Evidence map›Paper›PMID 23462141›Full record

ArticlePain practice : the official journal of World Institute of Pain2013

The practitioner proposes a treatment change and the patient declines: what to do next?

Paul R Falzer, Howard L Leventhal, Ellen Peters, Terri R Fried, Robert Kerns, Marion Michalski, Liana Fraenkel

Abstract read
In one paragraph

Article in Pain practice : the official journal of World Institute of Pain, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Paul R FalzerClinical Epidemiology Research Center, VA Connecticut Healthcare System, West Haven, Connecticut 06516, USA. paul.falzer@yale.edu
Howard L Leventhal
Ellen Peters
Terri R Fried
Robert Kerns
Marion Michalski
Liana Fraenkel

Funding

Improving Decision Making in Patients with Rheumatic DiseaseK24AR060231 · NIAMS · YALE UNIVERSITY · PI FRAENKEL, LIANA · 2011 to 2018
$1.2M
NIAMS NIH HHS K24 AR060231
6 · The paper itself

Abstract

objectiveThis study describes how pain practitioners can elicit the beliefs that are responsible for patients' judgments against considering a treatment change and activate collaborative decision making.

methodsBeliefs of 139 chronic pain patients who are in treatment but continue to experience significant pain were reduced to 7 items about the significance of pain on the patient's life. The items were aggregated into 4 decision models that predict which patients are actually considering a change in their current treatment.

resultsWhile only 34% of study participants were considering a treatment change overall, the percentage ranged from 20 to 70, depending on their ratings about current consequences of pain, emotional influence, and long-term impact. Generalized linear model analysis confirmed that a simple additive model of these 3 beliefs is the best predictor.

conclusionInitial opposition to a treatment change is a conditional judgment and subject to change as specific beliefs become incompatible with patients' current conditions. These beliefs can be elicited through dialog by asking 3 questions.

Indexed as

Health Knowledge, Attitudes, PracticeProfessional-Patient RelationsAdultAgedAged, 80 and overChronic PainDecision MakingDissent and DisputesFemaleHumansMaleMiddle AgedPainYoung Adult

Identifiers

PMID23462141
PMCPMC3668345

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.