Measuring Physical and Psychosocial Function in Patients with Low-Back Pain

Deyo, Richard A.; Diehl, Andrew K.

doi:10.1097/00007632-198309000-00009

Cited by 215 publications

(114 citation statements)

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“…Specifically, the ability of the SIP and the NHP to identify within-patient changes over time has been controversial, with some investigators showing correlations between improvements in these scales and clinical change in their patients 25,103,104 and others showing no correlation. [105][106][107][108] Third, unfortunately none of the included studies reported utility measures. Given that utilities are the only HRQL measures in a format useable in cost-effectiveness analyses, none of the HRQL data reported to date can be used for those important analyses.…”

Section: Quality Of Life After Liver Transplantationmentioning

confidence: 99%

Health-related quality of life after liver transplantation: A meta-analysis

et al. 1999

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The goal of this study is to assess health-related quality of life (HRQL) after orthotopic liver transplantation (OLT). Structured MEDLINE and Embase literature searches identified 5473 potentially relevant articles. Thirty-two additional references were collected from the bibliographies. Of the 5505 identified articles, 49 studies reporting data on 3576 transplant recipients met our inclusion criteria, which were an assessment of quality of life (QOL) in adult patients reported as either pretransplantation and posttransplantation data or with a comparison group and written in English. We combined posttransplantation QOL scores from 15 studies that reported data from the same QOL scales to assess the magnitude of the effect of OLT on QOL scales. We also performed a sign test on the 49 studies to evaluate the direction (positive or negative) of the effect of transplantation on QOL. Transplantation resulted in an improvement of 32% in Karnofsky scores, 11% in Sickness Impact Profile scores, and 20% to 50% in the domains of the Nottingham Health Profile. The sign test showed significant improvement in posttransplantation physical health (P F .0004), sexual functioning (P F .008), daily activities (P F .02), general HRQL (P F .02), and social functioning (P F .05), but not psychological health (P F .08). In general, the HRQL of the 3576 patients was impaired pretransplantation and improved posttransplantation. Transplant recipients reported large gains in those aspects of QOL most affected by physical health and smaller improvements in areas affected by psychological functioning.

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Section: Quality Of Life After Liver Transplantationmentioning

confidence: 99%

Health-related quality of life after liver transplantation: A meta-analysis

et al. 1999

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“…With its lifetime prevalence between 58 and 84 %, low back pain poses substantial burden on global health care [2][3][4]. A large proportion (85 %) of low back pain is non-specific and has an unknown aetiology [5]. Of the remaining group, one of the known causes for low back pain is scoliosis: a lateral and rotational deformity of the spine with a Cobb angle of more than 10°in the coronal plain [6,7].…”

Section: Introductionmentioning

confidence: 99%

De novo degenerative lumbar scoliosis: a systematic review of prognostic factors for curve progression

et al. 2016

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Purpose To identify prognostic factors for curve progression in de novo degenerative lumbar scoliosis (DNDLS) by performing a systematic review of the literature. Methods Studies were selected for inclusion following a systematic search in the bibliographic databases PubMed and EMBASE prior to September 2015 and hand searches of the reference lists of retrieved articles. Two authors independently assessed methodological quality. Data were extracted and presented according to a best evidence synthesis. Results The literature search generated a total of 2696 references. After removing duplicates and articles that did not meet inclusion criteria, 12 studies were included. Due to the lack of statistical analyses, pooling of data was not possible. Strong evidence indicates that increasing intervertebral disk degeneration, lateral vertebral translation C6 mm, and an intercrest line through L5 (rather than L4) are associated with DNDLS curve progression. Moderate evidence suggests that apical vertebral rotation Grade II or III is associated with curve progression. For the majority of other prognostic factors, we found limited, conflicting, or inconclusive evidence. Osteoporosis, a coronal Cobb angle \30°, lumbar lordosis, lateral osteophytes difference of C5 mm, and degenerative spondylolisthesis have not been shown to be risk factors. Clinical risk factors for progression were not identified. Conclusions This review shows strong evidence that increased intervertebral disk degeneration, an intercrest line through L5, and apical lateral vertebral translation C6 mm are associated with DNDLS curve progression. Moderate evidence was found for apical vertebral rotation (Grade II/III) as a risk factor for curve progression. These results, however, may not be directly applicable to the individual patient.

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“…We chose improvement or deterioration in ODI score as the main outcome variable, since the ODI is a well validated, reliable and a responsive measure of functional score and HROL [7,22]. Moreover, functional well being and better quality of life would be optimal therapeutic goals for the patients [18,33].…”

Section: Discussionmentioning

confidence: 99%

“…Several predictors of an unfavourable outcome have been identified [1,2,12,20,25,28,30,31,32] and socioeconomic and psychological factors seem to play a major role [7,9,15,21,24]. Risk factors for deterioration of functional status and HRQL after microdiscectomy have not been reported.…”

Section: Introductionmentioning

confidence: 99%

“…Some studies reported on increase in pain after microdiscectomy [17,26,29] and one study reported on decrease in health-related quality of life (HRQL) after such operations [30]. Prospective studies focusing on deterioration of functional status after microdiscectomy are lacking.Several predictors of an unfavourable outcome have been identified [1,2,12,20,25,28,30,31,32] and socioeconomic and psychological factors seem to play a major role [7,9,15,21,24]. Risk factors for deterioration of functional status and HRQL after microdiscectomy have not been reported.…”

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The risk of ?getting worse? after lumbar microdiscectomy

et al. 2004

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IntroductionLumbar microdiscectomy is the most frequently performed spinal operation. A frequent concern among the patients is the risk of "getting worse" after the operation. It is difficult to give an evidence-based estimate of the risk of deterioration, since previous studies have been more focused on unfavourable outcome in general, rather than on deterioration in particular. Some studies reported on increase in pain after microdiscectomy [17,26,29] and one study reported on decrease in health-related quality of life (HRQL) after such operations [30]. Prospective studies focusing on deterioration of functional status after microdiscectomy are lacking.Several predictors of an unfavourable outcome have been identified [1,2,12,20,25,28,30,31,32] and socioeconomic and psychological factors seem to play a major role [7,9,15,21,24]. Risk factors for deterioration of functional status and HRQL after microdiscectomy have not been reported. Furthermore, patients with a favourable outcome score at follow-up may have deteriorated, but this only becomes evident when a change in score is considered. This implies that risk factors for deterioration and a "poor outcome" might be different.The aim of this prospective study was to evaluate the frequency and the predictors of "getting worse" in a cohort of 180 consecutive patients operated by microdiscectomy for lumbar disc herniation. Abstract A frequent concern among patients operated for lumbar disc herniation is the risk of "getting worse". To give an evidence-based estimate of the risk for worsening has been difficult, since previous studies have been more focused on unfavourable outcome in general, rather than on deterioration in particular. In this prospective study of 180 patients, we report the frequency of and the risk factors for getting worse after first time lumbar microdiscectomy. Follow-up time was 12 months. Primary outcome measure was the Oswestry disability index, assessing functional status and health-related quality of life. Of the patients 4% got worse. Independent risk factors of deterioration were a long duration of sick leave and a better functional status and quality of life prior to operation. We conclude that the risk of deterioration is small, but larger if the patient has been unable to work despite relatively small health problems. This study also demonstrates that changes in instrument scores should be reported, so that an accurate failure rate can be assessed.

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Measuring Physical and Psychosocial Function in Patients with Low-Back Pain

Cited by 215 publications

References 0 publications

Health-related quality of life after liver transplantation: A meta-analysis

Health-related quality of life after liver transplantation: A meta-analysis

De novo degenerative lumbar scoliosis: a systematic review of prognostic factors for curve progression

The risk of ?getting worse? after lumbar microdiscectomy

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