Summary
Working together with international pain scientists, we have established a new framework to improve trustworthiness in pain science [1].
Context
In 2020, we identified some research that was untrustworthy in our field through a systematic review of psychological interventions for adults with chronic pain [2]. Next, we searched the literature for other similar trials by the same author and investigated them for trustworthiness. We found eight out of 10 papers in spinal pain were untrustworthy [3] so we wrote to journal editors to advise they should be retracted. Some journal editors retracted, whilst others did not [4]. We also assessed the impact on policy and clinical guidelines and found a median 58% reduction in the standardised mean difference when the untrustworthy trials were removed [5]. Since our investigation, other groups have found similar concerns in other trials by the first author.
One thing that struck us whilst completing this work was that there is no 'gold standard' way of identifying untrustworthy science, so we want to develop ideas around what would lead to trustworthy research.
This experience led us to want to establish a framework which could guide trustworthy research in pain science and beyond. This framework includes:
Equity, diversity, and inclusivity
Data authenticity
Balanced communication
Patient and public involvement and engagement
Methodological rigour
Openness and transparency
The framework provides guidance for researchers, institutions, policy makers, funders and journal editors. Short and long-term objectives are provided, as well as considerations for each aspect of trustworthy science along the research pipeline.
Reflections
We needed to bring together expertise from across science to develop the framework including data scientists, patient partners, preclinical researchers, clinical researchers, journal editors and researchers who had been involved in developing policy to ensure the framework was as relevant and applicable as possible.
Take home message
We should all be invested in making our research as trustworthy as possible and this framework provides immediate guidance and recommendations on how to improve trustworthiness and transparency.
About the author(s)
Dr Emma Fisher and Prof Christopher Eccleston helped to develop this framework, led by Prof Neil O’Connell at Brunel University.
Dr Fisher and Prof Eccleston's work is part of world-leading research being conducted at Bath by the Centre for Pain Research.
The work in this case study was funded by the ERA Network Grant (O’Connell NE, Belton J, Crombez C, Eccleston C, Fisher E, Ferraro MC, Hood A, Keefe F, Knaggs R, Norris E, Palermo T, Pickering G, Pogatzki-Zahn E, Rice ASCR, Richards G, Segelcke D, Smart KM, Soliman N, Stewart G, Tölle T, Turk D, Vollert J, Wainwright E, Wilkinson J, Williams A C de C. ENTRUST-PE: Enhancing Trust in Pain Evidence. ERA_NET NEURON)
Links
Further resources related to the framework can be found via the ENTRUST-PE initiative website. You can find out more from the video, factsheets, white paper, and related documents all linked from the site homepage.
The publication has recently been accepted into the Journal of Pain: https://doi.org/10.1016/j.jpain.2024.104736
References
O’Connell NE, Belton J, Crombez C, Eccleston C, Fisher E, Ferraro MC, Hood A, Keefe F, Knaggs R, Norris E, Palermo T, Pickering G, Pogatzki-Zahn E, Rice ASCR, Richards G, Segelcke D, Smart KM, Soliman N, Stewart G, Tölle T, Turk D, Vollert J, Wainwright E, Wilkinson J, WilliamS A C de C. ENTRUST-PE: An Integrated Framework for Trustworthy Pain Evidence (White paper). 2024; Open Science Framework Preprints.
Williams, A. C. D. C., Fisher, E., Hearn, L., Eccleston, C. Psychological interventions for adults with chronic pain (excluding headache). Cochrane Database of Systematic Reviews, 2020, 8. DOI: 10.1002/14651858.CD007407.pub4.
O'Connell, N.E., et al., Investigating the veracity of a sample of divergent published trial data in spinal pain. PAIN, 2023. 164(1): p. 72-83.
Williams A. C. D. C., Hearn, L., Moore, R.A., Stewart, G., Fisher, E., Eccleston, C., et al. Effective quality control in the medical literature: investigation and retraction vs inaction. J Clin Epidemiol 2023;157:156–7. https://doi.org/10.1016/j.jclinepi.2023.02.022
O’Connell NE, Moore RA, Stewart G, Fisher E, Hearn L, Eccleston C, et al. Investigating the veracity of a sample of divergent published trial data in spinal pain. PAIN, 2023;164:72–83. https://doi.org/10.1097/j.pain.0000000000002659