ArticleThe Journal of rheumatology2024
The Problem of Pain in Rheumatology: Variations in Case Definitions Derived From Chronic Pain Phenotyping Algorithms Using Electronic Health Records.
Article in The Journal of rheumatology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
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Who cites it
4 citing papers in PubMed, 8 citations in OpenAlex.
- Persistent Opioid Exposure in Older Adults with Rheumatic Disease: National Patterns, Disparities, and Cross-Specialty Prescribing.The Journal of rheumatology · 2026Article
- Visualizing Real-World Pain Treatment Pathways in Chronic Disease: A Sequence-Based Analysis of Polypharmacy in Systemic Lupus Erythematosus.ACR open rheumatology · 2025Article
- Latent class analysis identifies distinct pain phenotypes in newly diagnosed systemic juvenile idiopathic arthritis.Arthritis research & therapy · 2025Article
- Refining chronic pain phenotypes: A comparative analysis of sociodemographic and disease-related determinants using electronic health records.The journal of pain · 2025Article
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Authors and funding
9 authors at 3 institutions in 1 country.
Funding
Abstract
objectiveThe aim of this study was to investigate and compare different case definitions for chronic pain to provide estimates of possible misclassification when researchers are limited by available electronic health record and administrative claims data, allowing for greater precision in case definitions.
methodsWe compared the prevalence of different case definitions for chronic pain (N = 3042) in patients with autoimmune rheumatic diseases. We estimated the prevalence of chronic pain based on 15 unique combinations of pain scores, diagnostic codes, analgesic medications, and pain interventions.
resultsChronic pain prevalence was lowest in unimodal pain phenotyping algorithms: 15% using analgesic medications, 18% using pain scores, 21% using pain diagnostic codes, and 22% using pain interventions. In comparison, the prevalence using a well-validated phenotyping algorithm was 37%. The prevalence of chronic pain also increased with the increasing number (bimodal to quadrimodal) of phenotyping algorithms that comprised the multimodal phenotyping algorithms. The highest estimated chronic pain prevalence (47%) was the multimodal phenotyping algorithm that combined pain scores, diagnostic codes, analgesic medications, and pain interventions. However, this quadrimodal phenotyping algorithm yielded a 10% overestimation of chronic pain compared to the well-validated algorithm.
conclusionThis is the first empirical study to our knowledge that shows that established common modes of phenotyping chronic pain can lead to substantially varying estimates of the number of patients with chronic pain. These findings can be a reference for biases in case definitions for chronic pain and could be used to estimate the extent of possible misclassifications or corrections in using datasets that cannot include specific data elements.
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