{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T15:07:03Z","timestamp":1787238423371,"version":"build-2736575974"},"posted":{"date-parts":[[2026,5,27]]},"group-title":"Rheumatology","reference-count":36,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T00:00:00Z","timestamp":1779840000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.medrxiv.org\/about\/FAQ#license"}],"funder":[{"name":"NIH","award":["P50AR070600"],"award-info":[{"award-number":["P50AR070600"]}]},{"name":"NIH","award":["R01HD088712"],"award-info":[{"award-number":["R01HD088712"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2026,5,27]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>A substantial minority (\u223c20%) of patients fail to achieve meaningful pain reduction following surgery intended to relieve pain. Risk is elevated in patients with nociplastic pain features, but available self-report measures were not designed for pre-surgical screening. We aimed to develop a brief, data-driven screener for poor analgesic response to surgery.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Participants were recruited from tertiary orthopedic and chronic pelvic pain clinics. Total hip arthroplasty participants had Kellgren\u2013Lawrence grades III\u2013IV with hip pain \u22651 year; hysterectomy participants had chronic pelvic pain \u22656 months. The primary outcome was a 50% reduction in worst pain at six months. Items were selected via elastic net regression with k-fold cross-validation from 68 candidates.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 428 participants (81% female; mean age 51), 35% failed to achieve a 50% pain reduction. The resulting 11-item screener \u2014 the GenerAlized sensory sensitivity for sUrGical rEsponsiveness (GAUGE) \u2014 comprises pain across seven body regions and four symptom items measuring interoception (nausea, numbness\/tingling) and exteroception (sensitivity to sound, sensitivity to odors). GAUGE outperformed the Central Sensitization Inventory, Fibromyalgia Survey Criteria, and PainDETECT for predicting surgical non-response (RR 1.535, 95% CI 1.342\u20131.55; AUC 0.738; sensitivity 0.741, specificity 0.635) and for predicting Patient Global Impression of Change. In an independent validation cohort of 54 total knee arthroplasty patients, GAUGE outperformed the Fibromyalgia Survey Criteria in predicting pain severity at six-months.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>GAUGE is a data-driven, theoretically grounded screener for poor analgesic response to surgery, with potential utility for pre-surgical counseling and clinical trial enrichment.<\/jats:p>\n                <\/jats:sec>","DOI":"10.64898\/2026.05.26.26354108","type":"posted-content","created":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T18:50:11Z","timestamp":1779907811000},"source":"Crossref","is-referenced-by-count":1,"title":["Generalized Sensory Sensitivity for Prediction of Post-Surgical Analgesic Outcomes: An Observational Cohort Study of Total Hip Arthroplasty and Hysterectomy"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4291-0320","authenticated-orcid":false,"given":"Andrew","family":"Schrepf","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, USA"},{"name":"Department of Obstetrics & Gynecology, University of Michigan Medical School, Ann Arbor, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tristin","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1284-218X","authenticated-orcid":false,"given":"Noah","family":"Waller","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, USA"},{"name":"Neuroscience Graduate Program, University of Michigan Medical School, Ann Arbor, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard E.","family":"Harris","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, USA"},{"name":"Susan Samueli Integrative Health Institute, School of Medicine, University of California Irvine, Irvine, CA, USA"},{"name":"Department of Anesthesiology and Perioperative Care, School of Medicine, University of California Irvine, Irvine, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Ichesco","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9324-655X","authenticated-orcid":false,"given":"Chelsea M.","family":"Kaplan","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, USA"},{"name":"Neuroscience Graduate Program, University of Michigan Medical School, Ann Arbor, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6790-132X","authenticated-orcid":false,"given":"Sara R.","family":"Till","sequence":"additional","affiliation":[{"name":"Department of Obstetrics & Gynecology, University of Michigan Medical School, Ann Arbor, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David A.","family":"Williams","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, USA"},{"name":"Department of Internal Medicine, Division of Rheumatology, University of Michigan Medical School, Ann Arbor, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7166-1979","authenticated-orcid":false,"given":"Sawsan","family":"As-Sanie","sequence":"additional","affiliation":[{"name":"Department of Obstetrics & Gynecology, University of Michigan Medical School, Ann Arbor, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2992-6889","authenticated-orcid":false,"given":"Julia M.","family":"Evanski","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, University of Michigan Medical School, Ann Arbor, MI, USA"},{"name":"Neuroscience Graduate Program, University of Michigan Medical School, Ann Arbor, MI, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Urquhart","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of Michigan Medical School, Ann Arbor, MI, 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