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

    85 Scopus citations

    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 1 2014

    Keywords

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

    ASJC Scopus subject areas

    • Neurology
    • Clinical Neurology
    • Anesthesiology and Pain Medicine

    Fingerprint Dive into the research topics of 'The ACTTION-American Pain Society Pain Taxonomy (AAPT): An evidence-based and multidimensional approach to classifying chronic pain conditions'. Together they form a unique fingerprint.

  • Cite this

    Fillingim, R. B., Bruehl, S., Dworkin, R. H., Dworkin, S. F., Loeser, J. D., Turk, D. C., Widerstrom-Noga, E., Arnold, L., Bennett, R., Edwards, R. R., Freeman, R., Gewandter, J., Hertz, S., Hochberg, M., Krane, E., Mantyh, P. W., Markman, J., Neogi, T., Ohrbach, R., ... 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