EA - Pain relief: a shallow cause exploration by Samuel Dupret

Link to original articleWelcome to The Nonlinear Library, where we use Text-to-Speech software to convert the best writing from the Rationalist and EA communities into audio. This is: Pain relief: a shallow cause exploration, published by Samuel Dupret on January 27, 2023 on The Effective Altruism Forum.This shallow investigation was commissioned by Founders Pledge.SummaryThis report is a shallow cause exploration, completed in two weeks, which expands on our previous work considering pain as a potential cause area (Sharma et al., 2020). Here, we attempt to explore the relationship between pain and subjective wellbeing (SWB) more directly, both conceptually and quantitatively.First, we try to calculate a conversion rate between self-reported pain intensity and SWB measures. However, the limited literature provides us with two potential conversion rates: a 1-point change on a 0-10 pain scale could lead to either a 0.1-point or 1-point change on a 0-10 SWB scale. Choosing one or the other leads to drastically different results when evaluating the cost-effectiveness of pain treatments.Second, we assess the severity and scale of chronic pain in terms of life satisfaction to be large. However, we think this is likely an underestimate which will benefit from further evaluation.Third, we offer some novel back-of-the-envelope calculations for the cost-effectiveness of several interventions to treat pain. We conclude - in agreement with Sharma et al. (2020) - that providing opioids for terminal pain and drugs for migraines are potentially cost-effective interventions. We add an analysis suggesting that psychotherapy for chronic pain could be moderately cost-effective if it can be deployed in ways that reduce costs (task-shifted, grouped, and/or digital), although we doubt it would be as cost-effective as psychotherapy for depression. We also present other interventions which we are more uncertain about but we think are worth researching further.There are many interventions we were unable to review. Reviewing the medical literature on pain was more time intensive than for our other projects because most meta-analyses evaluated their evidence as “moderate to low” quality. Furthermore, our subjective judgement was that these meta-analyses were of lower quality than the work we typically review from the fields of economics, psychology, and global health.The most valuable directions for further cause prioritisation research are (1) narrowing our substantial uncertainty about the conversion rates between pain scores and SWB measures, and (2) investigating the potential of advocacy campaigns to increase access to opioids.OutlineIn Section 1 we define pain and present how it is measured.In Section 2 we explore the relationship between pain and subjective wellbeing.In Section 3 we model the scale and severity of chronic pain in subjective wellbeing terms.In Section 4 we present potential interventions to treat pain.In Section 5 we present our recommendations for future research and conclude with the key takeaways from the report.NotesThis report focuses on impact in terms of WELLBYs. One WELLBY is a 1 point change in life satisfaction for one year (or any equivalent combination of change in life satisfaction and time). In some cases, we convert results in standard deviations of life satisfaction to WELLBYs using a 2 point standard deviation on 0-10 life satisfaction scales (i.e., 1 SD change is the equivalent of 2 point changes on a 0-10 life satisfaction scale). This naive conversion is based on estimates from large scale data sets like the World Happiness Reports. See our post on the WELLBY method for more details.The shallowness of this investigation means (1) we include more guesses and uncertainty in our models, (2) we couldn’t always conduct the most detailed or complex analyses, (3) we might have missed some data, and (4) we take some findings at face value.Our calculations and data extraction can be found in this spreadsheet and GitHub rep...