Updates & Features
PainSpectrum: What, how, who?
July 2019
What is the PainSpectrum and what are its objectives?
The PainSolve Editorial Team
The PainSpectrum represents a single point of reference for those pain conditions with the highest burden of disease and greatest unmet medical need. It can be broken down into two parts: The PainSpectrum Anatomy and The PainSpectrum Modules.
PainSpectrum Anatomy
The PainSpectrum Anatomy is an interactive tool enabling the exploration of almost 100 pain indications. The distribution of these indications is represented in Figure 1. This can be accessed through the PainSpectrum drop-down or here.
Figure 1 – The distribution of pain indications available on the PainSpectrum Anatomy
Each of the indications has information about its type of pain (neuropathic, nociceptive inflammatory, visceral or other), the body part affected, prevalence, top-line pathophysiology, symptoms and its McGill pain score.
PainSpectrum Modules
From the indications represented in the PainSpectrum Anatomy, 80 of these were selected and developed into PainSpectrum Modules, hosted in a downloadable online repository for pain researchers and clinicians. They can be accessed either from the indication-specific PainSpectrum Anatomy pages, through the PainSpectrum dropdown or here.
The most recent versions of these slide sets have been reviewed by external experts in the UK and France and are regularly updated to keep them relevant, particularly as advances in disease understanding lead to improved insights in pathophysiologies. The modules contain in-depth information about the pain conditions and the modules are broken down into 9 key sections:
Figure 2 – The scope of each PainSpectrum Module
A recent addition to all of the pain indication modules are the International Classification of Diseases (ICD)-10 and -11 codes, which are available at the beginning of each slide set. This aims to facilitate the elaboration and handling of database coding.
How was the PainSpectrum developed?
Preliminary research was conducted to identify the spectrum of pain conditions. Initial searches were performed using Wall & Melzack’s Textbook of Pain and Essential Pain Pharmacology: The Prescriber’s Guide, and search strings in PubMed, EMBASE and Google Scholar (e.g. “Pain”[tiab] AND “Chronic”[tiab] AND “Treatment”[mh] OR “Therapy”[mh] OR “Management”[mh]). To further understand which pain conditions have the highest burden of disease and the most limited knowledge, structured interviews were conducted with 64 experts from a range of specialties (such as pain physicians, neurologists, rheumatologists general practitioners and gastroenterologists) across Spain, Italy, France, the UK, Germany and the Netherlands. Following these interviews, face-to-face meetings were organised to provide a deeper understanding of pain types/disease areas. The information gathered gave information about the pain indications with the highest unmet need, leading to the exclusion of indications. There were multiple reasons for exclusion of indications from the final set, the main one being the disease burden not being high enough (Figure 3).
Figure 3 – Reasons for exclusion of indications for the final selection (approximate proportions)
Once the indications were selected, they were included into the previously mentioned PainSpectrum Anatomy layout and subsequently chosen for the PainSpectrum Modules section.
Who can it benefit?
This comprehensive, educational repository is available through PainSolve for researchers and healthcare professionals with a special interest in pain. It is hoped that this repository will raise awareness, improve knowledge and encourage collaboration around these pain conditions. Ultimately, we hope this will lead a better understanding of the science of the pain diseases with a highest disease burden and unmet need, and to increase the outcomes for those patients suffering from them.