Tim Carey, MD, MPH
Can risk prediction instruments identify which patients are most likely to develop persistent, disabling low back pain (LBP)?
Included studies prospectively assessed the accuracy of risk prediction instruments to identify which adult patients with < 8 weeks of LBP would develop persistent, disabling LBP (i.e., pain that had at least moderate effects on ability to work or function and lasted > 3 mo after initial symptoms). Outcomes included likelihood ratios (LRs).
MEDLINE (to wk 2, Jan 2010) and EMBASE/Excerpta Medica (to Feb 2010) were searched for English-language studies; references of retrieved studies were also reviewed. 10 studies (n = 5373, range of mean ages 37 to 43 y) of risk prediction instruments met the selection criteria. Mean quality score was 4.5 out of 8; 4 studies assessed the instrument in an external validation cohort.
7 risk prediction instruments were reported. Test characteristics for each are presented in the Table. (The review also assessed individual risk factors, but these results are not reported in this abstract.)
Some instruments predict development of persistent, disabling low back pain.
Test characteristics of instruments for predicting persistent, disabling low back pain (LBP)*
*ALBPSQ = Acute Low Back Pain Screening Questionnaire; AUROC = area under receiver-operating characteristic curve; DC = derivation cohort; LR = likelihood ratio; VC = validation cohort; VDPQ = Vermont Disability Prediction Questionnaire; other abbreviations defined in Glossary.
Carey T. Review: Some instruments predict development of persistent, disabling low back pain. Ann Intern Med. 2010;153:JC2–13. doi: 10.7326/0003-4819-153-4-201008170-02013
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Published: Ann Intern Med. 2010;153(4):JC2-13.
Back Pain, Rheumatology.
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