Evidence map›Paper›PMID 39725452›Full record

ArticleBMJ paediatrics open2024

Reaching experts for enhanced referral (REFER) to pain psychology: a modified Delphi approach with multidisciplinary paediatric pain providers at a specialised center in the USA.

Lea Schemer, Lauren E Harrison, Courtney W Hess, Alexandra J Neville, Nicole Jehl, Ryan S L Ma, Julia A Glombiewski, Laura E Simons

Abstract read
In one paragraph

Article in BMJ paediatrics open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing 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

1 citing paper in PubMed.

  1. Article
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

8 authors.

Lea SchemerDepartment for Clinical Psychology and Psychotherapy, Rheinland-Pfälzische Technische Universität (RPTU) Kaiserslautern-Landau, Landau, Germany lea.schemer@rptu.de.ORCID 0000-0001-7830-4889
Lauren E HarrisonDepartment of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, California, USA.ORCID 0000-0002-2113-6471
Courtney W HessDepartment of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, California, USA.ORCID 0000-0001-5207-7411
Alexandra J NevilleDepartment of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, California, USA.ORCID 0000-0002-1947-2994
Nicole JehlDepartment of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, California, USA.
Ryan S L MaDepartment of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, California, USA.ORCID 0009-0004-5897-2790
Julia A GlombiewskiDepartment for Clinical Psychology and Psychotherapy, Rheinland-Pfälzische Technische Universität (RPTU) Kaiserslautern-Landau, Landau, Germany.
Laura E SimonsDepartment of Anesthesiology, Perioperative, and Pain Medicine, Stanford University School of Medicine, Stanford, California, USA.ORCID 0000-0002-3395-9483

Funding

Mentoring and Research in Biobehavioral Aspects of Pediatric PainK24AR078945 · NIAMS · STANFORD UNIVERSITY · PI LAURA E SIMONS · 2022 to 2026
$970k
NIAMS NIH HHS K24 AR078945
6 · The paper itself

Abstract

backgroundTo minimise the referral gap to pain psychology, the purpose of this study was to describe clinician-perceived patient suitability for pain psychology referral, develop a referral plan and outline essential elements of a referral conversation via a modified Delphi approach with multidisciplinary paediatric pain providers.

methodsWe employed a three-round modified Delphi approach consulting multidisciplinary paediatric pain providers (n=18) including physicians, psychologists, physical therapists, occupational therapists and nurse practitioners (PT, OT, NP). Based on the responses to an online survey (Round 1), initial statements regarding the pain psychology referral process were developed. These statements were revised in three separate panels (MD panel, PSY panel, PT, OT, NP panel; Round 2). A priori consensus criteria were verified for each statement within and between groups using anonymous responses to a concluding online survey (Round 3).

resultsApproximately one-third of the statements (35%) reached consensus across all panels. For example, paediatric pain providers agreed that referrals should be communicated verbally, along with written materials, and that pain should be explained early from a biopsychosocial perspective. Paediatric pain providers also suggested minimising barriers through a flexible, stepped-care approach that adapts the delivery of pain psychology beyond traditional models. However, most statements reached consensus in only one or two panels (52%), indicating a lack of consensus across disciplines. The data suggest that it was comparatively easier to reach an overall consensus on statements formulating an ideal referral process to pain psychology (50%) than on statements characterising patient suitability (13%).

conclusionsPaediatric pain providers developed an actionable plan for pain psychology referrals. This plan could bridge referral gaps and improve access to pain psychology treatment. Given the low provider consensus on patient suitability, further research is warranted to understand pain psychology referral decision-making, including differing perceptions of patient suitability across disciplines.

Indexed as

Delphi TechniquePain ManagementReferral and ConsultationChildConsensusFemaleHumansMalePainPediatricsSurveys and QuestionnairesUnited StatesAdolescent HealthPainPsychology

Identifiers

PMID39725452
PMCPMC11683953

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.