To do no harm, we must first "know harms" . The challenge of measuring and reporting adverse events in interventions for pain: To do no harm we must first “know harms”. The challenge of measuring and reporting adverse events in interventions for pain.

Neil E. O'Connell; Christina Christina Abdel-Shaheed; Riaz Qureshi; Georgia Richards; Nadia Soliman; Emma  Fisher; Aidan G. Cashin; Michael C. Ferraro

doi:10.1097/j.pain.0000000000003796

To do no harm, we must first "know harms" . The challenge of measuring and reporting adverse events in interventions for pain: To do no harm we must first “know harms”. The challenge of measuring and reporting adverse events in interventions for pain.

Neil E. O'Connell, Christina Christina Abdel-Shaheed, Riaz Qureshi, Georgia Richards, Nadia Soliman, Emma Fisher, Aidan G. Cashin, Michael C. Ferraro

Research output: Contribution to journal › Review article › peer-review

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Abstract

To meet the Hippocratic commitment to “first, do no harm”, it is essential to have access to accurate information about the harms of interventions. In the development, evaluation and implementation of interventions for pain, patient safety and the risk of intervention-related harms are a critical consideration.

In this Perspective article, we discuss challenges relating to: nomenclature and definitions for intervention harms; measurement of harms and sources of information; and reporting of harms. We consider the state of the reporting of harms in the pain and analgesic literature, recommendations for the collection and reporting of harms in randomized controlled trials (RCTs) and systematic reviews (SRs), and future directions for harms research.

Original language	English
Journal	Pain
Early online date	26 Aug 2025
DOIs	https://doi.org/10.1097/j.pain.0000000000003796
Publication status	E-pub ahead of print - 26 Aug 2025

Funding

NOC: Between 2020 and 2023 NOC was Coordinating Editor of the Cochrane Pain, Palliative and Supportive Care group, whose activities were funded by The UK National Institute of Health and Care Research (NIHR). He is the Chair of the International Association for the Study of Pain (IASP) Methodology, Evidence Synthesis and Implementation Special Interest Group and has held a grant from the ERA-NET Neuron Co-Fund. CAS holds grants from the National Health and Medical Research Council and Medical Research Future Fund. GCR is employed by King's College London and has an honorary contract at the University of Oxford. GCR has had travel expenses reimbursed to attend and present at conferences and received fees for speaking at events, training coroners, and teaching. GCR is the director of a limited company and receive fees from subscriptions to a personal SubStack newsletter. EF is a Versus Arthritis Career Development and has received funding from UKRI, MRC, and Medical Research Foundation. AGC was supported by an Australian National Health and Medical Research Council Investigator Grant (ID 2010088). MCF is the Treasurer of the IASP Methodology, Evidence Synthesis and Implementation Special Interest Group. The remaining authors have no conflict of interest to declare.

Funders	Funder number
Medical Research Council
National Institute for Health and Care Research
Medical Research Foundation
Medical Research Future Fund
Versus Arthritis
UK Research and Innovation
National Health and Medical Research Council	2010088

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10.1097/j.pain.0000000000003796

harms perspective (accepted author manuscript)Accepted author manuscript, 202 KBLicence: CC BY

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O'Connell, N. E., Christina Abdel-Shaheed, C., Qureshi, R., Richards, G., Soliman, N., Fisher, E., Cashin, A. G., & Ferraro, M. C. (2025). To do no harm, we must first "know harms" . The challenge of measuring and reporting adverse events in interventions for pain: To do no harm we must first “know harms”. The challenge of measuring and reporting adverse events in interventions for pain. Pain. Advance online publication. https://doi.org/10.1097/j.pain.0000000000003796

To do no harm, we must first "know harms" . The challenge of measuring and reporting adverse events in interventions for pain: To do no harm we must first “know harms”. The challenge of measuring and reporting adverse events in interventions for pain. / O'Connell, Neil E.; Christina Abdel-Shaheed, Christina; Qureshi, Riaz et al.
In: Pain, 26.08.2025.

Research output: Contribution to journal › Review article › peer-review

O'Connell, NE, Christina Abdel-Shaheed, C, Qureshi, R, Richards, G, Soliman, N, Fisher, E, Cashin, AG & Ferraro, MC 2025, 'To do no harm, we must first "know harms" . The challenge of measuring and reporting adverse events in interventions for pain: To do no harm we must first “know harms”. The challenge of measuring and reporting adverse events in interventions for pain.', Pain. https://doi.org/10.1097/j.pain.0000000000003796

O'Connell NE, Christina Abdel-Shaheed C, Qureshi R, Richards G, Soliman N, Fisher E et al. To do no harm, we must first "know harms" . The challenge of measuring and reporting adverse events in interventions for pain: To do no harm we must first “know harms”. The challenge of measuring and reporting adverse events in interventions for pain. Pain. 2025 Aug 26. Epub 2025 Aug 26. doi: 10.1097/j.pain.0000000000003796

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To do no harm, we must first "know harms" . The challenge of measuring and reporting adverse events in interventions for pain: To do no harm we must first “know harms”. The challenge of measuring and reporting adverse events in interventions for pain.

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