Jeremy,
I'm not at all clear why you want a "definitive" attribution (amongst
your categories) of pain "measured by a visual analog scale" (VAS).
When a subject ticks a box on a VAS, that is a record of *perception*
of intensity of pain. As a perception, that has to be primarily
psychological (from a definitional point of view).
However, the intensity of perception could be very directly driven
by the physical (including physiological) mechanisms giving rise
to the pain; and they could also be modulated by psychological
processes.
As an example of this: Say you knock you head on a door-frame.
Then you can (or most people can) hold that pain "at arm's length"
by a psychological effort (e.g. concentrating on something else),
and then be less distressed by the pain.
By contrast, if the pain is perceived via the sympathetic nervous
system (e.g. from a gallstone or a kidney stone) then it is almost
imposssible to hold it "at arms length" by conscious effort.
And then, when drugs are administered, what is their primary action?
Perhaps to counteract the primary physiological process generating the
pain (e,g, anti-inflammatory drugs); perhaps to inhibit the
neurological transmission of pain signals; perhaps (e.g. anaesthetics)
to suppress tha brain's perception of pain (and possibly everything
alse as well).
Given the complexity of attributing pain to "physical" pain or to
"psychological" pain. I do wonder what the point of your question is!
And I have not included the "purely phychological" pain which is
what is imagined (without any physical trauma whatever) by someone
whose brain is going off the rails!
Best wishes,
Ted.
On Wed, 2017-07-19 at 11:00 +0000, Jeremy Howick wrote:
> Dear List Members,
>
>
> Within the context of a trial or systematic review, is change in pain
> (for example with a visual analog scale): (a) physical outcome, (b)
> psychological outcome, or (c) both.neither?
>
>
> I am aware that many causes of pain (such as bumping my head into a
> low door frame) are purely physical. What I am interested in is
> whether pain as an outcome measured by a visual analog scale itself is
> physical, psychological, or both/neither.
>
>
> I’m specifically interested in what the scientific consensus is or,
> better, whether there is evidence of some kind that could resolve
> this.
>
>
> Thanks in advance,
>
>
> Jeremy
>
> T: +44 (0)1865 289 258 E: [log in to unmask]
>
> http://www.phc.ox.ac.uk/team/jeremy-howick
>
>
>
> Nuffield Department of Primary Care Health Sciences, University of
> Oxford
> Radcliffe Primary Care Building, Radcliffe Observatory Quarter,
> Woodstock Road, Oxford, OX2 6GG
>
>
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