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Record W2076110105 · doi:10.2217/pmt.14.18

Minimize Opioids by Optimizing Pain Psychology

2014· editorial· en· W2076110105 on OpenAlex
Beth D. Darnall

Why this work is in the frame

A frame that forgets how it found something cannot be audited. These are the routes that admitted this work.

aboutThe title or abstract carries a Canadian signal from the geographic lexicon.
no affNo Canadian affiliation: this work is invisible to an affiliation-only frame.
No Canadian affiliation. An affiliation-only frame, the usual design, would never have seen this work. It is one of the works that make the case for inverting the frame.

Bibliographic record

VenuePain Management · 2014
Typeeditorial
Languageen
FieldMedicine
TopicMusculoskeletal pain and rehabilitation
Canadian institutionsnot available
FundersNational Center for Complementary and Integrative HealthNational Institutes of Health
KeywordsChronic painMedicineOpioidMoodOpioid use disorderIrritabilityFibromyalgiaMedical prescriptionPsychiatryDepression (economics)Pain catastrophizingEpidemiologyPain ladderPhysical therapyAnxietyInternal medicine

Abstract

fetched live from OpenAlex

More than 100 million Americans have chronic pain [1] and estimates suggest that pain affects more than 1 billion people globally [2].Pain is the primary reason people seek medical care, and in the past decade or so there has been increasing emphasis on assessing and treating chronic pain.Few would argue against reducing human suffering through pain treatment, but the devil is in the details of how pain is being treated.Epidemiological studies in the US [3] and abroad [4] have shown steeply increased opioid prescribing trends for chronic pain without good efficacy data to support the practice.In recent years the unintended consequences of long-term opioid use have emerged, thus shepherding in the realization that for the majority of patients, chronic pain must be treated differently.The unintended consequences of long-term opioid use include paradoxical increases in pain, medical comorbidity and psychological symptoms that emerge through various pathways.For instance, long-term opioid use is associated with disrupted sleep architecture [5].Opioids act as a barrier to the deeper stages of sleep and thus can contribute to day-time fatigue and increased pain intensity.Similarly, long-term opioid use is associated with decreased sex hormones in men and women [6], and hormone imbalance is associated with increased pain, problems with sleep and mood, and irritability.The iatrogenic consequences of opioids may masquerade as primary depression, thus placing patients at risk for yet another prescription to treat these new or worsening symptoms.Ideally, the very first step in pain treatment would be to optimize low-risk, nonpharmaceutical, evidence-based options such as pain psychology.Yet how do we do this in the current healthcare climate, where 20% of the US budget is going to healthcare and close to double that amount for Canada?The truth is that the current model is unsustainable.Despite massive expenditures, few patients access specialized pain psychology services, and those that do typically have been living and suffering with pain for years.A perfect and daunting storm has coalesced: increasing prevalence of chronic pain, increasing opioid prescribing and associated

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.011
metaresearch head score (Gemma)0.002
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesMeta-epidemiology (narrow)
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Not applicable · Consensus signal: Not applicable
GenreCandidate signal: Editorial · Consensus signal: Editorial
Teacher disagreement score0.165
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0110.002
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0010.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0010.001
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.006
GPT teacher head0.291
Teacher spread0.285 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it