The Centralized Pain Score: A Method to Identify Nociplastic Pain in Electronic Health Records.
Lori Schirle, Makayla Cordoza, Stephen Bruehl and 1 others
PMID 41484019WHAT IT FOUND
A score built from chronic pain diagnoses in electronic health records was higher in records clinicians judged to have centralized pain than in matched or general records.
It is a research method, not a bedside test.
Key findings
01The mean Centralized Pain Score was 3.7 in the manually identified Nociplastic Pain Group, compared with 0.47 in the Sex- and Age-Matched Group and 0.43 in the General Population Group.
02A Centralized Pain Score of 3 or higher was present in 71% of the Nociplastic Pain Group and 5.8% of the Age- and Sex-Matched Group.
03In the 100 Nociplastic Pain Group records, the most common clinician term was central pain syndrome (35 notes), and no record used the term nociplastic pain.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
All phases were done in one academic medical center, so terminology and ICD coding may differ at other sites. The Nociplastic Pain Group was 100 manually selected records, and review stopped after 100 confirmed cases rather than using an exhaustive or randomized sample. Only 17% of the Nociplastic Pain Group were male, so sex differences could not be tested statistically. The score uses only documented EHR data, so undocumented pain conditions or treatments are missing. The CPS includes only 8 chronic overlapping pain conditions and was created before a suggested ICD10 code list for these conditions. 17 of the 100 Nociplastic Pain Group records had a CPS of 0, and many notes used central pain syndrome codes not intended for nociplastic pain. Validation in external data sources is still needed.
Declared interests
No author conflict of interest or funding statement is included in the supplied text. The publication types list research support from NIH, extramural.
The easy way to misread this
Do not use the Centralized Pain Score as a clinical diagnostic test for an individual patient. It was built from ICD codes and tested against 100 manually selected records from one health system, and 17 of those records had a score of 0.