Using a vast database of electronic medical records, researchers at the Stanford School of Medicine were able to show “to a high level of statistical significance” that women report feeling pain more intensely than men regardless of the source of such pain, according to a medical school press release.
The study, which was published on Jan. 23 in the Journal of Pain, took advantage of the Stanford Translational Research Integrated Database Environment (STRIDE) — a warehouse of electronic patient records aggregated from both the Lucile Packard’s Children Hospital and Stanford Hospital and Clinics. Researchers were able to search through this data to find more than 160,000 instances in which a pain score was recorded, coming from around 72,000 adult patients.
A pain score ranges from zero to 10, a number that represents how patients respond when asked to rank the intensity of their pain. Zero indicates if one reports “no pain,” while 10 indicates “worse than imaginable” pain.
The data was then whittled down to a sample of more than 11,000 individual adult patients. This sample consisted of 47 separate diagnostic categories in which there were more than 40 pain reports for each gender. Researchers then compressed the 47 diagnostic categories into 16 different disease clusters.
The average pain scores in each of these disease clusters was higher for women than for men, with the most profound difference in pain recorded coming from the category of “musculoskeletal- and connective tissue-” related pain.
“We saw higher pain scores for female patients practically across the board,” said Atul Butte, associate professor pediatrics and the study’s lead author, in the press release. He added that these differences were clinically significant.
“In many cases, the reported difference approached a full point on the 1-to-10 scale,” Butte said. “How big is that? A pain-score improvement of one point is what clinical researchers view as indicating that a pain medication is working.”
The researchers also said that there were several assumptions to the study that should be explored: could the patient’s pain already have been treated before he or she arrived in the hospital? Could patients respond differently about their pain depending on who is in the room? And do women actually feel more pain or simply report feeling more pain?
In an interview with the San Jose Mercury News, Jeffrey Mogil, a pain expert at McGill University in Montreal, who was not involved in the study, talked about the significance of the report.
“What this paper does above and beyond what came before is a matter of sheer size,” Mogil said. “In my mind, it puts the story to bed forever.”
The study’s first authors were graduate student in the School of Medicine Linda Liu and pediatrics postdoctoral scholar David Ruau. Professors of anesthesia Martin Angst and David Clark were co-authors.
— Kurt Chirbas