PREPRINT: Matching cognitive behavioural interventions to psychological processes to personalise chronic pain treatments: an adapted group Delphi study with clinical and science experts

Background. Cognitive Behavioural Therapy is guideline-recommended for the treatment of chronic pain with well-established efficacy. However, treatment effects remain moderate. Recent efforts to enhance outcomes focus on process-orientation and personalisation. Intuitive personalisation approaches are vulnerable to biases. As the data base for purely data-driven algorithms in chronic pain remains insufficient, input from clinical and scientific experts appears to be a necessary interim step that may also help bridging the science-practice gap.Methods. In this group Delphi study, a Matching Matrix linking cognitive behavioural modules to specific treatment targets was developed using an adapted group Delphi technique and online surveys. 22 clinicians selected two modules per target in the first Delphi round consisting of five separate groups. 15 clinicians contributed to the second round via an online survey. Their recommendations were validated by a focus group of four chronic pain science experts. Results. For all 23 targets, two modules could be matched based on the assessed data. Eight out of 46 matches required discussion within the study team. Especially the first-choice modules appear well-founded.Conclusion. The presented Matching Matrix is a first step towards the development of a broader evidence base for data-informed clinical decision-making in the treatment of chronic pain. The described method provides a transparent, replicable procedure for future extensions.