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Research design considerations for confirmatory chronic pain clinical trials: IMMPACT recommendations
Abstract
There has been an increase in the number of chronic pain clinical trials in which the treatments being evaluated did not differ significantly from placebo in the primary efficacy analyses despite previous research suggesting that efficacy could be expected. These findings could reflect a true lack of efficacy or methodological and other aspects of these trials that compromise the demonstration of efficacy. There is substantial variability among chronic pain clinical trials with respect to important research design considerations, and identifying and addressing any methodological weaknesses would enhance the likelihood of demonstrating the analgesic effects of new interventions. An IMMPACT consensus meeting was therefore convened to identify the critical research design considerations for confirmatory chronic pain trials and to make recommendations for their conduct. We present recommendations for the major components of confirmatory chronic pain clinical trials, including participant selection, trial phases and duration, treatment groups and dosing regimens, and types of trials. Increased attention to and research on the methodological aspects of confirmatory chronic pain clinical trials has the potential to enhance their assay sensitivity and ultimately provide more meaningful evaluations of treatments for chronic pain.
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“This trial followed the Initiative on Methods, Measurement, and Pain Assessment in Clinical Trials, or IMMPACT, recommendations for chronic pain clinical trials [31] and the Consolidated Standards of Reporting Trials, or CONSORT, recommendations for randomised, controlled trials [32].”
From Effectiveness of cognitive behaviour therapy for the treatment of catastrophisation in patients with fibromyalgia: A randomised controlled trial (2011) · cites this paper as [31]
Citations
Cites
Assessing the quality of reports of randomized clinical trials: Is blinding necessary?
Jadad, A. R., Moore, R. A., Carroll, D., Jenkinson, C., Reynolds, D. J. M., Gavaghan, D. J., & McQuay, H. J. (1996) · Controlled Clinical Trials · doi:10.1016/0197-2456(95)00134-4 · Cited by 17,582
Self-citationCore outcome measures for chronic pain clinical trials: IMMPACT recommendations
Dworkin, R. H., Turk, D. C., Farrar, J. T., Haythornthwaite, J. A., Jensen, M. P., Katz, N. P., Kerns, R. D., Stucki, G., Allen, R. R., Bellamy, N., et al. (2005) · Pain · doi:10.1016/j.pain.2004.09.012 · Cited by 3,732
Self-citationCore outcome domains for chronic pain clinical trials: IMMPACT recommendations
Turk, D. C., Dworkin, R. H., Allen, R. R., Bellamy, N., Brandenburg, N., Carr, D. B., Cleeland, C., Dionne, R., Farrar, J. T., Galer, B. S., et al. (2003) · Pain · doi:10.1016/j.pain.2003.08.001 · Cited by 3,510
Self-citationDworkin, R. H., Turk, D. C., Wyrwich, K. W., Beaton, D., Cleeland, C. S., Farrar, J. T., Haythornthwaite, J. A., Jensen, M. P., Kerns, R. D., Ader, D. N., et al. (2008) · The Journal of Pain · doi:10.1016/j.jpain.2007.09.005 · Cited by 3,471
Self-citationClassification of Chronic Pain: Descriptions of Chronic Pain Syndromes and Definitions of Pain Terms
Merskey, H. (1994) · Medical Entomology and Zoology · Cited by 3,362
Cella, D., Yount, S., Rothrock, N., Gershon, R., Cook, K., Reeve, B., Ader, D., Fries, J. F., Bruce, B., & Rose, M. (2007) · Medical Care · doi:10.1097/01.mlr.0000258615.42478.55 · Cited by 3,118
Self-citationTreede (2008) · doi:10.1212/01.wnl.0000282763.29778.59 · Cited by 2,746
Altman, R. D., Alarcón, G. S., Appelrouth, D. J., Bloch, D. A., BORENSTEIN, D. G., Brandt, K. D., Brown, C., Cooke, T. D. V., Daniel, W., Feldman, D. P., et al. (1991) · Arthritis & Rheumatism · doi:10.1002/art.1780340502 · Cited by 2,631
Rolke, R., Baron, R., Maier, C., Tölle, T. R., Treede, R., Beyer, A., Binder, A., Birbaumer, N., Birklein, F., Bötefür, I. C., et al. (2006) · Pain · doi:10.1016/j.pain.2006.01.041 · Cited by 2,606
Self-citationKirsch, I., Deacon, B. J., Huedo-Medina, T. B., Scoboria, A., Moore, T. J., & Johnson, B. T. (2008) · PLoS Medicine · doi:10.1371/journal.pmed.0050045 · Cited by 2,442
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Items 301–381 of 381
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Kemp, H. I., Eliahoo, J., Vase, L., Nguyen, S. N., Abdallah, A. B., Rice, A. S. C., Finnerup, N. B., & Haroutounian, S. (2020) · Scandinavian Journal of Pain · doi:10.1515/sjpain-2019-0152 · Cited by 3
Levy, R. M. (2012) · Neuromodulation Technology at the Neural Interface · doi:10.1111/j.1525-1403.2011.00425.x · Cited by 3
Stemper, B., Löwen, S., Fritsch, A., Hoffmann, A., & Sarkar, A. (2025) · Pain · doi:10.1097/j.pain.0000000000003642 · Cited by 2
Nishtar, M., Mark, R., Langford, D. J., McDermott, M., Markman, J. D., Evans, S. R., France, F. O., Park, M., Sharma, S., Turk, D. C., et al. (2023) · Regional Anesthesia & Pain Medicine · doi:10.1136/rapm-2023-104809 · Cited by 2
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Childs, D. S., Novotny, P. J., Marell, P. S., Ruddy, K. J., & Loprinzi, C. L. (2022) · BMJ Supportive & Palliative Care · doi:10.1136/bmjspcare-2022-003681 · Cited by 2
Boxem, K. V., Cahana, A., & Zundert, J. H. M. V. (2010) · European Spine Journal · doi:10.1007/s00586-010-1580-x · Cited by 2
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Quessy, S. N. (2010) · Pain · doi:10.1016/j.pain.2010.11.028 · Cited by 2
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Garton, P., Murphy, G., & O’Halloran, P. (2016) · Work · doi:10.3233/wor-162276 · Cited by 2
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Booker, S. Q., Herr, K., & Tripp‐Reimer, T. (2016) · Western Journal of Nursing Research · doi:10.1177/0193945916648952 · Cited by 2
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Cleeland, C. S., Fisch, M. J., & Dunn, A. J. (2010) · Cambridge University Press eBooks · doi:10.1017/cbo9780511780868.034 · Cited by 2
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Aslakson, R. A., Brookman, J., & Smith, T. J. (2012) · Elsevier eBooks · doi:10.1016/b978-1-4377-3796-7.00019-7 · Cited by 3
Clinical Trial Design Methodology for Pain Outcome Studies
Vetter, T. R., & Chou, R. (2013) · Elsevier eBooks · doi:10.1016/b978-0-323-08340-9.00080-3 · Cited by 2
Smith, S. M., D, M. F. M., Jensen, M. P., Mbowe, O. B., McDermott, M., Turk, D. C., & Dworkin, R. H. (2019) · Journal of Pain · doi:10.1016/j.jpain.2019.09.008 · Cited by 2
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Ilfeld, B. M., Said, E. T., Alexander, B. S., Ball, S. T., Abdullah, B., Jensen, E. J., Schaar, A. N., & Finneran, J. J. (2025) · Cureus · doi:10.7759/cureus.78920 · Cited by 1
Loughran, T., Scharer, J. L., Moskal, D., Funderburk, J. S., Buckheit, K. A., & Beehler, G. P. (2025) · Journal of Clinical Psychology in Medical Settings · doi:10.1007/s10880-025-10072-6 · Cited by 1
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Idahor, C. O., Okorie, M. A., Mokobia, S., Erhuanga, P., Ogbonna, N., Ogunfuwa, O., Etoroma, O. M., Abhulimen, I. J., & Chinedu, E. (2025) · Cureus · doi:10.7759/cureus.94508 · Cited by 1
Frisaldi, E. (2025) · Handbook of clinical neurology · doi:10.1016/b978-0-443-29884-4.00013-3 · Cited by 1
Adair, E., Mardian, A. S., Saxena, K., Dorsonne, B., Hailu, A. Y., Heggan, E., Riazi, G., Slater, K., Poupore‐King, H., Clifton, J., et al. (2026) · Pain Medicine · doi:10.1093/pm/pnag027 · Cited by 1
Finneran, J. J., Bechis, S. K., Sur, R. L., Monga, M., Miller, K. S., Alexander, B. S., Abdullah, B., Donohue, M., Schaar, A. N., & Ilfeld, B. M. (2026) · Anesthesiology · doi:10.1097/aln.0000000000006129 · Cited by 1
Assessment of neuropathic pain in the setting of intervention trials
Attal, N. (2011) · Clinical Investigation · doi:10.4155/cli.11.22 · Cited by 1
External validity and psychiatric disorder exclusions in orofacial pain clinical trials
Raphael, K. G. (2011) · Journal of Oral Rehabilitation · doi:10.1111/j.1365-2842.2011.02238.x · Cited by 1
Werner, M. U. (2013) · Scandinavian Journal of Pain · doi:10.1016/j.sjpain.2013.04.003 · Cited by 1
Designing Randomized Controlled Trials of Oral Analgesics for Chronic Postherpetic Neuralgia
Gilron, I., & Watson, C. P. N. (2017) · Springer eBooks · doi:10.1007/978-3-319-44348-5_21 · Cited by 1
Self-citationSaulino, M. F. (2017) · Elsevier eBooks · doi:10.1016/b978-0-323-48566-1.00020-6 · Cited by 1
Valentini, E., Vaughan, S., & Clauwaert, A. (2023) · Neuromethods · doi:10.1007/978-1-0716-3068-6_7 · Cited by 1
Klokker, L., Christensen, R., Osborne, R. H., Aaboe, J., Bliddal, H., & Henriksen, M. (2013) · OA Musculoskeletal Medicine · doi:10.13172/2052-9287-1-3-906 · Cited by 1
Mazzei, L. G., Bergamaschi, C. D. C., Silva, M. T., & Lopes, L. C. (2017) · BMJ Open · doi:10.1136/bmjopen-2016-014904 · Cited by 1
Relief of Cancer Pain in Patients with Pancreatic Cancer
Choe, J. W., & Hyun, J. J. (2019) · Korean Journal of Gastroenterology · doi:10.4166/kjg.2019.74.2.81 · Cited by 1
Rafferty, H., Rocha, E. C., Gonzalez‐Mego, P., Ramos, C. L., El-Hagrassy, M. M., Gunduz, M. E., Uygur-Kucukseymen, E., Zehry, H. I., Chaudhari, S., Teixeira, P. E. P., et al. (2022) · Principles and Practice of Clinical Research Journal · doi:10.21801/ppcrj.2022.82.5 · Cited by 1
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Meyer, E. M. (2014) · doi:10.51415/10321/964 · Cited by 1
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Thakur, M., & McMahon, S. B. (2016) · doi:10.1002/9781118455968.ch3 · Cited by 1
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Houck, P. J., Haché, M., & Busse, J. A. (2016) · Journal of Neurosurgical Anesthesiology · doi:10.1097/ana.0000000000000352 · Cited by 1
Davis, M. P. (2013) · Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature · doi:10.3410/f.718000622.793475004 · Cited by 1
Budsberg, S. C., & Hinson, W. D. (2024) · doi:10.1002/9781119830306.ch71 · Cited by 1
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Boxem, K. V. (2014) · doi:10.26481/dis.20140605kb · Cited by 1
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O'Connell, N. E., & Wand, B. M. (2013) · European Journal of Pain · doi:10.1002/j.1532-2149.2012.00238.x
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Puolakka, P. A. (2011) · Tampere University Institutional Repository (Tampere University)
Rhodes, T. (2011) · Rutgers University Community Repository (Rutgers University) · doi:10.7282/t37p8xpb
Self-citationHazime, F. A. (2016) · Digital Library of Theses and Dissertations (Universidade de São Paulo) · doi:10.11606/t.5.2016.tde-24022016-115652
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Keogh, P., & Mehta, V. (2016) · Current anesthesiology reports · doi:10.1007/s40140-016-0186-1
Giannopoulou, C. (2015) · Queen Margaret University eTheses Repository
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Singh, C. (2018) · Springer eBooks · doi:10.1007/978-981-10-8282-5_30
Budsberg, S. C. (2015) · doi:10.1002/9781119421375.ch56
Pandey, N., Park, J., & Datta, S. (2019) · Springer eBooks · doi:10.1007/978-3-030-18005-8_4
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Management of Pain in Pancreatic Cancer
Domínguez‐Muñoz, J. E. (2021) · doi:10.1002/9781119570097.ch62
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Cameron, M. G., & Kersten, C. (2021) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2021.06.018
RetractedEngle, A. M., Abd-Elsayed, A. A., Pope, J. E., & Fishman, M. A. (2021) · Pain and Therapy · doi:10.1007/s40122-021-00323-3
(2010) · Current Opinion in Anaesthesiology · doi:10.1097/aco.0b013e32833f3f68
When Should Nerve Blocks Be Used for Pain Management?
Sacks, S. H., & Aslakson, R. A. (2023) · Elsevier eBooks · doi:10.1016/b978-0-323-84702-5.00014-2
Katz, N. P., Dworkin, R. H., North, R. B., Thomson, S., Eldabe, S. S., Hayek, S. M., Kopell, B. H., Markman, J. D., Rezai, A. R., Taylor, R. S., et al. (2022) · NeuroTarget · doi:10.47924/neurotarget2022124
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Hansford, K. J., Baker, D. H., McKenzie, K. J., & Preston, C. (2025) · PLoS ONE · doi:10.1371/journal.pone.0317693
Ilfeld, B. M., Finneran, J. J., Said, E. T., Ball, S. T., Sandler, B. J., Broderick, R. C., Gonzales, F. B., Lau, N. J., Schaar, A. N., & Abdullah, B. (2025) · Neuromodulation Technology at the Neural Interface · doi:10.1016/j.neurom.2025.01.008
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Lopez, A. I. A., Herrero, R., Vizcaíno, Y., Molinari, G., González, E. D. R., & Arbona, C. B. (2011) · LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas)
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Toth, C. C., & Moulin, D. E. (2013) · Cambridge University Press eBooks · doi:10.1017/cbo9781139152211.027
Kubo, T., Kumai, T., Ikegami, H., Kano, K., Nishii, M., & Seo, T. (2022) · Figshare · doi:10.6084/m9.figshare.19625516
Kubo, T., Kumai, T., Ikegami, H., Kano, K., Nishii, M., & Seo, T. (2022) · Figshare · doi:10.6084/m9.figshare.19625528
Kubo, T., Kumai, T., Ikegami, H., Kano, K., Nishii, M., & Seo, T. (2022) · Figshare · doi:10.6084/m9.figshare.19625525
Rees, C. A., Brousseau, D. C., Cohen, D. M., Villella, A. D., Dampier, C., Brown, K., Campbell, A., Chumpitazi, C. E., Airewele, G. E., Chang, T., et al. (2023) · Figshare · doi:10.6084/m9.figshare.23972970
Rees, C. A., Brousseau, D. C., Cohen, D. M., Villella, A. D., Dampier, C., Brown, K., Campbell, A., Chumpitazi, C. E., Airewele, G. E., Chang, T., et al. (2023) · Figshare · doi:10.6084/m9.figshare.23972967
Kubo, T., Kumai, T., Ikegami, H., Kano, K., Nishii, M., & Seo, T. (2022) · Figshare · doi:10.6084/m9.figshare.19625507
Kubo, T., Kumai, T., Ikegami, H., Kano, K., Nishii, M., & Seo, T. (2022) · Figshare · doi:10.6084/m9.figshare.19625504
Kubo, T., Kumai, T., Ikegami, H., Kano, K., Nishii, M., & Seo, T. (2022) · Figshare · doi:10.6084/m9.figshare.19625522
Hummer, C. D., Huang, Y., & Sheehan, B. (2022) · Figshare · doi:10.6084/m9.figshare.19218423
Kubo, T., Kumai, T., Ikegami, H., Kano, K., Nishii, M., & Seo, T. (2022) · Figshare · doi:10.6084/m9.figshare.19625519
Kubo, T., Kumai, T., Ikegami, H., Kano, K., Nishii, M., & Seo, T. (2022) · Figshare · doi:10.6084/m9.figshare.19625531
Kubo, T., Kumai, T., Ikegami, H., Kano, K., Nishii, M., & Seo, T. (2022) · Figshare · doi:10.6084/m9.figshare.19625510
Hummer, C. D., Huang, Y., & Sheehan, B. (2022) · Figshare · doi:10.6084/m9.figshare.19218417
Kubo, T., Kumai, T., Ikegami, H., Kano, K., Nishii, M., & Seo, T. (2022) · Figshare · doi:10.6084/m9.figshare.19625513
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Corriger, A. (2019) · theses.fr (ABES) · doi:10.70675/668e4777zf8d0z4bdcz9780z0f91fedfe2b6
Malaktaris, A. L., Afari, N., Casmar, P. V., Herbert, M. S., Raver, R., Kangas, J. L., Liu, L., Zeidan, F. Z., & Lang, A. J. (2026) · Contemporary Clinical Trials Communications · doi:10.1016/j.conctc.2026.101646
Eerdekens, M., Both, C., & Freitas, R. L. (2026) · Pain and Therapy · doi:10.1007/s40122-026-00884-1
Verrills, P., Mohabbati, V., Yu, J., Green, M. D. S., Bates, D., Mihailidis, H., & Russo, M. (2026) · Journal of Clinical Medicine · doi:10.3390/jcm15218389
Metadata
- Authors
- Dworkin, R. H., Turk, D. C., Peirce-Sandner, S., Baron, R., Bellamy, N., Burke, L. B., Chappell, A., Chartier, K., Cleeland, C. S., Costello, A., Cowan, P., Dimitrova, R., Ellenberg, S., Farrar, J. T., French, J. A., Gilron, I., Hertz, S., Jadad, A. R., Jay, G. W., Kalliomäki, J., Katz, N. P., Kerns, R. D., Manning, D. C., McDermott, M. P., McGrath, P. J., Narayana, A., Porter, L., Quessy, S., Rappaport, B. A., Rauschkolb, C., Reeve, B. B., Rhodes, T., Sampaio, C., Simpson, D. M., Stauffer, J. W., Stucki, G., Tobias, J., White, R. E., & Witter, J.
- Affiliations
- Dalhousie University (CA)
- University of Washington (US)
- Christian-Albrechts-Universität zu Kiel (DE)
- The University of Queensland (AU)
- United States Food and Drug Administration (US)
- Eli Lilly (United States) (US)
- The University of Texas MD Anderson Cancer Center (US)
- American Chronic Pain Association (US)
- New York University (US)
- Queen's University (CA)
- University of Toronto (CA)
- AstraZeneca (Sweden) (SE)
- United States Department of Veterans Affairs (US)
- University of Rochester (US)
- Izaak Walton Killam Health Centre (CA)
- National Institutes of Health (US)
- Janssen Research & Development (United States) (US)
- Merck & Co., Inc., Rahway, NJ, USA (United States) (US)
- University of Lisbon (PT)
- University of Rochester Medicine (US)
- University of Lucerne (CH)
- Corresponding author
- Dworkin, Robert H.
- ORCID
- Dworkin, Robert H.
- Baron, Ralf
- Burke, Laurie B.
- Cleeland, Charles S.
- Ellenberg, Susan
- Farrar, John T.
- French, Jacqueline A.
- Gilron, Ian
- Hertz, Sharon
- Jadad, Alejandro R.
- Katz, Nathaniel P.
- Kerns, Robert D.
- McDermott, Michael P.
- McGrath, Patrick J.
- Reeve, Bryce B.
- Rhodes, Thomas
- Sampaio, Cristina
- Simpson, David M.
- Stucki, Gerold
- Tobias, Jeffrey
- Venue
- Pain
- Published
- 2010-05
- Volume
- 149
- Issue
- 2
- Pages
- 177-193
- ISSN
- 0304-3959 (ISSN-L)
- OpenAlex
- W2061974517
- Cited by
- 381
- References
- 158
- Citations by year
- 2026: 6 · 2025: 18 · 2024: 11 · 2023: 21 · 2022: 39 · 2021: 23 · 2020: 27 · 2019: 27 · 2018: 19 · 2017: 20 · 2016: 24 · 2015: 20 · 2014: 27 · 2013: 36 · 2012: 27
- FWCI
- 27.01
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Pain (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Clinical Trials
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
- Health Sciences › Medicine › Physiology (medical) › Pain Mechanisms and Treatments
- Keywords
- chronic pain, confirmatory trials, research design, IMMPACT, clinical trial design, participant selection, assay sensitivity, analgesic efficacy, placebo response
- MeSH terms
- Analgesics, Clinical Trials as Topic, Dose-Response Relationship, Drug, Drug Administration Schedule, Humans, Pain Measurement, Pain, Intractable, Intractable Pain, Random Allocation, Research Design, Outcome Assessment, Health Care, Patient Selection
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