ArticleContemporary clinical trials2018
A SMART design to determine the optimal treatment of chronic pain among military personnel.
Article in Contemporary clinical trials, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 3 of them syntheses that pooled 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.
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.
Who cites it
16 citing papers in PubMed, 3 syntheses or guidelines pooled it, 28 citations in OpenAlex.
- A systematic review of physical activity-based interventions to prevent or reduce chronic post-surgical pain.Pain medicine (Malden, Mass.) · 2026Pooled it
- The use of sequential multiple assignment randomized trials (SMARTs) in physical activity interventions: a systematic review.BMC medical research methodology · 2024Pooled it
- Sequential multiple assignment randomized trial studies should report all key components: a systematic review.Journal of clinical epidemiology · 2022Pooled it
- Association of physical function and sleep with oxidative stress in adults with chronic pain: A pragmatic clinical trial secondary analysis.The Journal of international medical research · 2026Trial
- The Adaptive Physical Activity Study in Stroke (TAPAS): A Feasibility Sequential Multiple Assignment Randomized Trial.Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2026Trial
- Fatigue and Sleep-related Impairment as Predictors of the Effect of Nonpharmacological Therapies for Active duty Service Members With Chronic Pain: A Secondary Analysis of a Pragmatic Randomized Clinical Trial.Military medicine · 2025Trial
- Trial
- Estimating minimal important change of the National Institutes of health research task force impact score using computer adaptive measures: a secondary analysis of two randomized clinical trials in a military population with chronic pain.BMC musculoskeletal disorders · 2025Trial
- Optimal allocation to treatments in a sequential multiple assignment randomized trial.Statistical methods in medical research · 2021Trial
- A review of use of external data and update on reporting standards in Sequential Multiple-Assignment Randomised Trials.Clinical trials (London, England) · 2026Review
- Knowledge, mechanisms, and intervention of the polytrauma clinical triad in military pain medicine.The Korean journal of pain · 2025Review
- Mixed pain: clinical practice recommendations.Frontiers in medicine · 2025Review
- Role of Pain Catastrophizing in the Effects of Cognitive Behavioral Therapy for Chronic Pain in Different Subgroups: An Exploratory Secondary Data Analysis Using Finite Mixture Models.Military medicine · 2024Article
- Comparison the Effects of Physical Therapy on Chronic Pain in Active or Sedentary Military Personnel.Materia socio-medica · 2021Article
- The sequence of disease-modifying anti-rheumatic drugs: pathways to and predictors of tocilizumab monotherapy.Arthritis research & therapy · 2021Article
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 4 institutions in 1 country.
Funding
Abstract
Chronic pain is a leading cause of disability among active duty service members in the U.S. armed forces. Standard rehabilitative care and complementary and integrative health therapies are used for chronic pain rehabilitation. However, the optimal sequence and duration of these therapies has yet to be determined. This article describes a sequential multiple assignment randomized trial (SMART) protocol being used to identify the optimal components and sequence of standard rehabilitative care and complementary and integrative health therapies for reducing pain impact and improving other patient outcomes. Active duty service members referred to Madigan Army Medical Center for treatment of chronic pain are being recruited to the Determinants of the Optimal Dose and Sequence of Functional Restoration and Integrative Therapies study. Study participants are randomized to either standard rehabilitative care (physical and occupational therapy and psychoeducation) or complementary and integrative health therapies (chiropractic, acupuncture, yoga and psychoeducation). Those participants who do not respond to the first 3 weeks of treatment are randomized to receive an additional 3 weeks of either (1) the alternative treatment or (2) the first-stage treatment plus the alternative treatment. This study will also determine factors associated with treatment response that can support clinical decision making, such as baseline fitness, pain catastrophizing, kinesiophobia, post-traumatic stress, pain self-efficacy, and biological indicators. The information gained from this research will be applicable to all integrative chronic pain rehabilitation programs throughout the U.S. Department of Defense and the U.S. Department of Veterans Affairs, and the broader rehabilitation community.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.