Characteristics Associated With High-Impact Pain in People With Temporomandibular Disorder: A Cross-Sectional Study

Vanessa E. Miller, Charles Poole, Yvonne Golightly, Deborah Barrett, Ding Geng Chen, Richard Ohrbach, Joel Daniel Greenspan, Roger B. Fillingim, Gary D. Slade

Research output: Contribution to journalArticle

Abstract

High-impact (disabling) pain diminishes the quality of life and increases health care costs. The purpose of this study was to identify the variables that distinguish between high- and low-impact pain among individuals with painful temporomandibular disorder (TMD). Community-dwelling adults (N = 846) with chronic TMD completed standardized questionnaires that assessed the following: 1) sociodemographic characteristics, 2) psychological distress, 3) clinical pain, and 4) experimental pain. We used high-impact pain, classified using the Graded Chronic Pain Scale, as the dependent variable in logistic regression modeling to evaluate the contribution of variables from each domain. Cross-validated area under the receiver operating characteristic curve (AUC) quantified model discrimination. One-third of the participants had high-impact pain. Sociodemographic variables discriminated weakly between low- and high-impact pain (AUC =.61, 95% confidence interval [CI] = 0.57, 0.65), with the exception of race. An 18-variable model encompassing all 4 domains had good discrimination (AUC = 0.79, 95% CI = 0.75, 0.82), as did a simplified model (sociodemographic variables plus catastrophizing, jaw limitation, and number of painful body sites) (AUC = 0.79, 95% CI = 0.76, 0.82). Duration of pain, sex, and experimental pain testing results were not associated. The characteristics that discriminated most effectively between people with low- and high-impact TMD pain included clinical pain features and the ability to cope with pain. Perspective: This article presents the results of a multivariable model designed to discriminate between people with high- and low-impact pain in a community-based sample of people with painful chronic TMD. The findings emphasize the importance of catastrophizing, jaw limitation, and painful body sites associated with pain-related impact.

Original languageEnglish (US)
JournalJournal of Pain
DOIs
StateAccepted/In press - Jan 1 2018
Externally publishedYes

Fingerprint

Temporomandibular Joint Disorders
Cross-Sectional Studies
Pain
Area Under Curve
Catastrophization
Confidence Intervals
Jaw
Independent Living
Aptitude
ROC Curve
Chronic Pain
Health Care Costs

Keywords

  • area under the receiver operating characteristic curve
  • pain-related disability
  • predictive value of tests
  • quality of life
  • Temporomandibular disorders

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Anesthesiology and Pain Medicine

Cite this

Miller, V. E., Poole, C., Golightly, Y., Barrett, D., Chen, D. G., Ohrbach, R., ... Slade, G. D. (Accepted/In press). Characteristics Associated With High-Impact Pain in People With Temporomandibular Disorder: A Cross-Sectional Study. Journal of Pain. https://doi.org/10.1016/j.jpain.2018.09.007

Characteristics Associated With High-Impact Pain in People With Temporomandibular Disorder : A Cross-Sectional Study. / Miller, Vanessa E.; Poole, Charles; Golightly, Yvonne; Barrett, Deborah; Chen, Ding Geng; Ohrbach, Richard; Greenspan, Joel Daniel; Fillingim, Roger B.; Slade, Gary D.

In: Journal of Pain, 01.01.2018.

Research output: Contribution to journalArticle

Miller, Vanessa E. ; Poole, Charles ; Golightly, Yvonne ; Barrett, Deborah ; Chen, Ding Geng ; Ohrbach, Richard ; Greenspan, Joel Daniel ; Fillingim, Roger B. ; Slade, Gary D. / Characteristics Associated With High-Impact Pain in People With Temporomandibular Disorder : A Cross-Sectional Study. In: Journal of Pain. 2018.
@article{1a2ff203cb534f779ecba8128a760684,
title = "Characteristics Associated With High-Impact Pain in People With Temporomandibular Disorder: A Cross-Sectional Study",
abstract = "High-impact (disabling) pain diminishes the quality of life and increases health care costs. The purpose of this study was to identify the variables that distinguish between high- and low-impact pain among individuals with painful temporomandibular disorder (TMD). Community-dwelling adults (N = 846) with chronic TMD completed standardized questionnaires that assessed the following: 1) sociodemographic characteristics, 2) psychological distress, 3) clinical pain, and 4) experimental pain. We used high-impact pain, classified using the Graded Chronic Pain Scale, as the dependent variable in logistic regression modeling to evaluate the contribution of variables from each domain. Cross-validated area under the receiver operating characteristic curve (AUC) quantified model discrimination. One-third of the participants had high-impact pain. Sociodemographic variables discriminated weakly between low- and high-impact pain (AUC =.61, 95{\%} confidence interval [CI] = 0.57, 0.65), with the exception of race. An 18-variable model encompassing all 4 domains had good discrimination (AUC = 0.79, 95{\%} CI = 0.75, 0.82), as did a simplified model (sociodemographic variables plus catastrophizing, jaw limitation, and number of painful body sites) (AUC = 0.79, 95{\%} CI = 0.76, 0.82). Duration of pain, sex, and experimental pain testing results were not associated. The characteristics that discriminated most effectively between people with low- and high-impact TMD pain included clinical pain features and the ability to cope with pain. Perspective: This article presents the results of a multivariable model designed to discriminate between people with high- and low-impact pain in a community-based sample of people with painful chronic TMD. The findings emphasize the importance of catastrophizing, jaw limitation, and painful body sites associated with pain-related impact.",
keywords = "area under the receiver operating characteristic curve, pain-related disability, predictive value of tests, quality of life, Temporomandibular disorders",
author = "Miller, {Vanessa E.} and Charles Poole and Yvonne Golightly and Deborah Barrett and Chen, {Ding Geng} and Richard Ohrbach and Greenspan, {Joel Daniel} and Fillingim, {Roger B.} and Slade, {Gary D.}",
year = "2018",
month = "1",
day = "1",
doi = "10.1016/j.jpain.2018.09.007",
language = "English (US)",
journal = "Journal of Pain",
issn = "1526-5900",
publisher = "Churchill Livingstone",

}

TY - JOUR

T1 - Characteristics Associated With High-Impact Pain in People With Temporomandibular Disorder

T2 - A Cross-Sectional Study

AU - Miller, Vanessa E.

AU - Poole, Charles

AU - Golightly, Yvonne

AU - Barrett, Deborah

AU - Chen, Ding Geng

AU - Ohrbach, Richard

AU - Greenspan, Joel Daniel

AU - Fillingim, Roger B.

AU - Slade, Gary D.

PY - 2018/1/1

Y1 - 2018/1/1

N2 - High-impact (disabling) pain diminishes the quality of life and increases health care costs. The purpose of this study was to identify the variables that distinguish between high- and low-impact pain among individuals with painful temporomandibular disorder (TMD). Community-dwelling adults (N = 846) with chronic TMD completed standardized questionnaires that assessed the following: 1) sociodemographic characteristics, 2) psychological distress, 3) clinical pain, and 4) experimental pain. We used high-impact pain, classified using the Graded Chronic Pain Scale, as the dependent variable in logistic regression modeling to evaluate the contribution of variables from each domain. Cross-validated area under the receiver operating characteristic curve (AUC) quantified model discrimination. One-third of the participants had high-impact pain. Sociodemographic variables discriminated weakly between low- and high-impact pain (AUC =.61, 95% confidence interval [CI] = 0.57, 0.65), with the exception of race. An 18-variable model encompassing all 4 domains had good discrimination (AUC = 0.79, 95% CI = 0.75, 0.82), as did a simplified model (sociodemographic variables plus catastrophizing, jaw limitation, and number of painful body sites) (AUC = 0.79, 95% CI = 0.76, 0.82). Duration of pain, sex, and experimental pain testing results were not associated. The characteristics that discriminated most effectively between people with low- and high-impact TMD pain included clinical pain features and the ability to cope with pain. Perspective: This article presents the results of a multivariable model designed to discriminate between people with high- and low-impact pain in a community-based sample of people with painful chronic TMD. The findings emphasize the importance of catastrophizing, jaw limitation, and painful body sites associated with pain-related impact.

AB - High-impact (disabling) pain diminishes the quality of life and increases health care costs. The purpose of this study was to identify the variables that distinguish between high- and low-impact pain among individuals with painful temporomandibular disorder (TMD). Community-dwelling adults (N = 846) with chronic TMD completed standardized questionnaires that assessed the following: 1) sociodemographic characteristics, 2) psychological distress, 3) clinical pain, and 4) experimental pain. We used high-impact pain, classified using the Graded Chronic Pain Scale, as the dependent variable in logistic regression modeling to evaluate the contribution of variables from each domain. Cross-validated area under the receiver operating characteristic curve (AUC) quantified model discrimination. One-third of the participants had high-impact pain. Sociodemographic variables discriminated weakly between low- and high-impact pain (AUC =.61, 95% confidence interval [CI] = 0.57, 0.65), with the exception of race. An 18-variable model encompassing all 4 domains had good discrimination (AUC = 0.79, 95% CI = 0.75, 0.82), as did a simplified model (sociodemographic variables plus catastrophizing, jaw limitation, and number of painful body sites) (AUC = 0.79, 95% CI = 0.76, 0.82). Duration of pain, sex, and experimental pain testing results were not associated. The characteristics that discriminated most effectively between people with low- and high-impact TMD pain included clinical pain features and the ability to cope with pain. Perspective: This article presents the results of a multivariable model designed to discriminate between people with high- and low-impact pain in a community-based sample of people with painful chronic TMD. The findings emphasize the importance of catastrophizing, jaw limitation, and painful body sites associated with pain-related impact.

KW - area under the receiver operating characteristic curve

KW - pain-related disability

KW - predictive value of tests

KW - quality of life

KW - Temporomandibular disorders

UR - http://www.scopus.com/inward/record.url?scp=85056246883&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85056246883&partnerID=8YFLogxK

U2 - 10.1016/j.jpain.2018.09.007

DO - 10.1016/j.jpain.2018.09.007

M3 - Article

C2 - 30292793

AN - SCOPUS:85056246883

JO - Journal of Pain

JF - Journal of Pain

SN - 1526-5900

ER -