Developing clinical prediction models for nonrecovery in older patients seeking care for back pain: the back complaints in the elders prospective cohort study

Gaag, Wendelien H van der; Chiarotto, Alessandro; Heymans, Martijn W.; Enthoven, Wendy T. M.; Rijckevorsel-Scheele, Jantine van; Bierma-Zeinstra, Sita M A; Bohnen, Arthur M.; Koes, Bart W.

doi:10.1097/j.pain.0000000000002161

Cited by 16 publications

(17 citation statements)

References 64 publications

(139 reference statements)

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“…Comorbidity has previously been associated with the clinical course of a back pain episode in older adults and can thus be considered a promising prognostic factor. 5,30,51,54,57,65 Comorbidity was defined by Feinstein as “any distinct additional entity that has existed or may occur during the clinical course of a patient who has the index disease under study.” 8 Comorbidity is common in people with back pain, and the prevalence of 2 or more coexisting conditions increases with age. 14,18,34 Moreover, the presence of comorbidities is associated with increased personal and societal economic burden from back pain, and with lower compliance to clinical practice guidelines by healthcare providers.…”

Section: Introductionmentioning

confidence: 99%

The one-year clinical course of back-related disability and the prognostic value of comorbidity among older adults with back pain in primary care

Vigdal

Storheim

Killingmo

et al. 2022

Pain

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Back pain and comorbidity are common in older adults. Comorbidity is a promising prognostic factor for the clinical course of backrelated disability, but confirmatory studies assessing its prognostic value are needed. Thus, the aims of this study were to describe the clinical course of back-related disability during 1-year follow-up in patients aged $55 years visiting primary care (general practitioner, physiotherapist, or chiropractor) with a new episode of back pain and assess the prognostic value of comorbidity on back-related disability during 1-year follow-up. A prospective cohort study was conducted, including 452 patients. The outcome measure was Roland-Morris Disability Questionnaire (RMDQ, range 0-24) measured at baseline and at 3-, 6-, and 12-month followup. The Self-Administered Comorbidity Questionnaire was used to assess comorbidity count (CC, range 0-15) and comorbidity burden (CB, range 0-45). The RMDQ scores improved from median (interquartile range) 9 (4-13) at baseline to 4 (1-9), 4 (0-9), and 3 (0-9) at 3, 6, and 12 months, respectively. Using linear mixed-effects models, we found that CC and CB were independently associated with RMDQ scores. A 1-point increase in CC was associated with an increase in RMDQ score of 0.76 points (95% confidence interval [0.48-1.04]) over the follow-up year, adjusted for known prognostic factors. A 1-point increase in CB was associated with an increased RMDQ score of 0.47 points (95% confidence interval [0.33-0.61]). In conclusion, the clinical course of back-related disability for older adults presenting in primary care was favorable, and increased comorbidity was an independent prognostic factor for increased disability levels.

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Section: Introductionmentioning

confidence: 99%

The one-year clinical course of back-related disability and the prognostic value of comorbidity among older adults with back pain in primary care

Vigdal

Storheim

Killingmo

et al. 2022

Pain

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“…Given multiple factors (eg, psychological and physical comorbidities, maladaptive coping, and age-related physical problems) can modify the LBP experience in older adults. 47,50 Physical function is a core outcome domain for patients with LBP. 6,24,43,51 International consensus recommends using the Roland-Morris Disability Questionnaire (RMDQ) or the Oswestry Disability Index (ODI) to measure physical function in clinical trials.…”

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confidence: 99%

Roland-Morris Disability Questionnaire, Oswestry Disability Index, and Quebec Back Pain Disability Scale: Which Has Superior Measurement Properties in Older Adults With Low Back Pain?

Jenks¹,

Hoekstra²,

Tulder³

et al. 2022

Journal of Orthopaedic & Sports Physical Therapy

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“…One population-based cohort and one primary care cohort reported that self-reported morning stiffness is clearly associated with features of spinal OA (22,23). Interestingly, whereas painful range of motion has recently been found to be associated with poor prognosis of back pain (24), it did not reach consensus in this Delphi process to be included in a symptomatic definition of spinal OA. These results suggest discerning levels of pain severity for both the structural aspects and symptoms.…”

Section: Discussionmentioning

confidence: 99%

Consensus for Statements Regarding a Definition for Spinal Osteoarthritis for Use in Research and Clinical Practice: A Delphi Study

Luca

Chiarotto

Cicuttini

et al. 2023

Arthritis Care & Research

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Objective To determine consensus among an international, multidisciplinary group of experts regarding definitions of spinal osteoarthritis for research and for clinical practice. Methods A 15‐member, multidisciplinary steering committee generated 117 statements for a 3‐round Delphi study. Experts in back pain and/or osteoarthritis were identified and invited to participate. In round 1, participants could propose additional statements for voting. All statements were rated on a 1–9 Likert scale, and consensus was set at ≥70% of respondents agreeing or disagreeing with the statement and <15% of respondents providing the opposite response. Results In total, 255 experts from 11 different professional backgrounds were invited. From 173 available experts, 116 consented to participate. In round 1, 103 participants completed the survey, followed by 85 of 111 participants in round 2 (77%) and 87 of 101 participants in round 3 (86%). One‐third of participants were from Europe (30%), most were male (58%), one‐fifth were physical therapists (21%), and over one‐third had been in their profession for 11–20 years (35%). Of 131 statements, consensus was achieved for 71 statements (54%): 53 in agreement (75%) and 18 in disagreement (25%). Conclusion Although there was consensus for statements for definitions of spinal osteoarthritis that were analogous to definitions of osteoarthritis in appendicular joints, a future definition still needs refinement. Importantly, this Delphi highlighted that a future definition should be considered across a spectrum of structural changes and patient symptoms and expressed on a progressive scale.

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Developing clinical prediction models for nonrecovery in older patients seeking care for back pain: the back complaints in the elders prospective cohort study

Abstract: Three clinical prediction models were developed for nonrecovery in older adults seeking care for back pain; the model predicting persistent disability performed best (optimism-adjusted R 2 46%, area under the curve 0.85).

Cited by 16 publications

References 64 publications

The one-year clinical course of back-related disability and the prognostic value of comorbidity among older adults with back pain in primary care

The one-year clinical course of back-related disability and the prognostic value of comorbidity among older adults with back pain in primary care

Roland-Morris Disability Questionnaire, Oswestry Disability Index, and Quebec Back Pain Disability Scale: Which Has Superior Measurement Properties in Older Adults With Low Back Pain?

Consensus for Statements Regarding a Definition for Spinal Osteoarthritis for Use in Research and Clinical Practice: A Delphi Study

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