{"doi":"10.1093/pm/pnaf158","title":"When clinical intuition fails: exploration of clinicians’ underrecognition of preoperative pain catastrophizing despite direct observation","abstract":"Dear Editor, In preparation for perioperative care, anesthesia providers form impressions of patients during brief preoperative encounters and electronic medical record review to intuitively forecast patients’ pain and anxiety. These impressions guide preoperative anxiolytic use, procedural management, intraoperative anesthetic and analgesic strategies, and postoperative pain planning. However, it remains unclear how accurately providers discern patients’ psychological states. One study found that anesthesia providers poorly estimated anxiety during preoperative encounters.1 A key factor might be patients’ internal dialogue about pain, particularly pain catastrophizing, which involves negative affective and cognitive responses to pain, including magnification, rumination, and helplessness.2,3 The Pain Catastrophizing Scale (PCS; range 0–52) is a validated 13-question questionnaire3 that takes <2 minutes to systematically measure trait pain catastrophizing across diverse settings.4 Higher PCS scores are associated with greater acute and chronic pain.5,6 Identifying patients with elevated PCS scores preoperatively can guide targeted interventions, such as regional anesthesia,7,8 and inform personalized anesthetic care.9","journal":"Pain Medicine","year":2025,"id":581854,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9483,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":875001,"name":"Jenna M. Wilson","orcid":"0000-0003-3154-0467","position":1,"is_corresponding":false},{"id":1493751,"name":"Sheila R Gokul","orcid":null,"position":2,"is_corresponding":false},{"id":1144735,"name":"Patrick W Collins","orcid":null,"position":3,"is_corresponding":false},{"id":1493752,"name":"Martin Kiik","orcid":null,"position":4,"is_corresponding":false},{"id":1297578,"name":"Emily Rosado","orcid":null,"position":5,"is_corresponding":false},{"id":312863,"name":"Kamen Vlassakov","orcid":null,"position":6,"is_corresponding":false},{"id":348424,"name":"Kristin L. Schreiber","orcid":"0000-0002-7361-2214","position":7,"is_corresponding":false},{"id":710211,"name":"Yun-Yun K. Chen","orcid":"0000-0002-3770-2749","position":0,"is_corresponding":true}],"reference_count":10,"raw_metadata":null,"created_at":"2026-07-19T02:58:51.328454Z","pmid":"41259040","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}