The UNT Health Science Center in Fort Worth is pioneering a new way to combat back pain. It's called the Precision Pain Research Registry. Dr. John Licciardone is spearheading the project for the center — it aims to analyze the DNA of volunteers across Texas to come up with a better way to treat pain.
On the 'pain registry':
"Well, the pain registry right now is very unique because no other state in the United States has a similar registry. What we do is we collect data from patients that we've screened that qualify as having either subacute or chronic low back pain. And we will be using the data from the registry to help do research in various aspects of pain development."
On how it works:
"Actually, the registry involves much more than just DNA. We're looking at factors that may be related to the development of chronic pain and also at bio-psychosocial factors that may be related to pain. In addition to that the aspect that you're talking about is the genetics which leads into precision medicine and looking at identifying or targeting new therapies or drugs for certain patients based on their genetic components.
We're attempting to do what we call pragmatic research. What happens many times in clinical research is that the investigators focus on only one therapy. So for example in drug trials there may be a new drug that a pharmaceutical company is developing and they look only at the effect of that drug.
In the registry, we're looking at multiple components of pain and seeing how people are treated for their pain in real life. That involves not only what drugs they may be taking but also other non pharmacological treatments or even how they interact with their patient. Sometimes patients may be getting the same treatment but the way the physician explains the treatment and the rapport that they have with the physician may affect how the treatment works."
On precision medicine:
"The name precision medicine is suggestive of the concepts that we wanted to espouse in the registry. The registry was really developed back in 2016 following the president's State of the Union address where they rolled out the Precision Medicine Initiative.
The goal of the registry is to look at aspects of precision medicine as they relate to chronic pain. And so we're combining the genetics the pharmacokinetics and the bio-psychosocial aspects; and we called it precision because we want to target therapy to an individual person. And so that's the precision of the precise aspect of it."
On what patients are doing:
"They provide samples. So we collect blood samples saliva samples which are used for DNA analysis. And they basically answer a lot of questions about the nature of their pain. We have a series of validated research instruments that have been used elsewhere that are known to be good measures of pain.
We also collect information about as I mentioned before, their physician, how they handle their pain, how they cope with pain, how resilient they are. And then every quarter or every three months we ask them to come in and repeat many of those same measures.
We follow our patients longitudinally over time to determine which factors are related to progression of pain or which factors may be related to recovery from chronic pain."
What's behind the expansion in Dallas and Fort Worth:
"Quite simply we want to expand the number of people in the registry to increase our sample size because that will enable us to do more research involving many other treatment modalities or other research questions that we wish to answer.
So by increasing the numbers not only that we make our studies more statistically powerful but enables us to answer research questions that otherwise we could not."