PREDICTION OF THE CLINICAL COURSE OF LOW-BACK TROUBLE USING MULTIVARIABLE MODELS

被引：44

作者：

BURTON, AK ^{[1
]}

TILLOTSON, KM ^{[1
]}

机构：

[1] HUDDERSFIELD POLYTECH,SCH HUMAN & HLTH SCI,HUDDERSFIELD HD1 3DH,W YORKSHIRE,ENGLAND

来源：

SPINE | 1991年 / 16卷 / 01期

关键词：

Lowback pain; Multivariable models; Outcome; Prediction;

D O I：

10.1097/00007632-199101000-00002

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

The inability to predict outcome in patients with low-back pain seriously impedes clinical trials and leads to inappropriate or unnecessary treatment. This prospective study investigated the value of multivariable mathematical models to predict the 1-year clinical course of 109 patients with low-back trouble (LBT). Discriminant analysis was used to determine predictive models for outcome groups at 1 month, 3 months and 1 year. The variables selected in the analyses were subsets of 29 items from a clinical interview at presentation. These included anamnestic features of the first episode as well as symptomatic details and results from clinical tests for the current spell. The derived models successfully discriminated outcome groups with estimates of sensitivity and specificity ranging from 63 to 99%. When models from one set of patients were tested for predictive accuracy by the application of them to a different set, nonrecovery and satisfactory improvement were predicted with a 76-100% success rate. The results affirmed the importance of considering combinations of interrelated variables for prediction and discrimination in LBT. This work has demonstrated that outcome can be predicted successfully by the use of mathematic models based just on presentation data. The ability to determine homogenous groups in respect to outcome is seen as an important aid to therapeutic research; further work will enable refinement of these models for general clinical use and for incorporation into computer-based interview systems.

引用

页码：7 / 14

页数：8

共 50 条

[11] Burton A.K., Getty C., Differences between ‘orthopaedic’ and ‘osteopathic’ Patients with Low Back Trouble Implications for Selecting Patients for Rehabilitation, Back Pain: New Approaches to Rehabilitation and Education, pp. 166-173, (1989)
[12] Burton A.K., Tillotson K.M., Troup J., Prediction of low-back trouble frequency in a working population, Spine, 14, pp. 939-946, (1989)
[13] Cairns D., Mooney V., Crane P., Spinal pain rehabilitation: Inpatient and outpatient treatment results and development of predictors for outcome, Spine, 9, pp. 91-95, (1984)
[14] Dales J.L., Macdonald E.B., Porter R.W., Back pain: The risk factors and its prediction in work people, Clin Biomech, 1, pp. 216-221, (1986)
[15] Dales J.L., Macdonald E.B., Porter R.W., Report of the Working Group on Back Pain, (1979)
[16] Fairbank J., Park W.M., McCall I.W., O'Brien J.P., Apophyseal injection of local anaesthetic as a diagnostic aid in primary low-back pain syndromes, Spine, 6, pp. 598-604, (1981)
[17] Frymoyer J.W., Selby D.K., Segmental instability: Rationale for treatment, Spine, 10, pp. 280-286, (1985)
[18] Gardner A., Pusell L.M., Murty K., Smith D.G., The Management of the Clinical Problem of Spinal Pain with the Aid of a Microcomputer, Back Pain Methods of Clinical Investigation and Assessment, pp. 23-41, (1986)
[19] Heinrich I., O'Hare H., Sweetman B., Erson J., Validation aspects of an empirically derived classification for ‘non-specific’ low back pain, Statistician, 34, pp. 215-230, (1985)
[20] Horal J., The clinical appearance of low back pain disorders in the city of Gothenburg, Sweden: Comparisons of incapacitated probands with matched controls, Acta Orthop Scand, 18, (1969)

← 1 2 3 4 5 →