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 (Rob) 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. Paice & 8 others Frank 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

    73 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 (Rob); 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, RR, 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 (Rob) ; 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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