Transitional Pain Service for Preventing Chronic Postsurgical Pain: A Scoping Review of Published Literature and Considerations for Research and Practice
Bibliographic record
Abstract
Since its introduction, the transitional pain service, a multicomponent perioperative program, has been considered to hold the promise of reducing the risk of chronic postsurgical pain unlike single-modality interventions. This scoping review on the use of transitional pain service or transitional pain service-like programs observed limited and low-quality evidence in the form of fifteen studies (seven retrospective chart reviews, five cohort studies, and only one randomized controlled trial), with only six studies assessing any postoperative pain outcomes and only one assessing postsurgical pain as a secondary outcome. A majority of studies focused on postoperative opioid use, observing important reductions. Along with a comprehensive review of transitional pain service, this study discusses its inherent appeal for reducing chronic postsurgical pain; essential components based on its theoretical foundations and the need to distinguish it from other multimodal perioperative strategies; challenges and limitations; and lastly the need for effectiveness research through pragmatic trials. Despite continuing to be an important outcome, the overall prescription opioid use rate has decreased due to practice and regulatory oversight. Hence, the incentive to convince stakeholders and develop a transitional pain service program based on opioid reduction may not be a viable long-term strategy.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot 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.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.016 | 0.013 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
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.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".