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| Comprehensive Pain |
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Patient Population
The Comprehensive Pain Program (CPP) at Toronto Western Hospital evaluates
650 new patients and about 1,500 follow-up patients yearly.
The majority of patients suffer from neuropathic pain or suspected neuropathic
pain. However, a substantial number suffer from a multiplicity of malignant
and non malignant pain disorders. The CPP is the most comprehensive diagnostic
and treatment center in the country and referrals come from within the
GTA, the province and nationally.
Education
The CPP is the training site for Physical Medicine, Anesthesia and
other subspecialty program residents. The ambulatory program serves
as an Ambulatory Clinic site for undergraduate medical students and
a Pain Fellowship program has been in place for 14 years. The CPP is
a premier research/clinical training site for provincial, national and
international trainees and visitors.
Research
CPP researchers have published unique research tools that advance the
understanding of the mechanisms and management of neuropathic pain.
These include the pioneering use of barbiturates for discrimination
of central versus peripheral contributions in neuropathic pain and the
establishment of algometric pain pressure thresholds as a quantitative
instrument for deep pain. Research into the physiological and psychological
effects of non specific treatment effects and on the psychophysiological
basis of hysteria are further research interests. Areas of ongoing research
activity include:
- Human Neuropathic Pain: syndromes (epidemiology and demographics,
genetic predisposition, causation), effects of drugs, personality profiles,
quantitative
measurements, functional imaging, genetic research
- Chronic Pain
Syndromes: intractable pain beyond healing time of injury and in
the absence of obvious ongoing nociception (mechanisms, psychobiological
model, functional imaging)
- Painful clinical syndromes: epidemiology,
mechanisms, treatment response
- Placebo/nocebo effects: mechanisms,
pathophysiology, personality profile
- Chronic pain and health care
utilization/costs: demographics, epidemiology
- Educational research: development of guidelines, learning instruments in chronic pain
- Evidence-based
medicine, literature reviews/meta-analysis: member of the
Cochrane collaboration (UK).
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