219: Psychosocial Biomarkers of the Acute to Chronic Pain Signatures (A2CPS) Program

Topic: Clinical Science
Subtopic: Pain category (ICD-11), Chronic postsurgical pain, Psychology

Background and Aims: Post-surgical chronic pain is an under-recognized public health problem. Research shows that psychosocial factors are critical to the transition to chronic pain after injury, yet no large-scale comprehensive, multi-modal studies have considered biological factors alongside PROs. The Acute to Chronic Pain Signatures (A2CPS) study of over 2,400 participants examines a comprehensive array of factors including psychosocial factors. The goals of the A2CPS program are to identify individual factors and combined biosignatures that predict the transition from acute to chronic pain.

Methods: A2CPS includes psychosocial data from a comprehensive panel of patient-reported outcomes (PRO) and functional testing. These factors are evaluated before and for up to six months after surgery. This presentation will focus on psychosocial measures in the third A2CPS data release, including pre-surgery data collected from 1935 participants. Here we describe the rationale for the selected psychosocial measures, timing of administration, and group differences between knee arthroplasty and thoracic surgery psychosocial cohort measures. We also discuss psychosocial variable associations at pre-surgery, and simple cross-modality analyses, demonstrating their utility and value.

Results: We selected a comprehensive battery of self-reported measures across multiple domains, including function, psychological, symptoms, and quality of life, as well as performance-based functional tests. To determine the overlap between measures, we used an exploratory factor analysis, which revealed that A2CPS questionnaires evaluated five distinct psychosocial domains: resilience, behavioral perseverance, negative affect, behavioral avoidance, and personality.

Conclusions: These findings support the overall value of this dataset in examining distinct psychosocial characteristics of surgery patients. The power of these PROs in combination with EHR, brain imaging, and mult-omics data give this comprehensive dataset tremendous potential for analysis beyond pain conditions as well as predicting who will develop persistent pain after surgery.

References: Berardi G, Frey-Law L, Sluka KA, Bayman EO, Coffey CS, Ecklund D, Vance CGT, Dailey DL, Burns J, Buvanendran A, McCarthy RJ, Jacobs J, Zhou XJ, Wixson R, Balach T, Brummett CM, Clauw D, Colquhoun D, Harte SE, Harris RE, Williams DA, Chang AC, Waljee J, Fisch KM, Jepsen K, Laurent LC, Olivier M, Langefeld CD, Howard TD, Fiehn O, Jacobs JM, Dakup P, Qian WJ, Swensen AC, Lokshin A, Lindquist M, Caffo BS, Crainiceanu C, Zeger S, Kahn A, Wager T, Taub M, Ford J, Sutherland SP, Wandner LD. Multi-Site Observational Study to Assess Biomarkers for Susceptibility or Resilience to Chronic Pain: The Acute to Chronic Pain Signatures (A2CPS) Study Protocol. Front Med (Lausanne). 2022 Apr 25;9:849214. doi: 10.3389/fmed.2022.849214. PMID: 35547202; PMCID: PMC9082267.

Sluka KA, Wager TD, Sutherland SP, Labosky PA, Balach T, Bayman EO, Berardi G, Brummett CM, Burns J, Buvanendran A, Caffo B, Calhoun VD, Clauw D, Chang A, Coffey CS, Dailey DL, Ecklund D, Fiehn O, Fisch KM, Frey Law LA, Harris RE, Harte SE, Howard TD, Jacobs J, Jacobs JM, Jepsen K, Johnston N, Langefeld CD, Laurent LC, Lenzi R, Lindquist MA, Lokshin A, Kahn A, McCarthy RJ, Olivier M, Porter L, Qian WJ, Sankar CA, Satterlee J, Swensen AC, Vance CGT, Waljee J, Wandner LD, Williams DA, Wixson RL, Zhou XJ; A2CPS Consortium. Predicting chronic postsurgical pain: current evidence and a novel program to develop predictive biomarker signatures. Pain. 2023 Sep 1;164(9):1912-1926. doi: 10.1097/j.pain.0000000000002938. Epub 2023 Jun 15. PMID: 37326643; PMCID: PMC10436361.

Presenting Author: Kathleen Sluka
Submitting Author: Kathleen Sluka

Senior Author: Emine Bayman

IASP 2026 Global Year theme of Neuropathic Pain: Yes

• Laura Frey- Law - University of Iowa
• John Burns - Rush University Medical College
• Briha Ansari - Johns Hopkins University
• Giovanni Berardi - University of Iowa
• Kathleen Sluka - University of Iowa
• Ezgi Yarasir - University of Iowa
• Josh Jacobs - Rush University Medical College
• Dana Dailey - University of Iowa
• Carol Vance - University of Iowa
• Seth Ryan Berke - Johns Hopkins University
• Stephani Sutherland - Johns Hopkins University
• David Williams - University of Michigan
• Emine Bayman - University of Iowa
• et al A2CPS Consortium - Johns Hopkins University