European journal of pain : EJP
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Diagnostic uncertainty is the subjective perception of an inability to provide an accurate explanation of the patient's health problem or that a label is missing or incorrect. While recently explored in youth with chronic pain and families, this is the first study to investigate diagnostic uncertainty from the perspectives of physicians. ⋯ How physicians manage diagnostic uncertainty must be understood, as it is likely to critically impact how a diagnosis of chronic pain is communicated, the diagnostic investigations undertaken, the wait time to receiving a diagnosis, and ultimately youths' pain experiences.
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In pain research and clinics, it is common practice to subgroup subjects according to shared pain characteristics. This is often achieved by computer-aided clustering. In response to a recent EU recommendation that computer-aided decision making should be transparent, we propose an approach that uses machine learning to provide (1) an understandable interpretation of a cluster structure to (2) enable a transparent decision process about why a person concerned is placed in a particular cluster. ⋯ Assessing the variables importance in clustering is important for understanding any cluster structure. XAI models are able to provide a human-understandable interpretation of the cluster structure. Model selection must be adapted individually to the clustering problem. The advantage of comprehensibility comes at an expense of accuracy.
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Individuals vary in their temperature and pungency preferences; whereas some individuals prefer to bath in, or consume food and beverages at very high temperatures, others prefer lukewarm temperatures. Similarly, pungent food may be preferred by some, but not by others. The aim was to investigate, for the first time whether temperature and pungency preferences are associated with variations in thermal sensitivity or ethnic origin related to pungency consumption. ⋯ People vary with regard to their temperature and spiciness preferences for reasons yet unknown. The study revealed that these preferences correlate with one another and were associated with the sensitivity to noxious heat but not with age, gender and cultural background, which suggests that they may be innate.
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The term 'visually induced analgesia' describes a reduced pain perception induced by watching the painful body part as opposed to watching a neutral object. In chronic back pain patients, experimental pain, movement-induced pain and habitual pain can be reduced with visual feedback. Visual feedback can also enhance the effects of both massage treatment and manual therapy. The impact of somatosensory attentional processes remains unclear. ⋯ Somatosensory attention reduced experimental pain intensity in the thumb and back in the presence of both congruent and incongruent visual feedback. We found no significant visual feedback effect on the complex interplay between visual feedback and somatosensory attention.
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Review Meta Analysis
Prescription of exercises for the treatment of chronic pain along the continuum of nociplastic pain: a systematic review with meta-analysis.
To compare different exercise prescriptions for patients with chronic pain along the continuum of nociplastic pain: fibromyalgia, chronic whiplash-associated disorders (CWAD), and chronic idiopathic neck pain (CINP). ⋯ The pain mechanism must be considered to optimize exercise prescription in patients with different chronic pain profiles. The main message of this article is that low to moderate intensity global exercises performed for a long period of treatment should be performed in patients with nociplastic pain predominance. Additionally, focused and intense exercises for a short period of treatment can be prescribed for patients with nociceptive pain predominance.