title: Gender differences in acute and chronic pain in the emergency department: results of the 2014 Academic Emergency Medicine consensus conference pain section.
abstract: Pain is a leading public health problem in the United States, with an annual economic burden of more than $630 billion, and is one of the most common reasons that individuals seek emergency department (ED) care. There is a paucity of data regarding sex differences in the assessment and treatment of acute and chronic pain conditions in the ED. The Academic Emergency Medicine consensus conference convened in Dallas, Texas, in May 2014 to develop a research agenda to address this issue among others related to sex differences in the ED. Prior to the conference, experts and stakeholders from emergency medicine and the pain research field reviewed the current literature and identified eight candidate priority areas. At the conference, these eight areas were reviewed and all eight were ratified using a nominal group technique to build consensus. These priority areas were: 1) gender differences in the pharmacological and nonpharmacological interventions for pain, including differences in opioid tolerance, side effects, or misuse; 2) gender differences in pain severity perceptions, clinically meaningful differences in acute pain, and pain treatment preferences; 3) gender differences in pain outcomes of ED patients across the life span; 4) gender differences in the relationship between acute pain and acute psychological responses; 5) the influence of physician-patient gender differences and characteristics on the assessment and treatment of pain; 6) gender differences in the influence of acute stress and chronic stress on acute pain responses; 7) gender differences in biological mechanisms and molecular pathways mediating acute pain in ED populations; and 8) gender differences in biological mechanisms and molecular pathways mediating chronic pain development after trauma, stress, or acute illness exposure. These areas represent priority areas for future scientific inquiry, and gaining understanding in these will be essential to improving our understanding of sex and gender differences in the assessment and treatment of pain conditions in emergency care settings.
authors.affiliation: Department of Emergency Medicine, Indiana University School of Medicine, Indianapolis, IN.
authors.forename: Paul I
authors.initials: PI
authors.lastname: Musey
authors.forename: Sarah D
authors.initials: SD
authors.lastname: Linnstaedt
authors.forename: Timothy F
authors.initials: TF
authors.lastname: Platts-Mills
authors.forename: James R
authors.initials: JR
authors.lastname: Miner
authors.forename: Andrey V
authors.initials: AV
authors.lastname: Bortsov
authors.forename: Basmah
authors.initials: B
authors.lastname: Safdar
authors.forename: Polly
authors.initials: P
authors.lastname: Bijur
authors.forename: Alex
authors.initials: A
authors.lastname: Rosenau
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Tsze
authors.forename: Andrew K
authors.initials: AK
authors.lastname: Chang
authors.forename: Suprina
authors.initials: S
authors.lastname: Dorai
authors.forename: Kirsten G
authors.initials: KG
authors.lastname: Engel
authors.forename: James A
authors.initials: JA
authors.lastname: Feldman
authors.forename: Angela M
authors.initials: AM
authors.lastname: Fusaro
authors.forename: David C
authors.initials: DC
authors.lastname: Lee
authors.forename: Mark
authors.initials: M
authors.lastname: Rosenberg
authors.forename: Francis J
authors.initials: FJ
authors.lastname: Keefe
authors.forename: David A
authors.initials: DA
authors.lastname: Peak
authors.forename: Catherine S
authors.initials: CS
authors.lastname: Nam
authors.forename: Roma G
authors.initials: RG
authors.lastname: Patel
authors.forename: Roger B
authors.initials: RB
authors.lastname: Fillingim
authors.forename: Samuel A
authors.initials: SA
authors.lastname: McLean
mesh_terms: D000208:Acute Disease; D002908:Chronic Disease; D004635:Emergency Medicine; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D005260:Female; D005783:Gender Identity; D006801:Humans; D008297:Male; D010146:Pain / Q000453:epidemiology* / Q000523:psychology; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement / Q000379:methods; D010817:Physician-Patient Relations; D011634:Public Health; D012727:Sex Characteristics; D012737:Sex Factors; D013315:Stress, Psychological / Q000453:epidemiology / Q000523:psychology; D013781:Texas; D014481:United States