The second meeting of the revitalized NIH Pain Consortium was convened on Monday November 17, 2003 from 1:00-2:30 pm. Thirty individuals representing 14 NIH Institutes, Centers (ICs), and NIH OD Offices participated in the meeting.

I. Welcome and Introductions

Recognizing the full agenda for this meeting, the Pain Consortium Co-chairs -- Dr. Patricia Grady, Director, National Institute of Nursing Research (NINR), Dr. Story Landis, Director, National Institute of Neurological Disorders and Stroke (NINDS), and Dr. Lawrence Tabak, Director National Institute of Dental and Craniofacial Research (NIDCR) -- briefly welcomed the group and moved to the first agenda item. This was Dr. Landis’ first meeting as Co-chair, following her appointment in September 2003 as NINDS Director.

II. NIH Pain Research Preliminary Portfolio Analysis

Dr. Linda Porter noted that in follow-up to the June meeting of the Consortium, the group agreed that an important first step was to analyze the current NIH portfolio in pain research. Dr. Porter agreed to lead a working group to address this analysis, and recognized the members: Ray Dionne, NIDCR, Barbara Kellner, NIA, John Kusiak, NIDCR, Wendy Liffers, NIDCR, Heather Rieff, NINDS and Paul Meyers and Janet He from NINDS. A request for an inventory of FY 2002 data was sent to the ICs and addressed projects supported by the ICs, a narrative description of the IC portfolio, and lists of workshops, initiatives, and outreach efforts. Dr. Porter informed the group that 18 ICs provided data relative to the request, and 24 ICs provided narratives.

Dr. Porter then presented a comprehensive review of the collected data and the results of the working group’s assorted analyses of this data. This PowerPoint presentation will be distributed to the full consortium membership along with the minutes. Five handouts related to the presentation were provided to the attendees:

• Definitions Provided to the IC Representatives to Determine Categories of Pain Research
  
• NIH Guide Listing for “PAIN;” Current Initiatives 2000-2003
  
• IC Participation in Recent Initiatives Related to Pain Data Reported for the Pain Survey
  
• Narrative Summaries of Pain Research Supported by ICs, and
  
• For the Future: Plans and Suggestion for Pain Research
  

Discussion of balance, opportunities and future directions

Dr. Porter and the Consortium Co-chairs then led a discussion with the full group addressing future directions for pain research at NIH. A draft list of perceived needs was reviewed. Dr. Tabak noted that the list seemed very specific and narrow. He questioned the group whether it should go broader in its thinking on what we are missing in pain research. He noted that the analysis just presented found that a total of approximately $173 million was spent by the ICs on pain research in FY 2002, out of a total NIH budget of $23.3 billion for the same year. This appeared to be an indicator of gaps and opportunities.

Dr. Ann Berger suggested that the group consider developing a comprehensive model of research for pain, noting the distinction between research and care/health services. The question was raised as to whether AHRQ should be asked to join the group to address the health services aspects. The distinction between research on acute versus chronic pain was also discussed.

The group agreed that the action items for this portfolio analysis should involved sending out Dr. Porter’s presentation and data, asking the consortium members to review it and to make specific suggestions regarding gaps and broad future directions for NIH pain research. It was noted that while ICs could be parochial in this regard relative to their missions and portfolios, they should ensure that their suggested future directions address multiple ICs.

The group then went a step further and began proposing specific future directions to be included for the group to address:

• Mechanisms and pathophysiology of pain
  
• Pharmacological treatments
  
• Non-pharmacological treatments
  
• Pain re-occurrence and prevention
  
• Long term pain management
  
• Psychosocial/spiritual therapies
  
• Acute vs. chronic pain/conversion from acute to chronic pain
  
• Instruments for pain measurement (OBSSR road map initiative)
  
• Development of physiologic measures
  
• Age/gender/ethnicity differences in pain
  
• Co-morbidity of pain disorders
  
• Strategies for introducing findings in to practice
  
• Dissemination of findings
  
• Professional education programs (for health care providers)
  
• Public outreach programs
  
• Translation from basic research to pain management in humans
  
• Bi-translational research–understanding mechanisms of alternative therapies
  
• Epidemiology of pain
  

The action item for the members is to:

1. Reorder and structure the above list of future directions, and
   
2. Identify your top 3 top key gaps/research needs in the above list.
   

The group was asked to forward their proposals and comments to Wendy Liffers (wendy.liffers@nih.gov) for compilation into a consolidated list to be discussed at the next meeting of the Pain Consortium.

III. Update on Status of Pain Consortium Website

The valuable discussion regarding the portfolio analysis took up the majority of time for the meeting, so it was agreed that we would have an abbreviated discussion of the website for the Pain Consortium, and postpone the scheduled “Overview and Update on the Activities of the Temporomandibular Joint and Muscle Disease Interagency Working Group” until the next meeting. In addition, the IC Round Robin and updates, including a discussion of the NCI Palliative Care Working group proposal, would be postponed until the next meeting.

Ms. Jody Dove, NIDCR, distributed a handout outlining the proposed structure and content for the NIH Pain Consortium Website. She next reviewed this information in an on-line demonstration via navigating the beta version of the Website that has already been constructed.

A number of issues of concern were raised regarding the content of the website, particularly as they related to the potential liabilities of “referring” visitors to the site, particularly patients, to either specialists or centers of research, and outlining treatment options. Issues relevant to policies for linkage to other non-NIH websites were also raised. It was agreed that the Consortium Co-chairs would meet to discuss overall philosophy regarding the content of the website, and that this would be addressed in more detail at the next meeting.

Ms. Dove asked the individual members to send her the name of their IC designated web contact who will serve as the point of coordination for issues related to the website, including providing and updating information on the site.

VII. Summary of Action Items and Next Steps

(1) Ms. Liffers to distribute Linda Porter’s PowerPoint presentation on the FY 2002 NIH Pain Portfolio Analysis

(2) The group should review this presentation and data, and make specific suggestions regarding gaps and broad future directions for NIH pain research. ICs can be parochial in this regard relative to their missions and portfolios, but should ensure that their suggested future directions address multiple ICs.

More specifically, members should review the specific future directions for NIH Pain Research listed above and:

(A) Reorder and structure the above list of future directions, and
(B) Identify your top 3 top key gaps/research needs in the above list.

Please send proposals/comments to Wendy Liffers (wendy.liffers@nih.gov) by January 5th.

(3) Ms. Liffers to schedule meeting of the Pain Consortium Co-chairs to discuss website content and policy.

(4) Provide the name of your IC designated web contact who will serve as the point of coordination for issues related to the website, including providing and updating information on the site, to Ms. Jody Dove (dovej@mail.nih.gov) by January 5th.