疼痛研究に疫学を取り入れる強みと面白さ

抄録

Epidemiological research is still uncommon in the research field of pain in Japan. As the International Epidemiological Association advocated, epidemiology is not only “the study of the distribution and determinants of health–related states and events in the popula­tions,” but also “the application of this study to the control of health problems.” Therefore, epidemiology is able to technically control pain problems. In this manuscript, the author introduces the strong and fun points of the epidemiological approach in pain research from the view point of “pain epidemiologist” as minority in Japan. She emphasized that reproducibility is obviously an important issue in epidemiology as well as other scientific fields such as basic science. For example, the self–administered questionnaire that is a common tool in epidemiological study is developed with validity and reliabili­ty (i.e., reproducibility) although when compared with objective measures such as physiological findings and biomarkers, it is often misinterpreted as an unscientific method. She introduced her previous studies using the data of the survey related to menstrual pain, the Japan Gerontological Evaluation Study, the Shozu Herpes Zoster study, and so on. Through studies using the data from these projects, she figured out psychosocial risk factors of chronic pain, and impacts of chronic pain on daily life. Subsequently, she would like to find more evidence on the effectiveness of non–pharmacological treatment such as such as cognitive behavioral therapy, physiotherapy, and multidisciplinary treatment for patients with chronic pain in the Japanese population, and she will also demonstrate mechanisms for improving the condition of patients with chronic pain symptoms by these treatments using epidemiological studies. As such, she is currently straggling with analyzing the data from a behavioral activation rehabilitation program that was developed by Dr. Michael Sullivan, her supervisor in McGill University, Canada. This program was designed to study disability and sick leave due to pain. She believes that the analytic strategy related to this program and valuable findings will contribute to future studies on the effectiveness of non–pharmacological treatment for patients with pain symptoms. She stated that the combination of basic science, clinical factors, and epidemiology (i.e., translational research or reverse translational research) has great power to shed light on the complicated pathology of pain symptoms.