The Development of Algorithms for Pain Care Including Neuromodulation Therapies

Abstract Traditional serial algorithms for medical care for chronic pain are based on cost effectiveness and noninvasiveness. These older ways of thinking place neuromodulation therapies as a last resort in the treatment continuum, and are outdated. Newer evidence supports the use of flexible algorithms based on four logical and critical principles for reviewing and comparing interventions in the relevant literature, termed the SAFE principles: safety, appropriateness, “time to fiscal neutrality,” and efficacy. The net goal is to provide effective therapies in a safe and expedient manner that is sustainable for the patient, the healthcare system, and the larger medical community.