Accurate pain reporting training diminishes the placebo response: Results from a randomised, double-blind, crossover trial.
Analgesic trials frequently fail to demonstrate efficacy of drugs known to be efficacious. Poor pain reporting accuracy is a possible source for this low essay-sensitivity. We report the effects of Accurate-Pain-Reporting-Training (APRT) on the placebo response in a trial of Pregabalin for painful-d...
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Public Library of Science (PLoS)
2018-01-01
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| Series: | PLoS ONE |
| Online Access: | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0197844&type=printable |
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| author | Roi Treister Oluwadolapo D Lawal Jonathan D Shecter Nevil Khurana John Bothmer Mark Field Steven E Harte Grant H Kruger Nathaniel P Katz |
| author_facet | Roi Treister Oluwadolapo D Lawal Jonathan D Shecter Nevil Khurana John Bothmer Mark Field Steven E Harte Grant H Kruger Nathaniel P Katz |
| author_sort | Roi Treister |
| collection | DOAJ |
| description | Analgesic trials frequently fail to demonstrate efficacy of drugs known to be efficacious. Poor pain reporting accuracy is a possible source for this low essay-sensitivity. We report the effects of Accurate-Pain-Reporting-Training (APRT) on the placebo response in a trial of Pregabalin for painful-diabetic-neuropathy. The study was a two-stage randomized, double-blind trial: In Stage-1 (Training) subjects were randomized to APRT or No-Training. The APRT participants received feedback on the accuracy of their pain reports in response to mechanical stimuli, measured by R-square score. In Stage-2 (Evaluation) all subjects entered a placebo-controlled, cross-over trial. Primary (24-h average pain intensity) and secondary (current, 24-h worst, and 24-h walking pain intensity) outcome measures were reported. Fifty-one participants completed the study. APRT patients (n = 28) demonstrated significant (p = 0.036) increases in R-square scores. The APRT group demonstrated significantly (p = 0.018) lower placebo response (0.29 ± 1.21 vs. 1.48 ± 2.21, mean difference ± SD = -1.19±1.73). No relationships were found between the R-square scores and changes in pain intensity in the treatment arm. In summary, our training successfully increased pain reporting accuracy and resulted in a diminished placebo response. Theoretical and practical implications are discussed. |
| format | Article |
| id | doaj-art-3fd794fb79e548b4a71f448058a3f037 |
| institution | DOAJ |
| issn | 1932-6203 |
| language | English |
| publishDate | 2018-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj-art-3fd794fb79e548b4a71f448058a3f0372025-08-20T03:04:36ZengPublic Library of Science (PLoS)PLoS ONE1932-62032018-01-01135e019784410.1371/journal.pone.0197844Accurate pain reporting training diminishes the placebo response: Results from a randomised, double-blind, crossover trial.Roi TreisterOluwadolapo D LawalJonathan D ShecterNevil KhuranaJohn BothmerMark FieldSteven E HarteGrant H KrugerNathaniel P KatzAnalgesic trials frequently fail to demonstrate efficacy of drugs known to be efficacious. Poor pain reporting accuracy is a possible source for this low essay-sensitivity. We report the effects of Accurate-Pain-Reporting-Training (APRT) on the placebo response in a trial of Pregabalin for painful-diabetic-neuropathy. The study was a two-stage randomized, double-blind trial: In Stage-1 (Training) subjects were randomized to APRT or No-Training. The APRT participants received feedback on the accuracy of their pain reports in response to mechanical stimuli, measured by R-square score. In Stage-2 (Evaluation) all subjects entered a placebo-controlled, cross-over trial. Primary (24-h average pain intensity) and secondary (current, 24-h worst, and 24-h walking pain intensity) outcome measures were reported. Fifty-one participants completed the study. APRT patients (n = 28) demonstrated significant (p = 0.036) increases in R-square scores. The APRT group demonstrated significantly (p = 0.018) lower placebo response (0.29 ± 1.21 vs. 1.48 ± 2.21, mean difference ± SD = -1.19±1.73). No relationships were found between the R-square scores and changes in pain intensity in the treatment arm. In summary, our training successfully increased pain reporting accuracy and resulted in a diminished placebo response. Theoretical and practical implications are discussed.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0197844&type=printable |
| spellingShingle | Roi Treister Oluwadolapo D Lawal Jonathan D Shecter Nevil Khurana John Bothmer Mark Field Steven E Harte Grant H Kruger Nathaniel P Katz Accurate pain reporting training diminishes the placebo response: Results from a randomised, double-blind, crossover trial. PLoS ONE |
| title | Accurate pain reporting training diminishes the placebo response: Results from a randomised, double-blind, crossover trial. |
| title_full | Accurate pain reporting training diminishes the placebo response: Results from a randomised, double-blind, crossover trial. |
| title_fullStr | Accurate pain reporting training diminishes the placebo response: Results from a randomised, double-blind, crossover trial. |
| title_full_unstemmed | Accurate pain reporting training diminishes the placebo response: Results from a randomised, double-blind, crossover trial. |
| title_short | Accurate pain reporting training diminishes the placebo response: Results from a randomised, double-blind, crossover trial. |
| title_sort | accurate pain reporting training diminishes the placebo response results from a randomised double blind crossover trial |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0197844&type=printable |
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