosocial
  • chronic pain
  • evidence-based
  • mechanism-based pain classification
  • pain classification
  • Taxonomy

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine
  • Neurology
  • Clinical Neurology

Cite this

Fillingim, R. B., Bruehl, S., Dworkin, R. H., Dworkin, S. F., Loeser, J. D., Turk, D. C., ... Wesselmann, U. (2014). The ACTTION-American Pain Society Pain Taxonomy (AAPT): An evidence-based and multidimensional approach to classifying chronic pain conditions. Journal of Pain, 15(3), 241-249. https://doi.org/10.1016/j.jpain.2014.01.004

The ACTTION-American Pain Society Pain Taxonomy (AAPT) : An evidence-based and multidimensional approach to classifying chronic pain conditions. / Fillingim, Roger B.; Bruehl, Stephen; Dworkin, Robert H.; Dworkin, Samuel F.; Loeser, John D.; Turk, Dennis C.; Widerstrom-Noga, Eva; Arnold, Lesley; Bennett, Robert; Edwards, Robert R.; Freeman, Roy; Gewandter, Jennifer; Hertz, Sharon; Hochberg, Marc; Krane, Elliot; Mantyh, Patrick W; Markman, John; Neogi, Tuhina; Ohrbach, Richard; Paice, Judith A.; Porreca, Frank; Rappaport, Bob A.; Smith, Shannon M.; Smith, Thomas J.; Sullivan, Mark D.; Verne, G. Nicholas; Wasan, Ajay D.; Wesselmann, Ursula.

In: Journal of Pain, Vol. 15, No. 3, 03.2014, p. 241-249.

Research output: Contribution to journalArticle

Fillingim, RB, Bruehl, S, Dworkin, RH, Dworkin, SF, Loeser, JD, Turk, DC, Widerstrom-Noga, E, Arnold, L, Bennett, R, Edwards, RR, Freeman, R, Gewandter, J, Hertz, S, Hochberg, M, Krane, E, Mantyh, PW, Markman, J, Neogi, T, Ohrbach, R, Paice, JA, Porreca, F, Rappaport, BA, Smith, SM, Smith, TJ, Sullivan, MD, Verne, GN, Wasan, AD & Wesselmann, U 2014, 'The ACTTION-American Pain Society Pain Taxonomy (AAPT): An evidence-based and multidimensional approach to classifying chronic pain conditions', Journal of Pain, vol. 15, no. 3, pp. 241-249. https://doi.org/10.1016/j.jpain.2014.01.004
Fillingim, Roger B. ; Bruehl, Stephen ; Dworkin, Robert H. ; Dworkin, Samuel F. ; Loeser, John D. ; Turk, Dennis C. ; Widerstrom-Noga, Eva ; Arnold, Lesley ; Bennett, Robert ; Edwards, Robert R. ; Freeman, Roy ; Gewandter, Jennifer ; Hertz, Sharon ; Hochberg, Marc ; Krane, Elliot ; Mantyh, Patrick W ; Markman, John ; Neogi, Tuhina ; Ohrbach, Richard ; Paice, Judith A. ; Porreca, Frank ; Rappaport, Bob A. ; Smith, Shannon M. ; Smith, Thomas J. ; Sullivan, Mark D. ; Verne, G. Nicholas ; Wasan, Ajay D. ; Wesselmann, Ursula. / The ACTTION-American Pain Society Pain Taxonomy (AAPT) : An evidence-based and multidimensional approach to classifying chronic pain conditions. In: Journal of Pain. 2014 ; Vol. 15, No. 3. pp. 241-249.
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