Kristin Schreiber

All Publications

• Effect of perioperative autonomic nervous system imbalance on surgical outcomes: role of regional sympathetic block. Comment on Br J Anaesth 2025; 135: 608-22. British journal of anaesthesia Bombardieri, A. M., Berger, M., Schreiber, K. 2026

  View details for DOI 10.1016/j.bja.2025.12.049

  View details for PubMedID 41580377

• Prioritization of outcome measures in regional anesthesia research. Regional anesthesia and pain medicine El-Boghdadly, K., Narouze, S., Ayad, A. E., Memtsoudis, S. G., Schreiber, K. L., Myles, P. S., Radcliffe, G., Rivett, K., Princova, Z., Adhikary, S., Albrecht, E., Bowness, J., Candido, K., Coppens, S., Gupta, R. K., Hanna, M., Johnson, R. L., Kandil, E., Kohan, L., Kopp, S., Lobo, C., Moka, E., Muse, I. O., Nsiri, A., Pasternak, J. J., Pino, C., Singh, V., Theron, A., Tolba, R., Van de Putte, P. B., Wolmarans, M., Elkassabany, N. M. 2025

  Abstract

  Outcome selection in regional anesthesia and acute pain research is inconsistent, often lacking patient-centered priorities and validated instruments. We aimed to prioritize key outcomes and propose suitable measurement tools to improve the quality, consistency, and relevance of regional anesthesia research.We conducted a multiround Delphi process, including two electronic voting rounds, a multiday in-person meeting, and a patient panel. Experts and patients evaluated existing and proposed outcomes for importance, validity, and relevance. Outcomes reaching ≥70% agreement were prioritized, and appropriate measurement instruments were identified.Thirty-two experts and three patients participated. Across three Delphi rounds, 10 outcomes were prioritized for future regional anesthesia research: seven efficacy outcomes (pain scores; opioid consumption; Brief Pain Inventory; functional outcomes; cognitive function; length of stay; block duration); two multidimensional outcomes (quality of recovery and development of a regional anesthesia-specific quality-of-recovery instrument); one safety outcome (chronic postsurgical pain). Patients prioritized cognitive recovery, function, chronic pain, and pain scores.This consensus-based, patient-centered framework defines the core priorities for future regional anesthesia and acute pain research. Future work should focus on developing and validating a regional anesthesia-specific quality-of-recovery instrument, refining multidimensional measures such as functional recovery, cognitive outcomes, and the Brief Pain Inventory, and standardizing the reporting of chronic pain and opioid-related outcomes. Adoption of these priorities will enhance methodological consistency, comparability, and patient relevance in future clinical trials.

  View details for DOI 10.1136/rapm-2025-107087

  View details for PubMedID 41151978

• Recommendations for disclosure of artificial intelligence in scientific writing and publishing: a regional anesthesia and pain medicine modified Delphi study. Regional anesthesia and pain medicine Fettiplace, M. R., Bhatia, A., Chen, Y., Orebaugh, S. L., Gofeld, M., Gabriel, R. A., Sessler, D. I., Lonsdale, H., Bungart, B., Cheng, C. P., Burnett, G. W., Han, L., Wiles, M., Coppens, S., Joseph, T., Schreiber, K. L., Volk, T., Urman, R. D., Kovacheva, V. P., Wu, C. L., Mariano, E. R., Ip, V. H. 2025

  Abstract

  The use of artificial intelligence (AI) in the scientific process is advancing at a remarkable speed, thanks to continued innovations in large language models. While AI provides widespread benefits, including editing for fluency and clarity, it also has drawbacks, including fabricated content, perpetuation of bias, and lack of accountability. The editorial board of Regional Anesthesia & Pain Medicine (RAPM) therefore sought to develop best practices for AI usage and disclosure.A steering committee from the American Society of Regional Anesthesia and Pain Medicine used a modified Delphi process to address definitions, disclosure requirements, authorship standards, and editorial oversight for AI use in publishing. The committee reviewed existing publication guidelines and identified areas of ambiguity, which were translated into questions and distributed to an expert workgroup of authors, reviewers, editors, and AI researchers.Two survey rounds, with 91% and 87% response rates, were followed by focused discussion and clarification to identify consensus recommendations. The workgroup achieved consensus on recommendations to authors about definitions of AI, required items to report, disclosure locations, authorship stipulations, and AI use during manuscript preparation. The workgroup formulated recommendations to reviewers about monitoring and evaluating the responsible use of AI in the review process, including the endorsement of AI-detection software, identification of concerns about undisclosed AI use, situations where AI use may necessitate the rejection of a manuscript, and use of checklists in the review process. Finally, there was consensus about AI-driven work, including required and optional disclosures and the use of checklists for AI-associated research.Our modified Delphi study identified practical recommendations on AI use during the scientific writing and editorial process. The workgroup highlighted the need for transparency, human accountability, protection of patient confidentiality, editorial oversight, and the need for iterative updates. The proposed framework enables authors and editors to harness AI's efficiencies while maintaining the fundamental principles of responsible scientific communication and may serve as an example for other journals.

  View details for DOI 10.1136/rapm-2025-106852

  View details for PubMedID 40897450

• Mindful Meditation for Epidural Catheter Placement During Labor: A Single-Center Randomized Controlled Trial. Pain medicine (Malden, Mass.) Lumbreras-Marquez, M. I., Lazaridou, A., Villela-Franyutti, D., Fields, K. G., Farber, M. K., Nelson, E. R., Schreiber, K. L., Arce, D. Y. 2025

  Abstract

  Labor epidural placement can cause significant procedural anxiety for patients. Behavioral interventions, such as mindful meditation, can effectively reduce anxiety, including during pregnancy. This study aimed to assess the impact of a 10-minute mindful meditation session on anxiety and pain during labor epidural placement.Pregnant women were recruited and randomized into two groups: A 10-minute guided mindful meditation, or a neutral content recording, both delivered via headphones before the epidural procedure as a recording. After the procedure, participants reported their levels of anxiety, pain, and satisfaction. Linear regression analyses were used to evaluate the main effects of the intervention on anxiety, pain, and satisfaction. Additionally, an exploratory post hoc moderation analysis assessed the role of baseline pain catastrophizing and its interaction with the intervention.A total of 100 participants were included (50 per group). There were no overall main effect of mindful meditation on primary outcomes of anxiety and pain, or secondary outcome of procedural satisfaction, compared to the neutral content recording (p's > 0.05). Exploratory post hoc analysis indicated a moderation of treatment effect, such that participants with higher baseline pain catastrophizing experienced greater benefits from mindful meditation compared to neutral content on anxiety ((b=-0.18, p = 0.01) and pain (b=-0.14, p = 0.03).While no overall group-level effects of mindful meditation were found, exploratory analysis suggested that the intervention may be more beneficial for participants with high baseline pain catastrophizing. Future studies enrolling a larger sample, or enriching for patients with these characteristics are needed to confirm these results.

  View details for DOI 10.1093/pm/pnaf075

  View details for PubMedID 40570097

• Brief Assessment of Patient Phenotype to Explain Variability in Postsurgical Pain and Opioid Consumption after Cesarean Delivery: Performance of a Novel Brief Questionnaire Compared to Long Questionnaires. Anesthesiology He, J., Wilson, J. M., Fields, K. G., Flowers Zachos, K. M., Franqueiro, A. R., Reale, S. C., Farber, M. K., Bateman, B. T., Edwards, R. R., Rathmell, J. P., Soens, M., Schreiber, K. L. 2024

  Abstract

  Understanding factors that explain why some women experience greater postoperative pain and consume more opioids after cesarean delivery (CD) is crucial to building an evidence base for personalized prevention. Comprehensive psychosocial assessment with validated questionnaires in the preoperative period can be time-consuming. A 3-item questionnaire has shown promise as a simpler tool to be integrated into clinical practice, but its brevity may limit the ability to explain heterogeneity in psychosocial pain modulators among individuals. We compared the explanatory ability of 3 models: (1) the 3-item questionnaire, (2) a 58-item questionnaire (Long) including validated questionnaires (e.g., BPI, PROMIS) plus the 3-item questionnaire, and (3) a novel 19-item questionnaire (Brief) assessing several psychosocial factors plus the 3-item questionnaire. Additionally, we explored the utility of adding a pragmatic quantitative sensory test (QST) to models.In this prospective, observational study, 545 women undergoing CD completed questionnaires pre-surgery. Pain during local anesthetic skin wheal prior to spinal placement served as a pragmatic QST. Postoperatively, pain and opioid consumption were assessed. Linear regression analysis assessed model fit and the association of model items with pain and opioid consumption during the 48 hours following surgery.A modest amount of variability was explained by each of the 3 models for postoperative pain and opioid consumption. Both Brief and Long questionnaire models performed better than the 3-item questionnaire, but were themselves statistically indistinguishable. Items that were independently associated with pain and opioid consumption included anticipated postsurgical pain medication requirement, surgical anxiety, poor sleep, pre-existing pain, and catastrophic thinking about pain. QST was itself independently associated with pain across models, but only modestly improved models for postoperative pain.The Brief questionnaire may be more clinically feasible than longer validated questionnaires, while still performing better and integrating a more comprehensive psychosocial assessment than the 3-item questionnaire.

  View details for DOI 10.1097/ALN.0000000000004900

  View details for PubMedID 38207329

• Journal-related Activities and Other Special Activities at the 2023 American Society of Anesthesiologists Meeting ANESTHESIOLOGY Avram, M. J., Bateman, B. T., Culley, D. J., Fernandez-Bustamante, A., Houle, T. T., London, M. J., Rathmell, J. P., Schreiber, K. L., Melo, M. 2023; 139 (4): 377-386

  View details for DOI 10.1097/ALN.0000000000004707

  View details for Web of Science ID 001144382600001

• Cryoneurolysis: Interest and Caution. Anesthesiology Rathmell, J. P., Forrester, J. D., Schreiber, K. 2022; 137 (5): 521-523

  View details for DOI 10.1097/ALN.0000000000004365

  View details for PubMedID 36264090

• Association of pain catastrophizing longitudinally with pain severity and interference in patients with chronic pain and cancer: A CHOIR study Azizoddin, D., Wilson, J., Mackey, S., Flowers, K., Darnall, B., Edwards, R., Schreiber, K. L. LIPPINCOTT WILLIAMS & WILKINS. 2022: 213

  View details for Web of Science ID 000891944700212

• Increased pain catastrophizing longitudinally predicts worsened pain severity and interference in patients with chronic pain and cancer: A CHOIR study. Psycho-oncology Wilson, J. M., Schreiber, K. L., Mackey, S., Flowers, K. M., Darnall, B. D., Edwards, R. R., Azizoddin, D. R. 2022

  Abstract

  OBJECTIVE: Little is known about how changes in psychosocial factors impact changes in pain outcomes among patients with cancer and chronic pain. This longitudinal cohort study of cancer patients investigated the relationships between changes in psychosocial factors and changes in pain severity and interference over time.METHODS: Data from patients with cancer and chronic pain (n=316) treated at a tertiary pain clinic were prospectively collected. At their baseline visit (Time 1), patients provided demographic and clinical information, and completed validated psychosocial and pain assessments. Psychosocial and pain assessments were repeated at a follow-up visit (Time 2), on average 4.9 months later. Change scores (Time 2-Time 1) were computed for psychosocial and pain variables. Multivariable hierarchical linear regressions assessed the associations between changes in psychosocial factors with changes in pain outcomes over time.RESULTS: Participants were an average age of 59 years, were 61% female, and 69% White. Overall, a decrease in pain severity (p≤.001), but not pain interference, was observed among the group over time. Increased pain catastrophizing was significantly associated with increased pain severity over time (beta=0.24, p≤.001). Similarly, increased pain catastrophizing (beta=0.21, p≤.001) and increased depression (beta=0.20, p≤.003) were significantly associated with increased pain interference over time. Demographic and clinical characteristics were not significantly related to changes in pain outcomes.CONCLUSIONS: Increased pain catastrophizing was uniquely associated with increased chronic pain severity and interference. Our findings indicate that cancer patients with chronic pain would likely benefit from the incorporation of nonpharmacological interventions, simultaneously address pain and psychological symptoms. This article is protected by copyright. All rights reserved.

  View details for DOI 10.1002/pon.6020

  View details for PubMedID 35988161

• Chronic pain severity, impact, and opioid use among patients with cancer: An analysis of biopsychosocial factors using the CHOIR learning health care system. Cancer Azizoddin, D. R., Schreiber, K., Beck, M. R., Enzinger, A. C., Hruschak, V., Darnall, B. D., Edwards, R. R., Allsop, M. J., Tulsky, J. A., Boyer, E., Mackey, S. 2021

  Abstract

  BACKGROUND: Despite the biopsychosocial underpinnings of chronic noncancer pain, relatively little is known about the contribution of psychosocial factors to chronic cancer pain. The authors aimed to characterize associations between biopsychosocial factors and pain and opioid use among individuals with chronic pain and cancer.METHODS: The authors conducted a retrospective, cross-sectional study of 700 patients with chronic pain and cancer seeking treatment at an academic tertiary pain clinic. Patients completed demographic questionnaires and validated psychosocial and pain measures. Multivariable, hierarchical linear and logistic regressions assessed the relative contributions of biopsychosocial factors to the primary dependent variables of pain severity, pain interference, and opioid use.RESULTS: Participants were 62% female and 66% White with a mean age of 59 ± 15 years, and 55% held a college degree or higher. Older age, African American or "other" race, sleep disturbance, and pain catastrophizing were significantly associated with higher pain severity (F(5,657) = 22.45; P ≤ .001; R2 = 0.22). Depression, sleep disturbance, pain catastrophizing, lower emotional support, and higher pain severity were significantly associated with pain interference (F(5,653) = 9.47; P ≤ .001; R2 = 0.44). Lastly, a poor cancer prognosis (Exp(B) = 1.62) and sleep disturbance (Exp(B) = 1.02) were associated with taking opioids, whereas identifying as Asian (Exp(B) = 0.48) or Hispanic (Exp(B) = 0.47) was associated with lower odds of using opioids.CONCLUSIONS: Modifiable psychological factors-specifically sleep disturbance, depression, and pain catastrophizing-were uniquely associated with pain and opioid use in patients with chronic pain and diverse cancer diagnoses. Future behavioral pain interventions that concurrently target sleep may improve pain among patients with cancer.LAY SUMMARY: Feeling depressed, worrying about pain, and bad sleep are related to higher pain symptoms in individuals with chronic pain and cancer. Specifically, those who struggle to sleep have worse pain and use more opioids. Also, individuals who have a bad prognosis for their cancer are more likely to be using opioid pain medications. Although race and cancer are related to chronic pain in patients, psychological well-being is also strongly related to this same pain.

  View details for DOI 10.1002/cncr.33645

  View details for PubMedID 34061975

• PSYCHOSOCIAL AND SOCIODEMOGRAPHIC MECHANISMS IN PAIN AND OPIOID USE AMONG CHRONIC PAIN AND CANCER Azizoddin, D. R., Schreiber, K., Hruschak, V., Beck, M., Enzinger, A. C., Allsop, M. J., Edwards, R. R., Darnall, B. D., Kizildag, D., Tulsky, J. A., Boyer, E. W., Mackey, S. OXFORD UNIV PRESS INC. 2021: S381

  View details for Web of Science ID 000648922700770

• The ACTTION-APS-AAPM Pain Taxonomy (AAAPT) Multidimensional Approach to Classifying Acute Pain Conditions JOURNAL OF PAIN Kent, M. L., Tighe, P. J., Belfer, I., Brennan, T. J., Bruehl, S., Brummett, C. M., Buckenmaier, C. C., Buvanendran, A., Cohen, R. I., Desjardins, P., Edwards, D., Fillingim, R., Gewandter, J., Gordon, D. B., Hurler, R. W., Kehlet, H., Loeser, J. D., Mackey, S., McLean, S. A., Polomano, R., Rahman, S., Raja, S., Rowbotham, M., Suresh, S., Schachte, B., Schreiber, K., Schumacher, M., Staceyi, B., Stanos, S., Todd, K., Turk, D. C., Weisman, S. J., Wu, C., Carr, D. B., Dworkin, R. H., Terman, G. 2017; 18 (5): 479-489

  Abstract

  With the increasing societal awareness of the prevalence and impact of acute pain, there is a need to develop an acute pain classification system that both reflects contemporary mechanistic insights and helps guide future research and treatment. Existing classifications of acute pain conditions are limiting, with a predominant focus on the sensory experience (eg, pain intensity) and pharmacologic consumption. Consequently, there is a need to more broadly characterize and classify the multidimensional experience of acute pain.Consensus report following expert panel involving the Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks (ACTTION), American Pain Society (APS), and American Academy of Pain Medicine (AAPM).As a complement to a taxonomy recently developed for chronic pain, the ACTTION public-private partnership with the US Food and Drug Administration, the APS, and the AAPM convened a consensus meeting of experts to develop an acute pain taxonomy using prevailing evidence. Key issues pertaining to the distinct nature of acute pain are presented followed by the agreed-upon taxonomy. The ACTTION-APS-AAPM Acute Pain Taxonomy will include the following dimensions: 1) core criteria, 2) common features, 3) modulating factors, 4) impact/functional consequences, and 5) putative pathophysiologic pain mechanisms. Future efforts will consist of working groups utilizing this taxonomy to develop diagnostic criteria for a comprehensive set of acute pain conditions.The ACTTION-APS-AAPM Acute Pain Taxonomy (AAAPT) is a multidimensional acute pain classification system designed to classify acute pain along the following dimensions: 1) core criteria, 2) common features, 3) modulating factors, 4) impact/functional consequences, and 5) putative pathophysiologic pain mechanisms.Significant numbers of patients still suffer from significant acute pain, despite the advent of modern multimodal analgesic strategies. Mismanaged acute pain has a broad societal impact as significant numbers of patients may progress to suffer from chronic pain. An acute pain taxonomy provides a much-needed standardization of clinical diagnostic criteria, which benefits clinical care, research, education, and public policy. For the purposes of the present taxonomy, acute pain is considered to last up to seven days, with prolongation to 30 days being common. The current understanding of acute pain mechanisms poorly differentiates between acute and chronic pain and is often insufficient to distinguish among many types of acute pain conditions. Given the usefulness of the AAPT multidimensional framework, the AAAPT undertook a similar approach to organizing various acute pain conditions.

  View details for DOI 10.1016/j.jpain.2017.02.421

  View details for Web of Science ID 000401219500001

  View details for PubMedID 28495013

• The ACTTION-APS-AAPM Pain Taxonomy (AAAPT) Multidimensional Approach to Classifying Acute Pain Conditions. Pain medicine (Malden, Mass.) Kent, M. L., Tighe, P. J., Belfer, I., Brennan, T. J., Bruehl, S., Brummett, C. M., Buckenmaier, C. C., Buvanendran, A., Cohen, R. I., Desjardins, P., Edwards, D., Fillingim, R., Gewandter, J., Gordon, D. B., Hurley, R. W., Kehlet, H., Loeser, J. D., Mackey, S., McLean, S. A., Polomano, R., Rahman, S., Raja, S., Rowbotham, M., Suresh, S., Schachtel, B., Schreiber, K., Schumacher, M., Stacey, B., Stanos, S., Todd, K., Turk, D. C., Weisman, S. J., Wu, C., Carr, D. B., Dworkin, R. H., Terman, G. 2017; 18 (5): 947-958

  Abstract

  With the increasing societal awareness of the prevalence and impact of acute pain, there is a need to develop an acute pain classification system that both reflects contemporary mechanistic insights and helps guide future research and treatment. Existing classifications of acute pain conditions are limiting, with a predominant focus on the sensory experience (e.g., pain intensity) and pharmacologic consumption. Consequently, there is a need to more broadly characterize and classify the multidimensional experience of acute pain.Consensus report following expert panel involving the Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks (ACTTION), American Pain Society (APS), and American Academy of Pain Medicine (AAPM).As a complement to a taxonomy recently developed for chronic pain, the ACTTION public-private partnership with the US Food and Drug Administration, the APS, and the AAPM convened a consensus meeting of experts to develop an acute pain taxonomy using prevailing evidence. Key issues pertaining to the distinct nature of acute pain are presented followed by the agreed-upon taxonomy. The ACTTION-APS-AAPM Acute Pain Taxonomy will include the following dimensions: 1) core criteria, 2) common features, 3) modulating factors, 4) impact/functional consequences, and 5) putative pathophysiologic pain mechanisms. Future efforts will consist of working groups utilizing this taxonomy to develop diagnostic criteria for a comprehensive set of acute pain conditions.The ACTTION-APS-AAPM Acute Pain Taxonomy (AAAPT) is a multidimensional acute pain classification system designed to classify acute pain along the following dimensions: 1) core criteria, 2) common features, 3) modulating factors, 4) impact/functional consequences, and 5) putative pathophysiologic pain mechanisms.Significant numbers of patients still suffer from significant acute pain, despite the advent of modern multimodal analgesic strategies. Mismanaged acute pain has a broad societal impact as significant numbers of patients may progress to suffer from chronic pain. An acute pain taxonomy provides a much-needed standardization of clinical diagnostic criteria, which benefits clinical care, research, education, and public policy. For the purposes of the present taxonomy, acute pain is considered to last up to seven days, with prolongation to 30 days being common. The current understanding of acute pain mechanisms poorly differentiates between acute and chronic pain and is often insufficient to distinguish among many types of acute pain conditions. Given the usefulness of the AAPT multidimensional framework, the AAAPT undertook a similar approach to organizing various acute pain conditions.

  View details for DOI 10.1093/pm/pnx019

  View details for PubMedID 28482098