Evidence map›Paper›PMID 37691103›Full record

ReviewBMC primary care2023

Identifying populations with chronic pain in primary care: developing an algorithm and logic rules applied to coded primary care diagnostic and medication data.

Nasrin Hafezparast, Ellie Bragan Turner, Rupert Dunbar-Rees, Amoolya Vusirikala, Alice Vodden, Victoria de La Morinière, Katy Yeo, Hiten Dodhia, Stevo Durbaba, Siddesh Shetty and 1 more

Open access · goldAbstract readReview
In one paragraph

Review in BMC primary care, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
1.9field-weighted citation impact, top 13% of its field
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

6 citing papers in PubMed, 9 citations in OpenAlex.

  1. Article
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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

11 authors at 3 institutions in 1 country.

Nasrin HafezparastOutcomes Based Healthcare, 11-13 Cavendish Square, Marylebone, London, W1G 0AN, UK.
Ellie Bragan TurnerOutcomes Based Healthcare, 11-13 Cavendish Square, Marylebone, London, W1G 0AN, UK.
Rupert Dunbar-ReesOutcomes Based Healthcare, 11-13 Cavendish Square, Marylebone, London, W1G 0AN, UK.
Amoolya VusirikalaOutcomes Based Healthcare, 11-13 Cavendish Square, Marylebone, London, W1G 0AN, UK.
Alice VoddenOutcomes Based Healthcare, 11-13 Cavendish Square, Marylebone, London, W1G 0AN, UK.
Victoria de La MorinièreOutcomes Based Healthcare, 11-13 Cavendish Square, Marylebone, London, W1G 0AN, UK.
Katy YeoOutcomes Based Healthcare, 11-13 Cavendish Square, Marylebone, London, W1G 0AN, UK.
Hiten DodhiaPublic Health Directorate, London Borough of Lambeth, Lambeth Civic Centre, 5th Floor, 2 Brixton Hill, London, SW2 1RW, UK.
Stevo DurbabaSchool of Life Course and Population Sciences, King's College London, Guy's Campus, Addison House, London, SE1 1UL, UK.
Siddesh ShettySchool of Life Course and Population Sciences, King's College London, Guy's Campus, Addison House, London, SE1 1UL, UK.
Mark AshworthSchool of Life Course and Population Sciences, King's College London, Guy's Campus, Addison House, London, SE1 1UL, UK. mark.ashworth@kcl.ac.uk.
Outcomes Based Healthcare · GBKing's College London · GBLambeth Council · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEstimates of chronic pain prevalence using coded primary care data are likely to be substantially lower than estimates derived from community surveys. Most primary care studies have estimated chronic pain prevalence using data searches confined to analgesic medication prescriptions. Increasingly, following recent NICE guideline recommendations, patients and doctors opt for non-drug treatment of chronic pain thus excluding these patients from prevalence estimates based on medication codes. We aimed to develop and test an algorithm combining medication codes with selected diagnostic codes to estimate chronic pain prevalence using coded primary care data.

methodsFollowing a scoping review 4 criteria were developed to identify cohorts of people with chronic pain. These were (1) people with one of 12 ('tier 1') conditions that almost always results in the individual having chronic pain (2) people with one of 20 ('tier 2') conditions included when there are also 3 or more prescription-only analgesics issued in the last 12 months (3) chronic neuropathic pain, or (4) 4 or more prescription-only analgesics issued in the last 12 months. These were translated into 8 logic rules which included 1,932 SNOMED CT codes.

resultsThe algorithm was run on primary care data from 41 GP Practices in Lambeth. The total population consisted of 386,238 GP registered adults ≥ 18 years as of the 31st March 2021. 64,135 (16.6%) were identified as people with chronic pain. This definition demonstrated notably high rates in Black ethnicity females, and higher rates in the most deprived, and older population.

conclusionsEstimates of chronic pain prevalence using structured healthcare data have previously shown lower prevalence estimates for chronic pain than reported in community surveys. This has limited the ability of researchers and clinicians to fully understand and address the complex multifactorial nature of chronic pain. Our study demonstrates that it may be possible to establish more representative prevalence estimates using structured data than previously possible. Use of logic rules offers the potential to move systematic identification and population-based management of chronic pain into mainstream clinical practice at scale and support improved management of symptom burden for people experiencing chronic pain.

Indexed as

Chronic PainAdultAlgorithmsDrug PrescriptionsEthnicityFemaleHumansPrimary Health CareChronic painElectronic health record dataLong term conditionsPrimary care

Identifiers

PMID37691103
PMCPMC10494405
OpenAlexW4386587388

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

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.