Pain Education and Knowledge (PEAK) Consensus Guidelines for Neuromodulation: A Proposal for Standardization in Fellowship and Training Programs

• Type of Material: Article
• Authors: Scott G. Pritzlaff, University of California, Davis; Johnathan H. Goree, University of Arkansas; Jonathan M. Hagedorn, Mayo Clinic, Rochester; David W. Lee, Fullerton Orthopedic Surgery Medical Group; Kenneth B. Chapman, The Spine and Pain Institute of New York; Sandy Christiansen, Oregon Health and Science University; Andrew Dudas, Mays and Schnapp Neurospine and Pain; Alexander Escobar, University of Toledo; Christopher J. Gilligan, Harvard Medical School; Maged Guirguis, Ochsner Health; Amitabh Gulati, Memorial Sloan Kettering Cancer Center; Jessica Jameson, Axis Spine Center; Christopher J. Mallard, University of Kentucky; Melissa Z. Murphy, North Texas Orthopedics and Spine Center; Kiran V. Patel, Donald and Barbara Zucker School of Medicine; Raj G. Patel, Capitol Pain Institute; Samir J. Sheth, Sutter Health; Stephanie Vanterpool, University of Tennessee; Vinita Singh, Emory University; Gregory Smith, University of Arkansas; Natalie H. Strand, Mayo Clinic, Scottsdale; Chau M. Vu, Evolve Restorative Center; Tolga Suvar, Rush University; Krishnan Chakravarthy, Coastal Pain and Spinal Diagnostics Medical Group; Leonardo Kapural, Carolinas Pain Institute; Michael S. Leong, Stanford University; Timothy R. Lubenow, Rush University; Alaa Abd-Elsayed, University of Wisconsin, Madison; Jason E. Pope, Evolve Restorative Center; Dawood Sayed, University of Kansas; Timothy R. Deer, The Spine and Nerve Center of the Virginias
• Language: English
• Date: 2023-09-13
• Publisher: Dove Medical Press
• Publication Version: Final Published Version
• Copyright Statement: © 2023 Pritzlaff et al.
• License: Creative Commons Attribution-Noncommercial 3.0 Unported
• Final Published Version (URL): https://doi.org/10.2147%2FJPR.S424589
• Title of Journal or Parent Work: Journal of Pain Research
• Volume: 16
• Start Page: 3101
• End Page: 3117
• Keywords: fellowship training; neuromodulation; spinal cord stimulation; dorsal root ganglion stimulation; peripheral nerve stimulation; pain education
• Research Categories: Biology, Neuroscience

Abstract

The need to be competent in neuromodulation is and should be a prerequisite prior to completing a fellowship in interventional pain medicine. Unfortunately, many programs lack acceptable candidates for these advanced therapies, and fellows may not receive adequate exposure to neuromodulation procedures. The American Society of Pain and Neuroscience (ASPN) desires to create a consensus of experts to set a minimum standard of competence for neurostimulation procedures, including spinal cord stimulation (SCS), dorsal root ganglion stimulation (DRG-S), and peripheral nerve stimulation (PNS). The executive board of ASPN accepted nominations for colleagues with excellence in the subject matter of neuromodulation and physician education. This diverse group used peer-reviewed literature and, based on grading of evidence and expert opinion, developed critical consensus guides for training that all accredited fellowship programs should adopt. For each consensus point, transparency and recusal were used to eliminate bias, and an author was nominated for evidence grading oversight and bias control. Pain Education and Knowledge (PEAK) Consensus Guidelines for Neuromodulation sets a standard for neuromodulation training in pain fellowship training programs. The consensus panel has determined several recommendations to improve care in the United States for patients undergoing neuromodulation. As neuromodulation training in the United States has evolved dramatically, these therapies have become ubiquitous in pain medicine. Unfortunately, fellowship programs and the Accreditation Council for Graduate Medical Education (ACGME) pain program requirements have not progressed training to match the demands of modern advancements. PEAK sets a new standard for fellowship training and presents thirteen practice areas vital for physician competence in neuromodulation.