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"Chronic Pain and the Brain" Impairment: Introducing a Translational Neuroscience-Based Metricстатья
Статья опубликована в высокорейтинговом журнале
Статья опубликована в журнале из списка Web of Science и/или Scopus- Авторы: Perlo S., Davydov D.M.
- Журнал: Pain Medicine
- Год издания: 2016
- Издательство: Blackwell Publishing Inc.
- Местоположение издательства: United Kingdom
- DOI: 10.1093/pm/pnw024
- Аннотация: This commentary is in response to Drs. Feinberg and Brigham’s request for reader feedback of their 2014 revision of their 2006 “Guide to the Guides…” [1]. They teach that its use improves rating accuracy. We concur. Their 2014 revision generates impairment rating protocols in injured workers that are based on the AMA Guides to the Evaluation of Permanent Impairment, 5th Edition (GUIDES) [2]. In response to their request for feedback, we wish to bring attention to published rating inaccuracies in the GUIDES and the unreliability of measuring chronic pain based only on self-report [3–6]. We have two goals. One is to introduce a neuroscience-based metric and related protocol that eliminates all identified GUIDES defects when rating chronic pain whole-person impairment. A second is to stimulate evaluation of this neuroscience-based assessment protocol as a potential gold-standard diagnostic benchmark in chronic pain medicine that currently does not exist. The search for a reliable chronic pain metric is the “holy grail” in all of pain medicine that challenges pain medicine practitioners, patients, drug developers, and the medical-legal community at large [6]. Historically we learn that the GUIDES is developed, “To enable physicians to evaluate functional impairment in an objective and consistent manner…” (p. 286 [5]). Seabury et al. challenge its “…controversial use when measuring impairment versus disability.” They, along with others, identify numerous “Catch 22s” that question GUIDES-derived impairment ratings as reliable and address them in detail [3–5]. As an example, we cite Dr. Rondinelli’s 2010 “Commentary” (4). He writes “…that the ratings themselves remain largely consensus-based …and subject to various stakeholder priorities and biases… (p. 1204;[4])” In our experience this invites speculative expert examiner opinions. Our first goal is to introduce a translational …
- Добавил в систему: Давыдов Дмитрий Михайлович