Challenging populations

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There are relatively few studies of treatment of chronic pain in children, but assessment methodology has been reviewed.30 Adolescents present particular challenges and a suitable compact measure has been developed.31

The elderly are often excluded from studies of chronic pain and so treatments cannot be based on sound evidence. Weiner32 sets an agenda for the improvement of analgesia in the elderly to include the improvement of measurement of outcome of studies. Unfortunately, the elderly with impaired mental function do even worse.33

Cultural and ethnic issues are starting to be taken into account in measurements of outcome34 and these may address some of the disparities in treatment allocation to different racial groups.35

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