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Chronic PainBITEC-TRNCT07673874

Validation of the Turkish Brief Inventory of Treatment Expectations in Chronic Pain

An observational study of Chronic Pain, run by Hacettepe University at 2 sites in Turkey (Türkiye).

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

The purpose of this study is to conduct the Turkish cross-cultural adaptation, validity, and reliability study of the "Brief Inventory of Treatment Expectations in Chronic Pain" (BITEC) scale. Chronic pain is a complex, multidimensional experience that affects a significant portion of the adult population. Read more about this study

Who is it for?
Ages 18 to 70 years
Conditions the study is for
Chronic Pain
What is being tested?
Survey Assessment Battery
How many people
250 participants
Where
2 sitesTurkey (Türkiye)
Study dates
15 Sep 2026to 31 Aug 2027
Phase
Observational
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 70 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Study population: The study population consists of adult patients who have been diagnosed with any type of non-cancer chronic pain condition (such as fibromyalgia, nociceptive pain, neuropathic pain, osteoarthritis, rheumatoid arthritis, or chronic headache/migraine) for at least three months, are literate, and are currently undergoing medical treatment. The sample will be recruited from patients admitting to the Physical Medicine and Rehabilitation Outpatient Clinic at Bingöl State Hospital. Data will be collected through both printed forms in the clinical setting and an online survey platform (Kobotoolbox), ensuring representation of both outpatient clinic attendees and accessible chronic pain patient groups.

Who may be able to join

  • Aged 18-70 years
  • Having chronic pain for at least 3 months according to the International Association for the Study of Pain (IASP) criteria
  • Diagnosed with any chronic pain condition (e.g., fibromyalgia, nociceptive pain, neuropathic pain, etc.)
  • Being literate
  • Currently receiving any medical treatment

Who cannot join

  • Presence of cancer-related pain
  • Diagnosis of acute pain
  • Being unable to fill out the questionnaire due to a diagnosed cognitive impairment or psychiatric illness
  • Presence of visual or motor disabilities that prevent completing the questionnaire

Trial locations and contacts

2 sites in 1 country. Contact the study team or a site near you to ask about taking part.

Turkey (Türkiye)2 sites, 2 recruiting
  • Bingol State Hospital, Physical Medicine and Rehabilitation Outpatient Clinic

    Bingoel

    Mehmet Gök, MD, +904262142217, mgok19866@gmail.com

    Recruiting
  • Bingol University Faculty of Physical Therapy and Rehabilitation

    Bingoel

    Aybüke Fanuscu, +904262160012-5548, afanuscu@bingol.edu.tr

    Recruiting

Other trials in Turkey (Türkiye)

About this study

Official title: Turkish Cross-Cultural Adaptation, Validity, and Reliability of the "Brief Inventory of Treatment Expectations in Chronic Pain" (BITEC) Scale

The purpose of this study is to conduct the Turkish cross-cultural adaptation, validity, and reliability study of the "Brief Inventory of Treatment Expectations in Chronic Pain" (BITEC) scale. Chronic pain is a complex, multidimensional experience that affects a significant portion of the adult population. Treatment expectations play a critical role in predicting clinical outcomes and directly influencing placebo/nocebo responses. While several tools exist to evaluate expectations, there is a lack of a concise, clinician-friendly, and Item Response Theory (IRT)-based instrument adapted for Turkish chronic pain populations. The BITEC is a 9-item scale that evaluates biological, psychological, and social/interactional expectation domains.

This methodological and cross-sectional study will be conducted with adult patients diagnosed with chronic pain for at least three months at Bingöl State Hospital. The study will be carried out in four consecutive stages: cross-cultural adaptation (forward and backward translation), comprehensibility pre-testing (with 30-40 volunteers), main data collection (with at least 200 participants), and statistical analyses. Data will be collected through printed forms and an online survey platform (Kobotoolbox), involving no clinical interventions. Participants will complete a sociodemographic information form, the Turkish version of the BITEC (BITEC-TR), the Treatment Expectations in Chronic Pain Scale (TEC-TR), the Pain Catastrophizing Scale (PCS), the Numerical Pain Rating Scale (NPRS), and the Hospital Anxiety and Depression Scale (HADS). Additionally, a subgroup of approximately 60 participants will recomplete the BITEC-TR 7-10 days after the initial session to evaluate test-retest reliability. Psychometric evaluation will include construct validity through exploratory and confirmatory factor analyses, and internal consistency and stability measurements.

Read the detailed description

This study is a methodological and cross-sectional research project aimed at the cultural adaptation and psychometric evaluation of the Brief Inventory of Treatment Expectations in Chronic Pain (BITEC) into Turkish. The study will be conducted at Bingöl University Faculty of Physical Therapy and Rehabilitation and Bingöl State Hospital Physical Medicine and Rehabilitation Outpatient Clinic. Data collection involves no clinical interventions and will be carried out using printed forms and an online survey platform (Kobotoolbox).

Procedure and Stages

The research will be executed in four consecutive stages:

Stage 1 - Cross-Cultural Adaptation: The BITEC will be adapted into Turkish following the ISPOR guidelines. Two independent native Turkish translators (one health professional, one linguist) will perform the forward translation. An expert panel will synthesize these translations into a consensus version. A native English speaker fluent in Turkish and blind to the original scale will perform the backward translation. The back-translated version will be compared with the original scale to eliminate semantic discrepancies.

Stage 2 - Comprehensibility Pre-testing: The provisional Turkish version will be administered to 30-40 volunteers diagnosed with chronic pain. Items will be rated on a scale from 0 (not comprehensible at all) to 10 (completely comprehensible). Items with a mean score below 8 will be revised.

Stage 3 - Main Data Collection: Eligible participants will be recruited to reach a target sample size of 200 to 250 individuals. Participants will complete a battery of assessments, including a sociodemographic and clinical information form, the BITEC-TR, the Treatment Expectations in Chronic Pain Scale (TEC-TR), the Pain Catastrophizing Scale (PCS), the Numerical Pain Rating Scale (NPRS), and the Hospital Anxiety and Depression Scale (HADS). For test-retest reliability, a subgroup of approximately 60 participants whose clinical status and treatment remain unchanged will recomplete the BITEC-TR 7-10 days after the initial assessment.

Stage 4 - Statistical Analysis: Data analysis will be performed using SPSS software (v.25). Normality will be assessed via the Shapiro-Wilk test. Construct validity will be examined using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA), reporting model fit indices such as CFI, NFI, RMSEA, and chi-square/df. Internal consistency will be evaluated using Cronbach's alpha, and test-retest reliability will be measured using the intra-class correlation coefficient (ICC). Measurement error will be calculated using the standard error of measurement (SEM) and minimal detectable change (MDC 95). Convergent, discriminant, and known-groups validities will be analyzed using Spearman correlation analyses based on pre-established hypotheses registered on the Open Science Framework (OSF). Ceiling and floor effects will also be evaluated.

Conditions
Chronic Pain
Being tested
Survey Assessment Battery
Keywords
treatment expectation, validation study, chronic pain, Cross-Cultural Adaptation
Medical subject headings
Chronic Pain

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Survey Assessment BatteryOther

    Participants will complete a comprehensive survey battery including:

    Sociodemographic and Clinical Information Form Turkish Brief Inventory of Treatment Expectations in Chronic Pain (BITEC-TR) Treatment Expectations in Chronic Pain Scale Pain Catastrophizing Scale (PCS) Numerical Pain Rating Scale (NPRS) Hospital Anxiety and Depression Scale (HADS)

Study groups in NCT07673874
Study groupRoleWhat they receive
Patients with Chronic PainAdult patients aged 18-70 who have been experiencing non-cancer chronic pain for at least three months, are literate, and are currently receiving medical treatment. Data will be collected through printed forms or the online survey platform Kobotoolbox.
Receives: Other: Survey Assessment Battery

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Turkish Brief Inventory of Treatment Expectations in Chronic Pain (BITEC-TR) Score

    The BITEC-TR is a 9-item scale that evaluates biological, psychological, and social/interactional domains of treatment expectations in individuals with chronic pain. Each item is scored on a 4-point category scale (Never, Sometimes, Almost Always, Always). Total scores reflect the patient's level of treatment expectations, with higher scores or specific classification levels indicating higher expectations. It will be used to assess the scale's construct validity, internal consistency, and test-retest reliability.

    Measured: Baseline (Day 1) and 7-10 days later for the test-retest subgroup.

  2. 11-point Numerical Pain Rating Scale Score

    An 11-point segment scale (0 to 10) used to measure average pain intensity over the last week. '0' represents no pain, and '10' represents unbearable pain. It will be used to evaluate the convergent validity of the BITEC-TR.

    Measured: Baseline (Day 1)

Secondary outcomes (3)
  1. Treatment Expectations in Chronic Pain Scale

    An 18-item scale consisting of two subscales (ideal expectations and predicted expectations) used to assess pain treatment expectations. Each item is rated on a 5-point Likert scale (1 = Strongly Disagree to 5 = Strongly Agree). Total scores range from 18 to 90, with higher scores indicating higher expectations. It will be used to evaluate the convergent validity of the BITEC-TR.

    Measured: Baseline (Day 1)

  2. Pain Catastrophizing Scale

    A 13-item scale used to evaluate catastrophic thoughts and feelings related to pain across three subscales: rumination, magnification, and helplessness. Items are scored from 0 (not at all) to 4 (all the time), with a total score ranging from 0 to 52. Higher scores indicate greater pain catastrophizing. It will be used to evaluate the convergent validity of the BITEC-TR.

    Measured: Baseline (Day 1)

  3. Hospital Anxiety and Depression Scale Score

    A 14-item scale assessing anxiety (7 items) and depression (7 items) symptoms. Items are scored from 0 to 3, with subscale scores ranging from 0 to 21. Higher scores indicate higher levels of anxiety or depression. It will be used to evaluate the discriminant validity of the BITEC-TR.

    Measured: Baseline (Day 1)

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted29 Jun 2026
  2. Study start15 Sep 2026
  3. Primary completion31 May 2027 (estimated)
  4. Study completion31 Aug 2027 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Other
Time perspective
Prospective
Enrolment
250 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07673874
Sponsor's protocol ID
AF-202601
Acronym
BITEC-TR
Status last verified
Oct 2026
First submitted
23 Jun 2026
Last updated
2 Nov 2026
Results posted
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: o ensure participant privacy and data confidentiality in accordance with national data protection laws (KVKK) and the approved ethical committee protocol, individual participant data will not be shared with third parties.

Publications

  • Wild D, Grove A, Martin M, Eremenco S, McElroy S, Verjee-Lorenz A, Erikson P; ISPOR Task Force for Translation and Cultural Adaptation. Principles of Good Practice for the Translation and Cultural Adaptation Process for Patient-Reported Outcomes (PRO) Measures: report of the ISPOR Task Force for Translation and Cultural Adaptation. Value Health. 2005 Mar-Apr;8(2):94-104. doi: 10.1111/j.1524-4733.2005.04054.x.

    PubMed 15804318
  • Caumo W, Franca BR, Ehlers J, de Jezus Castro SM, Borges RB, Hirakata VN, Bueno GB, da Torres IL, Fregni F. Development and Validation of the Brief Inventory of Treatment Expectations in Chronic Pain (BITEC). Eur J Pain. 2026 Feb;30(2):e70211. doi: 10.1002/ejp.70211.

    PubMed 41612668

Questions about this trial

What is this clinical trial studying?

An observational study of Chronic Pain, run by Hacettepe University at 2 sites in Turkey (Türkiye).

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 5 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 2 Nov 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Aybüke Fanuscu (+9004262160012-5548, afanuscu@bingol.edu.tr), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Turkish Brief Inventory of Treatment Expectations in Chronic Pain (BITEC-TR) Score (time frame: Baseline (Day 1) and 7-10 days later for the test-retest subgroup.). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07673874, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 2 Nov 2026.

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