Hieu-Pham/cpgQA huggingface dataset:
Background information

There were also some differences in the methodology used between the development of the VA/DoD OT  CPG and the CDC guideline. Along with a clinical evidence review, during which the evidence was evaluated using GRADE, the CDC guideline developers also considered the findings of a contextual evidence review. Further, the CDC Core Expert Group, which consisted of subject matter experts,  representatives of primary care professional societies and state agencies, and an expert in guideline methodology, reviewed recommendations drafted by the CDC and evaluated how the evidence was used in the development of the recommendations, rather than developing the recommendations themselves  (as was the VA/DoD OT Work Group’s role in the development of the VA/DoD OT CPG). While experts provided feedback on the CDC recommendations and their development, the CDC determined the final recommendations. CDC also used a review process considering and incorporating feedback from federal partners (e.g., SAMHSA, VA, DoD), stakeholders (e.g., professional organizations, delivery systems,  community organizations), and other constituents (e.g., clinicians, prospective patients). The CDC guideline development process included notice in the Federal Register for a public review and comment period as well as peer review. Thus, the recommendations made in the CDC guideline, although similar to those made in this CPG, were likely based on a slightly different evidence base and revised based on the feedback of individuals who were considering a larger group of potential patients relative to the VA/DoD. Thus, while the VA/DoD OT Work Group was aware of the release of the CDC guideline and considered potential implications, the CDC guideline did not form the basis of the deliberations on the strength or direction of these recommendations. The Work Group followed the VA/DoD Guideline for Guidelines, a document that details the process by which VA/DoD guidelines will be developed, including the use of the  GRADE methodology. As required by Congress in CARA, the Work Group reviewed and considered the  CDC guideline and its inclusion in the VA/DoD OT CPG.

Question: What is the VA/DoD Guideline for Guidelines?
Answer: a document that details the process by which VA/DoD guidelines will be developed, including the use of the  GRADE methodology
Background information

Pain is defined as “an unpleasant sensory and emotional experience associated with actual or potential  tissue damage, or described in terms of such damage…Pain is always subjective…It is unquestionably a  sensation in a part or parts of the body, but it is also always unpleasant and therefore also an emotional  experience.” All of these facets signify the complexity of pain as a condition by itself and how it  relates to both the brain and the body. Pain as a symptom is multifaceted and is described and  characterized by many factors such as its quality (e.g., sharp versus dull), intensity, timing, location, and  whether it is associated with position or movement.  

Question: Define pain according to the VA/DoD CPG.
Answer: an unpleasant sensory and emotional experience associated with actual or potential  tissue damage, or described in terms of such damage…Pain is always subjective…It is unquestionably a  sensation in a part or parts of the body, but it is also always unpleasant and therefore also an emotional  experience.
Background information

Pain is defined as “an unpleasant sensory and emotional experience associated with actual or potential  tissue damage, or described in terms of such damage…Pain is always subjective…It is unquestionably a  sensation in a part or parts of the body, but it is also always unpleasant and therefore also an emotional  experience.” All of these facets signify the complexity of pain as a condition by itself and how it  relates to both the brain and the body. Pain as a symptom is multifaceted and is described and  characterized by many factors such as its quality (e.g., sharp versus dull), intensity, timing, location, and  whether it is associated with position or movement.  

Question: How to characterize pain as a symptom?
Answer: multifaceted
Background information

Pain is defined as “an unpleasant sensory and emotional experience associated with actual or potential  tissue damage, or described in terms of such damage…Pain is always subjective…It is unquestionably a  sensation in a part or parts of the body, but it is also always unpleasant and therefore also an emotional  experience.” All of these facets signify the complexity of pain as a condition by itself and how it  relates to both the brain and the body. Pain as a symptom is multifaceted and is described and  characterized by many factors such as its quality (e.g., sharp versus dull), intensity, timing, location, and  whether it is associated with position or movement.  

Question: Which factors can describe and characterize pain as a symptom?
Answer: quality (e.g., sharp versus dull), intensity, timing, location, and  whether it is associated with position or movement
Background information

Chronic pain is defined as pain lasting three months or more. It is often associated with changes in the  central nervous system (CNS) known as central sensitization. Whereas acute and subacute pain are  thought to involve primarily nociceptive processing areas in the CNS, chronic pain is thought to be  associated with alterations in brain centers involved with emotions, reward, and executive function as well  as central sensitization of nociceptive pathways across several CNS areas.

Question: Define chronic pain according to the VA/DoD CPG.
Answer: pain lasting three months or more. It is often associated with changes in the  central nervous system (CNS) known as central sensitization.
Background information

Chronic pain is defined as pain lasting three months or more. It is often associated with changes in the  central nervous system (CNS) known as central sensitization. Whereas acute and subacute pain are  thought to involve primarily nociceptive processing areas in the CNS, chronic pain is thought to be  associated with alterations in brain centers involved with emotions, reward, and executive function as well  as central sensitization of nociceptive pathways across several CNS areas.

Question: Which areas in the CNS are involved in the acute and subacute pain?
Answer: primarily nociceptive processing areas
Background information

Chronic pain is defined as pain lasting three months or more. It is often associated with changes in the  central nervous system (CNS) known as central sensitization. Whereas acute and subacute pain are  thought to involve primarily nociceptive processing areas in the CNS, chronic pain is thought to be  associated with alterations in brain centers involved with emotions, reward, and executive function as well  as central sensitization of nociceptive pathways across several CNS areas.

Question: What is CNS?
Answer: central nervous system
Background information

Chronic pain is defined as pain lasting three months or more. It is often associated with changes in the  central nervous system (CNS) known as central sensitization. Whereas acute and subacute pain are  thought to involve primarily nociceptive processing areas in the CNS, chronic pain is thought to be  associated with alterations in brain centers involved with emotions, reward, and executive function as well  as central sensitization of nociceptive pathways across several CNS areas.

Question: Which areas in the CNS are involved in the chronic pain?
Answer: chronic pain is thought to be  associated with alterations in brain centers involved with emotions, reward, and executive function as well  as central sensitization of nociceptive pathways across several CNS areas.
Background information

There are many causes of chronic pain. Pain arising from persistent peripheral stimulation could be  mechanical or chemical/inflammatory in nature typically leading to well-localized nociceptive mechanism pain. Mechanical or inflammatory pain with a visceral origin may produce a less localized pain.  Neuropathic pain due to injury or disease of the central or peripheral nervous system (e.g., spinal cord  injury, diabetic neuropathy, radiculopathy) may lead to poorly localized symptoms such as diffuse pain,  burning, numbness, or a feeling of skin sensitivity.  

Question: What are the causes of chronic pain?
Answer: Pain arising from persistent peripheral stimulation could be  mechanical or chemical/inflammatory in nature typically leading to well-localized nociceptive mechanism pain. Mechanical or inflammatory pain with a visceral origin may produce a less localized pain.  Neuropathic pain due to injury or disease of the central or peripheral nervous system (e.g., spinal cord  injury, diabetic neuropathy, radiculopathy) may lead to poorly localized symptoms such as diffuse pain,  burning, numbness, or a feeling of skin sensitivity.
Background information

There are many causes of chronic pain. Pain arising from persistent peripheral stimulation could be  mechanical or chemical/inflammatory in nature typically leading to well-localized nociceptive mechanism pain. Mechanical or inflammatory pain with a visceral origin may produce a less localized pain.  Neuropathic pain due to injury or disease of the central or peripheral nervous system (e.g., spinal cord  injury, diabetic neuropathy, radiculopathy) may lead to poorly localized symptoms such as diffuse pain,  burning, numbness, or a feeling of skin sensitivity.  

Question: Which pain can lead to well-localized nociceptive mechanism pain?
Answer: Pain arising from persistent peripheral stimulation
Background information

There are many causes of chronic pain. Pain arising from persistent peripheral stimulation could be  mechanical or chemical/inflammatory in nature typically leading to well-localized nociceptive mechanism pain. Mechanical or inflammatory pain with a visceral origin may produce a less localized pain.  Neuropathic pain due to injury or disease of the central or peripheral nervous system (e.g., spinal cord  injury, diabetic neuropathy, radiculopathy) may lead to poorly localized symptoms such as diffuse pain,  burning, numbness, or a feeling of skin sensitivity.  

Question: Which pain could be mechanical or chemical/inflammatory in nature?
Answer: Pain arising from persistent peripheral stimulation
Background information

There are many causes of chronic pain. Pain arising from persistent peripheral stimulation could be  mechanical or chemical/inflammatory in nature typically leading to well-localized nociceptive mechanism pain. Mechanical or inflammatory pain with a visceral origin may produce a less localized pain.  Neuropathic pain due to injury or disease of the central or peripheral nervous system (e.g., spinal cord  injury, diabetic neuropathy, radiculopathy) may lead to poorly localized symptoms such as diffuse pain,  burning, numbness, or a feeling of skin sensitivity.  

Question: Which pain may produce a less localized pain?
Answer: Mechanical or inflammatory pain with a visceral origin
Background information

There are many causes of chronic pain. Pain arising from persistent peripheral stimulation could be  mechanical or chemical/inflammatory in nature typically leading to well-localized nociceptive mechanism pain. Mechanical or inflammatory pain with a visceral origin may produce a less localized pain.  Neuropathic pain due to injury or disease of the central or peripheral nervous system (e.g., spinal cord  injury, diabetic neuropathy, radiculopathy) may lead to poorly localized symptoms such as diffuse pain,  burning, numbness, or a feeling of skin sensitivity.  

Question: Which pain may lead to poorly localized symptoms?
Answer: Neuropathic pain due to injury or disease of the central or peripheral nervous system (e.g., spinal cord  injury, diabetic neuropathy, radiculopathy)
Background information

There are many causes of chronic pain. Pain arising from persistent peripheral stimulation could be  mechanical or chemical/inflammatory in nature typically leading to well-localized nociceptive mechanism pain. Mechanical or inflammatory pain with a visceral origin may produce a less localized pain.  Neuropathic pain due to injury or disease of the central or peripheral nervous system (e.g., spinal cord  injury, diabetic neuropathy, radiculopathy) may lead to poorly localized symptoms such as diffuse pain,  burning, numbness, or a feeling of skin sensitivity.  

Question: What are some examples of poorly localized symptoms?
Answer: diffuse pain,  burning, numbness, or a feeling of skin sensitivity
Background information

A comprehensive pain assessment includes a biopsychosocial interview and focused physical exam. Elements of the biopsychosocial pain interview include a pain-related history, assessment of pertinent  medical and psychiatric comorbidities including personal and family history of SUD, functional status and  functional goals, coping strategies, and a variety of psychosocial factors such as the patient’s beliefs and  expectations about chronic pain and its treatment. Patients with chronic pain may also experience  worsened quality of life, mental health, immune system function, physical function, sleep, employment  status, and impaired personal relationships. Worsening of some of these factors (e.g., quality of  life, change in employment status) seems to also be associated with pain severity and the presence of  psychiatric comorbidities. Patients with chronic pain report psychological complaints (e.g.,  depression, anxiety, poor self-efficacy, poor general emotional functioning) more often than patients  without chronic pain. Further, there can be social and psychological consequences such as decreased  ability to successfully maintain relationship and career roles and increased depression, fear, and anxiety as  a result of pain.

Question: What does a comprehensive pain assessment include?
Answer: a biopsychosocial interview and focused physical exam
Background information

A comprehensive pain assessment includes a biopsychosocial interview and focused physical exam. Elements of the biopsychosocial pain interview include a pain-related history, assessment of pertinent  medical and psychiatric comorbidities including personal and family history of SUD, functional status and  functional goals, coping strategies, and a variety of psychosocial factors such as the patient’s beliefs and  expectations about chronic pain and its treatment. Patients with chronic pain may also experience  worsened quality of life, mental health, immune system function, physical function, sleep, employment  status, and impaired personal relationships. Worsening of some of these factors (e.g., quality of  life, change in employment status) seems to also be associated with pain severity and the presence of  psychiatric comorbidities. Patients with chronic pain report psychological complaints (e.g.,  depression, anxiety, poor self-efficacy, poor general emotional functioning) more often than patients  without chronic pain. Further, there can be social and psychological consequences such as decreased  ability to successfully maintain relationship and career roles and increased depression, fear, and anxiety as  a result of pain.

Question: What are the elements of the biopsychosocial pain interview?
Answer: a pain-related history, assessment of pertinent  medical and psychiatric comorbidities including personal and family history of SUD, functional status and  functional goals, coping strategies, and a variety of psychosocial factors such as the patient’s beliefs and  expectations about chronic pain and its treatment
Background information

A comprehensive pain assessment includes a biopsychosocial interview and focused physical exam. Elements of the biopsychosocial pain interview include a pain-related history, assessment of pertinent  medical and psychiatric comorbidities including personal and family history of SUD, functional status and  functional goals, coping strategies, and a variety of psychosocial factors such as the patient’s beliefs and  expectations about chronic pain and its treatment. Patients with chronic pain may also experience  worsened quality of life, mental health, immune system function, physical function, sleep, employment  status, and impaired personal relationships. Worsening of some of these factors (e.g., quality of  life, change in employment status) seems to also be associated with pain severity and the presence of  psychiatric comorbidities. Patients with chronic pain report psychological complaints (e.g.,  depression, anxiety, poor self-efficacy, poor general emotional functioning) more often than patients  without chronic pain. Further, there can be social and psychological consequences such as decreased  ability to successfully maintain relationship and career roles and increased depression, fear, and anxiety as  a result of pain.

Question: What may be experienced by the patients with chronic pain?
Answer: worsened quality of life, mental health, immune system function, physical function, sleep, employment  status, and impaired personal relationships
Background information

A comprehensive pain assessment includes a biopsychosocial interview and focused physical exam. Elements of the biopsychosocial pain interview include a pain-related history, assessment of pertinent  medical and psychiatric comorbidities including personal and family history of SUD, functional status and  functional goals, coping strategies, and a variety of psychosocial factors such as the patient’s beliefs and  expectations about chronic pain and its treatment. Patients with chronic pain may also experience  worsened quality of life, mental health, immune system function, physical function, sleep, employment  status, and impaired personal relationships. Worsening of some of these factors (e.g., quality of  life, change in employment status) seems to also be associated with pain severity and the presence of  psychiatric comorbidities. Patients with chronic pain report psychological complaints (e.g.,  depression, anxiety, poor self-efficacy, poor general emotional functioning) more often than patients  without chronic pain. Further, there can be social and psychological consequences such as decreased  ability to successfully maintain relationship and career roles and increased depression, fear, and anxiety as  a result of pain.

Question: What can be associated with pain severity and the presence of  psychiatric comorbidities?
Answer: Worsening of some of these factors (e.g., quality of  life, change in employment status)
Background information

A comprehensive pain assessment includes a biopsychosocial interview and focused physical exam. Elements of the biopsychosocial pain interview include a pain-related history, assessment of pertinent  medical and psychiatric comorbidities including personal and family history of SUD, functional status and  functional goals, coping strategies, and a variety of psychosocial factors such as the patient’s beliefs and  expectations about chronic pain and its treatment. Patients with chronic pain may also experience  worsened quality of life, mental health, immune system function, physical function, sleep, employment  status, and impaired personal relationships. Worsening of some of these factors (e.g., quality of  life, change in employment status) seems to also be associated with pain severity and the presence of  psychiatric comorbidities. Patients with chronic pain report psychological complaints (e.g.,  depression, anxiety, poor self-efficacy, poor general emotional functioning) more often than patients  without chronic pain. Further, there can be social and psychological consequences such as decreased  ability to successfully maintain relationship and career roles and increased depression, fear, and anxiety as  a result of pain.

Question: Who report psychological complaints more often?
Answer: Patients with chronic pain
Background information

A comprehensive pain assessment includes a biopsychosocial interview and focused physical exam. Elements of the biopsychosocial pain interview include a pain-related history, assessment of pertinent  medical and psychiatric comorbidities including personal and family history of SUD, functional status and  functional goals, coping strategies, and a variety of psychosocial factors such as the patient’s beliefs and  expectations about chronic pain and its treatment. Patients with chronic pain may also experience  worsened quality of life, mental health, immune system function, physical function, sleep, employment  status, and impaired personal relationships. Worsening of some of these factors (e.g., quality of  life, change in employment status) seems to also be associated with pain severity and the presence of  psychiatric comorbidities. Patients with chronic pain report psychological complaints (e.g.,  depression, anxiety, poor self-efficacy, poor general emotional functioning) more often than patients  without chronic pain. Further, there can be social and psychological consequences such as decreased  ability to successfully maintain relationship and career roles and increased depression, fear, and anxiety as  a result of pain.

Question: What is reported more often by the patients with chronic pain than patients without chronic pain?
Answer: psychological complaints (e.g.,  depression, anxiety, poor self-efficacy, poor general emotional functioning)
Background information

A comprehensive pain assessment includes a biopsychosocial interview and focused physical exam. Elements of the biopsychosocial pain interview include a pain-related history, assessment of pertinent  medical and psychiatric comorbidities including personal and family history of SUD, functional status and  functional goals, coping strategies, and a variety of psychosocial factors such as the patient’s beliefs and  expectations about chronic pain and its treatment. Patients with chronic pain may also experience  worsened quality of life, mental health, immune system function, physical function, sleep, employment  status, and impaired personal relationships. Worsening of some of these factors (e.g., quality of  life, change in employment status) seems to also be associated with pain severity and the presence of  psychiatric comorbidities. Patients with chronic pain report psychological complaints (e.g.,  depression, anxiety, poor self-efficacy, poor general emotional functioning) more often than patients  without chronic pain. Further, there can be social and psychological consequences such as decreased  ability to successfully maintain relationship and career roles and increased depression, fear, and anxiety as  a result of pain.

Question: What are some examples of psychological complaints made by patients with chronic pain?
Answer: depression, anxiety, poor self-efficacy, poor general emotional functioning