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Cuenca-Martínez F, Herranz-Gómez A, Varangot-Reille C, Bajcar EA, Adamczyk WM, Suso-Martí L, Bąbel P. Pain memory in children: a systematic review and meta-analysis with a meta-regression. Pain 2024:00006396-990000000-00515. [PMID: 38314811 DOI: 10.1097/j.pain.0000000000003170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 12/04/2023] [Indexed: 02/07/2024]
Abstract
ABSTRACT The aim of this systematic review and meta-analysis was to analyze the accuracy of memory of pain and the variables that may influence it in children with acute, experimental, and chronic pain. We conducted a search in electronic databases from inception to February 11, 2022. Twelve observational studies and 3 randomized controlled studies were included in the study. The main outcome measure was the accuracy of the memory of the pain intensity (experienced/recalled). To compare the outcomes reported by the studies, we calculated the standardized mean difference (SMD) over time for the continuous variables. The overall meta-analysis showed a small effect size in favor of an overestimation of experienced pain intensity (SMD = 0.28). Subanalyzing per pain context, there was a small effect size in favor of overestimation in the clinical context (SMD = 0.33), but there was no evidence of any change in the accuracy of memory of pain in the experimental context (SMD = 0.07). The mean age of the participants and the proportion of girls significantly predicted the accuracy of the memory of pain. The period since the experienced pain measurement, the intensity of expected and recalled fear, trait anxiety, and anxiety sensitivity did not significantly predict the accuracy of the memory of pain. Children showed an overestimation in pain memory between the experienced and recalled intensity of acute pain, especially in a clinical context. Furthermore, only gender and age were predictors of the accuracy of pain memory. These results highlight the relevance of pain memory to medical practice and future research.
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Affiliation(s)
| | - Aida Herranz-Gómez
- Department of Physiotherapy, Faculty of Health Sciences, European University of Valencia, Valencia, Spain
| | | | - Elżbieta A Bajcar
- Jagiellonian University, Institute of Psychology, Pain Research Group, Kraków, Poland
| | - Wacław M Adamczyk
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Luis Suso-Martí
- Department of Physiotherapy, University of Valencia, Valencia, Spain
| | - Przemysław Bąbel
- Jagiellonian University, Institute of Psychology, Pain Research Group, Kraków, Poland
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2
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Gausel AM, Dalen I, Eklund A, Hoff Norvik A, Axén I. Exploring the outcome "days with bothersome pain" and its association with pain intensity, disability, and quality of life. Scand J Pain 2024; 24:sjpain-2023-0049. [PMID: 38447020 DOI: 10.1515/sjpain-2023-0049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 12/20/2023] [Indexed: 03/08/2024]
Abstract
OBJECTIVES The aim of this study is to investigate the criterion validity, specifically the concurrent validity of the measure of days with bothersome pain, by investigating its association with measures of pain intensity, disability, and quality of life. METHODS We used two separate cohorts to study the concurrent validity of "days with bothersome pain," by investigating its association with pain intensity, disability, and quality of life: (1) 321 patients with low back pain (LBP), using follow-up data at 1 year, and (2) 170 pregnant women with pelvic girdle pain (PGP), using data at 12 and 30 weeks of their pregnancy. In both studies, weekly text messages asked for the number of days with bothersome pain the previous week. Pearson's correlation, univariable, and multivariable linear regression were used to assess the association between days with bothersome pain per week and pain intensity, disability, and quality of life. Non-linear associations were explored. RESULTS Days with bothersome pain were moderately and inversely correlated with quality of life (r = -0.45, p < 0.001), and moderately correlated with pain intensity (r = 0.70, p < 0.001) and disability ( r = 0.51, p < 0.001), among patients with LBP, and to a lesser degree among pregnant women with PGP (corresponding values at 18 weeks of pregnancy for quality of life; r = -0.27, p = 0.005, for pain intensity r = 0.41, p < 0.001, and for disability r = 0.41, p < 0.001). Furthermore, it was best explained by pain intensity for LBP patients, and by pain intensity and disability for pregnant women with pelvic pain. For the latter cohort, non-linear analyses suggested that days with bothersome pain could not distinguish between individuals with different high pain intensities and disabilities and low quality of life. CONCLUSIONS We consider the concurrent validity of "days with bothersome pain" to be moderate in the correlations with pain intensity, disability, and quality of life in patients with LBP and in pregnant women with PGP. Ceiling effects may be an issue in populations with high pain severity. The differences between the cohorts suggested that also other constructs are involved in the concept of days with bothersome pain.
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Affiliation(s)
- Anne Marie Gausel
- Department of Research, Stavanger University Hospital, P.O. box 8100, 4068, Stavanger, Norway
- Department of Caring and Ethics, Faculty of Health Science, University of Stavanger, P.O. box 8600, 4036, Stavanger Norway
- Stiftelsen Et Liv i Bevegelse, Lilleakerveien 31, Oslo, Norway
| | - Ingvild Dalen
- Department of Research, Section of Biostatistics, Stavanger University Hospital, P.O. box 8100, 4068 Stavanger, Norway
- Department of Public Health, Faculty of Health Science, University of Stavanger, P.O. box 8600, 4036 Stavanger, Norway
| | - Andreas Eklund
- Karolinska Institutet, Institute of Environmental Medicine, Unit of Intervention and Implementation Research for Worker Health, Nobels väg 13, 171 77 Stockholm, Sweden
| | | | - Iben Axén
- Stiftelsen Et Liv i Bevegelse, Lilleakerveien 31, Oslo, Norway
- Karolinska Institutet, Institute of Environmental Medicine, Unit of Intervention and Implementation Research for Worker Health, Nobels väg 13, 171 77 Stockholm, Sweden
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Haase I. Accuracy of retrospective pain measurement in patients with chronic pain. Med Int (Lond) 2023; 3:35. [PMID: 37448767 PMCID: PMC10336923 DOI: 10.3892/mi.2023.95] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 06/30/2023] [Indexed: 07/15/2023]
Abstract
The use of pain scales that refer to a past time period is thereby based on the assumption that patients accurately remember their 'average', 'greatest' and 'least' pain. The present study addresses the validity of numerical pain rating scales that refer to a past period of time (herein, the past 7 days). Routine data from 94 patients with chronic pain were retrospectively analysed. Pain questionnaire data on the greatest, least and average pain during the past week and on current pain were compared with the mean value of entries in a pain diary from the corresponding period. The retrospectively assessed average, greatest and least pain values were consistently slightly higher than the corresponding values of daily current pain measured for the studied collective of chronic pain patients. Current pain (at the time of answering the questionnaire) better represents daily currently measured pain [intraclass correlation (ICC)=0.885] than retrospective individual measurements. The greatest correlation with averaged diary data was shown by the combination of questionnaire data on average, least and current pain (ICC=0.911). The high correlations between the questionnaire and diary data support the validity of retrospective pain surveys. However, the current status influences recall. Thus, composite retrospective pain data improve with the addition of current pain.
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Affiliation(s)
- Ingo Haase
- Department of Research, Development and Quality Assurance, Clinic Group Enzensberg, D-87629 Hopfen am See, Germany
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Shi Z, Yan F, Lu Y, Liu W, Wang Z, Zhang H. Pregnancy-related low back/pelvic girdle pain: Prevalence, severity, and risk factors in Zhengzhou, China. J Back Musculoskelet Rehabil 2023:BMR220147. [PMID: 37248876 DOI: 10.3233/bmr-220147] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Pregnancy-related low back pain (LBP) and pelvic girdle pain (PGP) significantly affect the quality of life of pregnant women. Understanding their severity and risk factors may help prevent and alleviate such pain and their resulting dysfunction. OBJECTIVE This study investigated the prevalence, severity, and biopsychosocial risk factors of pregnancy-related LBP and PGP in Zhengzhou, China. METHODS The Numeric Pain Rating Scale (NPRS), Chinese version of the Roland-Morris Disability Questionnaire (RMDQ), and other questionnaires were self-administered by 1020 pregnant women undergoing treatment at a tertiary hospital between July and December 2019. Binary logistic regression was used to identify factors associated with pregnancy-related LBP and/or PGP. RESULTS The prevalence of LBP and/or PGP during pregnancy was 63.0%, and most participants (80.4%) had both. The mean NPRS and RMDQ disability scores were 2.44 ± 2.10 and 6.66 ± 4.65, respectively. A higher gestational body mass index, LBP and/or PGP during menstruation, history of pregnancy-related LBP and/or PGP, and constant pressure were significantly associated with pregnancy-related LBP and/or PGP. Subjective support was a protective factor against LBP and/or PGP. CONCLUSION The prevalence of LBP and/or PGP was high. The risk factors should be included in routine prenatal care to identify patients at risk of LBP and/or PGP.
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Affiliation(s)
- Zhiyi Shi
- Department of Nursing, Henan Provincial People's Hospital, Zhengzhou, Henan, China
- Henan Provincial Key Medicine Laboratory of Nursing, Zhengzhou, Henan, China
- Zhengzhou University People's Hospital, Zhengzhou, Henan, China
| | - Fan Yan
- Department of Nursing, Henan Provincial People's Hospital, Zhengzhou, Henan, China
- Henan Provincial Key Medicine Laboratory of Nursing, Zhengzhou, Henan, China
- Zhengzhou University People's Hospital, Zhengzhou, Henan, China
| | - Ying Lu
- Department of Nursing, Henan Provincial People's Hospital, Zhengzhou, Henan, China
- Henan Provincial Key Medicine Laboratory of Nursing, Zhengzhou, Henan, China
- Zhengzhou University People's Hospital, Zhengzhou, Henan, China
| | - Weihua Liu
- Department of Nursing, Henan Provincial People's Hospital, Zhengzhou, Henan, China
- Henan Provincial Key Medicine Laboratory of Nursing, Zhengzhou, Henan, China
- Zhengzhou University People's Hospital, Zhengzhou, Henan, China
| | - Zhenzhen Wang
- Department of Nursing, Henan Provincial People's Hospital, Zhengzhou, Henan, China
- Henan Provincial Key Medicine Laboratory of Nursing, Zhengzhou, Henan, China
- Zhengzhou University People's Hospital, Zhengzhou, Henan, China
| | - Hongmei Zhang
- Department of Nursing, Henan Provincial People's Hospital, Zhengzhou, Henan, China
- Henan Provincial Key Medicine Laboratory of Nursing, Zhengzhou, Henan, China
- Zhengzhou University People's Hospital, Zhengzhou, Henan, China
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Müller UWD, Gerdes ABM, Alpers GW. Time is a great healer: Peak-end memory bias in anxiety - Induced by threat of shock. Behav Res Ther 2022; 159:104206. [PMID: 36270235 DOI: 10.1016/j.brat.2022.104206] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 09/22/2022] [Accepted: 10/05/2022] [Indexed: 12/14/2022]
Abstract
Recently, we demonstrated that the peak-end memory bias, which is well established in the context of pain, can also be observed in anxiety: Retrospective evaluations of a frightening experience are worse when peak anxiety is experienced at the end of an episode. Here, we set out to conceptually replicate and extend this finding with rigorous experimental control in a threat of shock paradigm. We induced two intensity levels of anxiety by presenting visual cues that indicated different strengths of electric stimuli. Each of the 59 participants went through one of two conditions that only differed in the order of moderate and high threat phases. As a manipulation check, orbicularis-EMG to auditory startle probes, electrodermal activity, and state anxiety confirmed the effects of the specific threat exposure. Critically, after some time had passed, participants for whom exposure had ended with high threat reported more anxiety for the entire episode than those for whom it ended with moderate threat. Moreover, they ranked their experience as more aversive when compared to other unpleasant everyday experiences. This study overcomes several previous limitations and speaks to the generalizability of the peak-end bias. Most notably, the findings bear implications for exposure therapy in clinical anxiety.
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Affiliation(s)
- Ulrich W D Müller
- School of Social Sciences, Department of Psychology, University of Mannheim, Germany
| | - Antje B M Gerdes
- School of Social Sciences, Department of Psychology, University of Mannheim, Germany
| | - Georg W Alpers
- School of Social Sciences, Department of Psychology, University of Mannheim, Germany.
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Stanhope J, Pisaniello D, Cook A, Weinstein P. Are music students at 'high-risk' of experiencing musculoskeletal symptom outcomes compared with other students? Int J Occup Saf Ergon 2022:1-8. [PMID: 35947800 DOI: 10.1080/10803548.2022.2111846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
Musicians have been described as a 'high-risk' group for experiencing musculoskeletal symptoms (MSSs), yet few studies have tested this assumption. We aimed to determine whether the prevalence and profile of MSS outcomes differed between university music students and a reference group (science students). A survey was conducted with university music and science students. Reported MSS outcomes among the two groups were compared using regression analyses. The majority of participants in both groups reported experiencing MSSs in the last 12 months and 7 days. Music students reported a higher prevalence of wrist/ hand MSSs compared with science students. Compared with symptomatic science students, music students reported a higher emotional impact of MSSs. We recommend prioritising research into interventions for music students that address MSSs in the wrist/ hand region, and the emotional impact of MSSs. Addressing these MSS outcomes could reduce the MSS burden for musicians during and beyond their studies.
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Affiliation(s)
- Jessica Stanhope
- School of Public Health, The University of Adelaide, Adelaide, Australia
| | - Dino Pisaniello
- School of Public Health, The University of Adelaide, Adelaide, Australia
| | - Angus Cook
- School of Population and Global Health, The University of Western Australia, Perth, Australia
| | - Philip Weinstein
- School of Biological Sciences, The University of Adelaide, Adelaide, Australia
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Reece A, Marini F, Mugnosso M, Frost G, Sullivan P, Zabihhosseinian M, Zenzeri J, Holmes MWR. Influence of Neck Pain, Cervical Extensor Muscle Fatigue, and Manual Therapy on Wrist Proprioception. J Manipulative Physiol Ther 2022; 45:216-226. [PMID: 35906104 DOI: 10.1016/j.jmpt.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 06/03/2022] [Accepted: 06/09/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVE The purpose of this study was to examine the effects of submaximal isometric neck muscle fatigue and manual therapy on wrist joint position sense (JPS) within healthy individuals and individuals with subclinical neck pain (SCNP). METHODS Twelve healthy participants and 12 participants with SCNP were recruited. Each group completed 2 sessions, with 48 hours between sessions. On day 1, both groups performed 2 wrist JPS tests using a robotic device. The tests were separated by a submaximal isometric fatigue protocol for the cervical extensor muscles (CEM). On day 2, both groups performed a wrist JPS test, followed by a cervical treatment consisting of manual therapy (SCNP) or neck rest (20 minutes, control group) and another wrist JPS test. Joint position sense was measured as the participant's ability to recreate a previously presented wrist angle. Each wrist JPS test included 12 targets, 6 into wrist flexion and 6 into wrist extension. Kinematic data from the robot established absolute, variability, and constant error. RESULTS Absolute error significantly decreased (P = .01) from baseline to post-fatigue in the SCNP group (baseline = 4.48 ± 1.58°; post-fatigue = 3.90 ± 1.45°) and increased in the control group (baseline = 3.12 ± 0.98°; post-fatigue = 3.81 ± 0.90°). The single session of manual cervical treatment significantly decreased absolute error in participants with SCNP (P = .004). CONCLUSION This study demonstrated that neck pain or fatigue can lead to altered afferent input to the central nervous system and can affect wrist JPS. Our findings demonstrate that acute wrist proprioception may be improved in individuals with SCNP by a single cervical manual therapy session.
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Affiliation(s)
- Ashley Reece
- Faculty of Applied Health Sciences, Brock University, St. Catharines, Ontario, Canada
| | | | - Maddalena Mugnosso
- Robotics, Brain and Cognitive Sciences, Italian Institue of Technology, Genoa, Italy
| | - Gail Frost
- Faculty of Applied Health Sciences, Brock University, St. Catharines, Ontario, Canada
| | - Philip Sullivan
- Faculty of Applied Health Sciences, Brock University, St. Catharines, Ontario, Canada
| | | | - Jacopo Zenzeri
- Robotics, Brain and Cognitive Sciences, Italian Institue of Technology, Genoa, Italy
| | - Michael W R Holmes
- Faculty of Applied Health Sciences, Brock University, St. Catharines, Ontario, Canada.
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Hage R, Detrembleur C, Dierick F, Brismée JM, Roussel N, Pitance L. Sensorimotor performance in acute-subacute non-specific neck pain: a non-randomized prospective clinical trial with intervention. BMC Musculoskelet Disord 2021; 22:1017. [PMID: 34863120 DOI: 10.1186/s12891-021-04876-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 11/15/2021] [Indexed: 01/01/2023] Open
Abstract
Background The assessment of cervical spine kinematic axial rotation performance is of great importance in the context of the study of neck sensorimotor control. However, studies addressing the influence of the level of provocation of spinal pain and the potential benefit of passive manual therapy mobilizations in patients with acute-subacute non-specific neck pain are lacking. Methods A non-randomized prospective clinical trial with an intervention design was conducted. We investigated: (1) the test-retest reliability of kinematic variables during a fast axial head rotation task standardized with the DidRen laser test device in 42 Healthy pain-free Control Participants (HCP) (24.3 years ±6.8); (2) the differences in kinematic variables between HCP and 38 patients with Acute-subacute Non-Specific neck Pain (ANSP) assigned to two different groups according to whether their pain was localized in the upper or lower spine (46.2 years ±16.3); and (3) the effect of passive manual therapy mobilizations on kinematic variables of the neck during fast axial head rotation. Results (1) Intra-class correlation coefficients ranged from moderate (0.57 (0.06-0.80)) to excellent (0.96 (0.91-0.98)). (2) Kinematic performance during fast axial rotations of the head was significantly altered in ANSP compared to HCP (age-adjusted) for one variable: the time between peaks of acceleration and deceleration (p<0.019). No significant difference was observed between ANSP with upper vs lower spinal pain localization. (3) After the intervention, there was a significant effect on several kinematic variables, e.g., ANSP improved peak speed (p<0.007) and performance of the DidRen laser test (p<0.001), with effect sizes ranging from small to medium. Conclusion (1) The DidRen laser test is reliable. (2) A significant reduction in time between acceleration and deceleration peaks was observed in ANSP compared to HCP, but with no significant effect of spinal pain location on kinematic variables was found. (3) We found that neck pain decreased after passive manual therapy mobilizations with improvements of several kinematic variables. Trial registration Registration Number: NCT 04407637 Supplementary Information The online version contains supplementary material available at 10.1186/s12891-021-04876-4.
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9
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Moll LT, Schmidt AM, Stapelfeldt CM, Labriola M, Jensen OK, Kindt MW, Jensen TS, Schiøttz-Christensen B. Prediction of 2-year work participation in sickness absentees with neck or shoulder pain: the contribution of demographic, patient-reported, clinical and imaging information. BMC Musculoskelet Disord 2019; 20:525. [PMID: 31706350 PMCID: PMC6842554 DOI: 10.1186/s12891-019-2906-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 10/22/2019] [Indexed: 11/11/2022] Open
Abstract
Background In cases of neck and shoulder pain, the responsibility for assessing work prognosis is held by clinicians with access to different domains of information. One of these domains is magnetic resonance imaging (MRI), and although MRI is increasingly used, it is unknown which domains of information contribute the most to the prediction of work prognosis. This retrospective cohort study explored the contribution of demographic, patient-reported, clinical, and MRI information to the prediction of work participation in sickness absentees with neck or shoulder pain. Methods From a secondary care setting, 168 sickness absentees with neck or shoulder pain were included. Based on registry data, a successful work outcome was defined as ≥50% work participation score (WPS) from Weeks 1 to 104 after enrolment. Prognostic variables were categorized into four domains (demographic, patient-reported, clinical, and MRI) resembling the order of information obtained in a clinical setting. Crude logistic regression analyses were used to identify prognostic variables for each domain (p < 0.2). This was followed by multivariable analyses including the identified variables in a domain-wise order. For each added domain, the probability of successful WPS was dichotomized leaving two possible classifications: ≥ 50% chance of successful WPS or not. In cross-tabulations of chance and the actual WPS outcome, positive and negative predictive values (PPV and NPV), sensitivity, specificity and area under the curve (AUC) were calculated. Results The combination of demographic and patient-reported variables yielded an NPV of 0.72 and a PPV of 0.67, while specificity was 0.82, sensitivity 0.54 and AUC 0.77. None of these values improved notably by adding clinical and MRI variables as predictors of successful WPS. Conclusions These results suggest that - among sickness absentees with neck or shoulder pain – clinical and MRI variables provide no additional information for the prediction of work participation compared with only demographic and patient-reported information.
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Affiliation(s)
- Line Thorndal Moll
- DEFACTUM, P.P. Oerums Gade 11, bygn. 1B, Aarhus C, DK-8000, Aarhus, Central Denmark Region, Denmark. .,Section of Clinical Social Medicine and Rehabilitation, Department of Public Health, Aarhus University, P.P. Oerums Gade 9-11, bygn. 1B, Aarhus C, DK-8000, Aarhus, Denmark. .,Spine Centre, Diagnostic Centre, Silkeborg Regional Hospital, Falkevej 1-3, DK-8600, Silkeborg, Denmark.
| | - Anne Mette Schmidt
- DEFACTUM, P.P. Oerums Gade 11, bygn. 1B, Aarhus C, DK-8000, Aarhus, Central Denmark Region, Denmark.,Section of Clinical Social Medicine and Rehabilitation, Department of Public Health, Aarhus University, P.P. Oerums Gade 9-11, bygn. 1B, Aarhus C, DK-8000, Aarhus, Denmark.,Sano Aarhus, Egernvej 5, DK-8270 Højbjerg, Aarhus, Denmark
| | - Christina Malmose Stapelfeldt
- DEFACTUM, P.P. Oerums Gade 11, bygn. 1B, Aarhus C, DK-8000, Aarhus, Central Denmark Region, Denmark.,Section of Clinical Social Medicine and Rehabilitation, Department of Public Health, Aarhus University, P.P. Oerums Gade 9-11, bygn. 1B, Aarhus C, DK-8000, Aarhus, Denmark
| | - Merete Labriola
- DEFACTUM, P.P. Oerums Gade 11, bygn. 1B, Aarhus C, DK-8000, Aarhus, Central Denmark Region, Denmark.,Section of Clinical Social Medicine and Rehabilitation, Department of Public Health, Aarhus University, P.P. Oerums Gade 9-11, bygn. 1B, Aarhus C, DK-8000, Aarhus, Denmark
| | - Ole Kudsk Jensen
- Spine Centre, Diagnostic Centre, Silkeborg Regional Hospital, Falkevej 1-3, DK-8600, Silkeborg, Denmark
| | - Morten Wasmod Kindt
- Department for Diagnostic Imaging, Diagnostic Centre, Silkeborg Regional Hospital, University Research Clinic for Innovative Patient Pathways, Falkevej 1-3, DK-8600, Silkeborg, Denmark
| | - Tue Secher Jensen
- Department for Diagnostic Imaging, Diagnostic Centre, Silkeborg Regional Hospital, University Research Clinic for Innovative Patient Pathways, Falkevej 1-3, DK-8600, Silkeborg, Denmark.,Nordic Institute of Chiropractic and Clinical Biomechanics, University of Southern Denmark, Campusvej 55 Odense M, DK-5230, Odense, Denmark
| | - Berit Schiøttz-Christensen
- Spine Centre of Southern Denmark, Hospital Lillebaelt Middelfart and Institute of Regional Health Research, University of Southern Denmark, Oestre Hougvej 55 Middelfart, DK-5500, Odense, Denmark
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Wei YJJ, Solberg L, Chen C, Fillingim RB, Pahor M, DeKosky S, Winterstein AG. Pain Assessments in MDS 3.0: Agreement with Vital Sign Pain Records of Nursing Home Residents. J Am Geriatr Soc 2019; 67:2421-2422. [PMID: 31403708 DOI: 10.1111/jgs.16122] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 07/20/2019] [Indexed: 11/28/2022]
Affiliation(s)
- Yu-Jung J Wei
- Department of Pharmaceutical Outcomes & Policy, College of Pharmacy, University of Florida, Gainesville, Florida.,Center for Drug Evaluation and Safety, University of Florida, Gainesville, Florida
| | - Laurence Solberg
- Department of Aging and Geriatric Research, Institute on Aging, University of Florida College of Medicine, Gainesville, Florida.,Geriatric Research Education Clinical Center, SG/NF Veterans Health Administration, Gainesville, Florida
| | - Cheng Chen
- Department of Pharmaceutical Outcomes & Policy, College of Pharmacy, University of Florida, Gainesville, Florida
| | - Roger B Fillingim
- College of Dentistry, University of Florida, Gainesville, Florida.,Pain Research and Intervention Center of Excellence, University of Florida, Gainesville, Florida
| | - Marco Pahor
- Department of Aging and Geriatric Research, Institute on Aging, University of Florida College of Medicine, Gainesville, Florida
| | - Steven DeKosky
- Department of Neurology, University of Florida, Gainesville, Florida
| | - Almut G Winterstein
- Department of Pharmaceutical Outcomes & Policy, College of Pharmacy, University of Florida, Gainesville, Florida.,Center for Drug Evaluation and Safety, University of Florida, Gainesville, Florida.,Department of Epidemiology, University of Florida Colleges of Medicine and Public Health and Health Professions, Gainesville, Florida
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Abstract
Recent reviews of musicians' musculoskeletal symptoms (MSS) have reported heterogeneity in the outcomes reported and data collection tools used, making it difficult to compare and synthesise findings. The purpose of this present review was to improve the consistency of future research, by documenting the outcomes reported in recent studies of musicians' MSS and the data collection tools used. All English language, peer-reviewed studies, published 2007-2016 that reported musicians' self-reported MSS outcomes were identified. Details of the types of outcomes reported and the tools used were extracted, and synthesised descriptively. A range of MSS outcomes were reported, including MSS with a temporal relationship to activities performed, and the consequences of symptoms. Only 24% of studies used standardised questionnaires, with the Nordic Musculoskeletal Questionnaire (NMQ) being the most commonly used. To improve the homogeneity of outcomes and data collection tools when investigating musicians' MSS, we recommend using the NMQ, where appropriate. Recall periods of 12-months and 7-d are the most appropriate for prevalence, and 7-d recall periods for ratings. Importantly, outcomes and the tools used to collect data should be reported in sufficient detail to ensure that the study can be replicated, critiqued, and accurately interpreted.
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Affiliation(s)
| | - Dino Pisaniello
- School of Public Health, The University of Adelaide, Australia
| | - Rebecca Tooher
- School of Public Health, The University of Adelaide, Australia
| | - Philip Weinstein
- School of Biological Sciences, The University of Adelaide, Australia
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12
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Georgsson S, Carlsson T. Pain and pain management during induced abortions: A web‐based exploratory study of recollections from previous patients. J Adv Nurs 2019; 75:3006-3017. [DOI: 10.1111/jan.14132] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 05/06/2019] [Accepted: 05/21/2019] [Indexed: 11/30/2022]
Affiliation(s)
- Susanne Georgsson
- The Swedish Red Cross University College Huddinge Sweden
- Department of Clinical Science, Intervention and Technology Karolinska Institutet Stockholm Sweden
| | - Tommy Carlsson
- Sophiahemmet University Stockholm Sweden
- Department of Women’s and Children’s Health Uppsala University Uppsala Sweden
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13
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Rice KL, Castex J, Redmond M, Burton J, Guo JW, Beck SL. Bundling Interventions to Enhance Pain Care Quality (BITE Pain) in Medical Surgical Patients. Ochsner J 2019; 19:77-95. [PMID: 31258419 DOI: 10.31486/toj.18.0164] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Background: Inadequate pain management and undertreatment remain a serious clinical issue among hospitalized adults, contributing to chronic pain syndromes and opioid dependency. Implementation of individual pain care interventions has been insufficient to improve pain care quality. The purpose of this interprofessional, patient-centered project was to implement a 6-component bundle of evidence-based pain management strategies to improve patients' perception of pain care quality and 24-hour pain experience outcomes. Methods: A quasi-experimental design was used to test the effect of a bundled pain management intervention on 3 medical surgical units. Baseline outcomes using the Pain Care Quality-Interdisciplinary (PainCQ-I©) and Pain Care Quality-Nursing (PainCQ-N©) surveys were measured monthly for 4 months preintervention and 30 months postintervention. Results: A convenience sample of 846 patients was analyzed. The effect of the intervention on pain outcomes could not be tested because unit-based adherence did not meet the goal of 80%. A subsample of 70.2% (594/846) of participants was sufficient to complete a 3-group analysis of preintervention and postintervention participants with confirmed intervention adherence. Participants in the postintervention group who received all 6 components (n=65) had significantly higher odds of higher PainCQ© scores than those in the preintervention group (n=141) (PainCQ-I©: odds ratio [OR] 2.61, 95% confidence interval [CI] 1.54-4.42; PainCQ-N©: OR 3.82, 95% CI 2.06-7.09) or those in the postintervention group receiving ≤5 components (n=388) (PainCQ-I©: OR 2.52, 95% CI 1.57-4.03; PainCQ-N©: OR 3.84, 95% CI 2.17-6.80). Conclusion: Medical surgical patients participating in this study who received the bundled 6-component intervention reported significantly higher levels of perceived pain care quality, suggesting that a bundled approach may be more beneficial than unstandardized strategies.
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14
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Lemeunier N, da Silva-Oolup S, Olesen K, Shearer H, Carroll LJ, Brady O, Côté E, Stern P, Tuff T, Suri-Chilana M, Torres P, Wong JJ, Sutton D, Murnaghan K, Côté P. Reliability and validity of self-reported questionnaires to measure pain and disability in adults with neck pain and its associated disorders: part 3-a systematic review from the CADRE Collaboration. Eur Spine J 2019; 28:1156-1179. [PMID: 30879185 DOI: 10.1007/s00586-019-05949-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 03/10/2019] [Indexed: 11/27/2022]
Abstract
PURPOSE To determine the reliability and validity of self-reported questionnaires to measure pain and disability in adults with grades I-IV neck pain and its associated disorders (NAD). METHODS We updated the systematic review of the 2000-2010 Bone and Joint Decade Task Force on Neck Pain and its Associated Disorders and systematically searched databases from 2005 to 2017. Independent reviewers screened and critically appraised studies using standardized tools. Evidence from low-risk-of-bias studies was synthesized according to best evidence synthesis principles. Validity studies were ranked according to the Sackett and Haynes classification. RESULTS We screened 2823 articles, and 26 were eligible for critical appraisal; 18 were low risk of bias. Preliminary evidence suggests that the Neck Disability Index (original and short versions), Whiplash Disability Questionnaire, Neck Pain Driving Index, and ProFitMap-Neck may be valid and reliable to measure disability in patients with NAD. We found preliminary evidence for the validity and reliability of pain measurements including the Body Pain Diagram, Visual Analogue Scale, the Numeric Rating Scale and the Pain-DETECT Questionnaire. CONCLUSION The evidence supporting the validity and reliability of instruments used to measure pain and disability is preliminary. Further validity studies are needed to confirm the clinical utility of self-reported questionnaires to assess pain and disability in patients with NAD. These slides can be retrieved under Electronic Supplementary Material.
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Affiliation(s)
- N Lemeunier
- Institut Franco-Européen de Chiropraxie (IFEC), 72 chemin de la Flambère, 31300, Toulouse, France.
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), 2000 Simcoe St. N., Oshawa, ON, L1H 7K4, Canada.
- Canadian Memorial Chiropractic College (CMCC), 6100 Leslie Street, Toronto, ON, M2H 3J1, Canada.
| | - S da Silva-Oolup
- Graduate Education and Research Programs, Canadian Memorial Chiropractic College (CMCC), 6100 Leslie Street, Toronto, ON, Canada
| | - K Olesen
- Graduate Education and Research Programs, Canadian Memorial Chiropractic College (CMCC), 6100 Leslie Street, Toronto, ON, Canada
| | - H Shearer
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), 2000 Simcoe St. N., Oshawa, ON, L1H 7K4, Canada
- Canadian Memorial Chiropractic College (CMCC), 6100 Leslie Street, Toronto, ON, M2H 3J1, Canada
| | - L J Carroll
- School of Public Health, University of Alberta, 4075 Research Transition Facility, 8308 - 114 St., Edmonton, AB, T6G 2E1, Canada
| | - O Brady
- School of Physical Therapy and Rehabilitation Sciences, Morsani College of Medicine, University of South Florida, 3515 E. Fletcher Ave, Tampa, FL, USA
| | - E Côté
- Department of Ophthalmology and Vision Sciences, University of Toronto, 340 College St., Toronto, ON, M5T 3A9, Canada
| | - P Stern
- Graduate Education and Research Programs, Canadian Memorial Chiropractic College (CMCC), 6100 Leslie Street, Toronto, ON, Canada
| | - T Tuff
- Graduate Education and Research Programs, Canadian Memorial Chiropractic College (CMCC), 6100 Leslie Street, Toronto, ON, Canada
| | - M Suri-Chilana
- Graduate Education and Research Programs, Canadian Memorial Chiropractic College (CMCC), 6100 Leslie Street, Toronto, ON, Canada
| | - P Torres
- Rehabilitation Centre, San Cristobal Clinic, Santiago Spine Group, Santiago, Chile
| | - J J Wong
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), 2000 Simcoe St. N., Oshawa, ON, L1H 7K4, Canada
- Canadian Memorial Chiropractic College (CMCC), 6100 Leslie Street, Toronto, ON, M2H 3J1, Canada
- Graduate Education and Research Programs, Canadian Memorial Chiropractic College (CMCC), 6100 Leslie Street, Toronto, ON, Canada
| | - D Sutton
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), 2000 Simcoe St. N., Oshawa, ON, L1H 7K4, Canada
- Canadian Memorial Chiropractic College (CMCC), 6100 Leslie Street, Toronto, ON, M2H 3J1, Canada
| | - K Murnaghan
- Canadian Memorial Chiropractic College (CMCC), 6100 Leslie Street, Toronto, ON, M2H 3J1, Canada
| | - P Côté
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), 2000 Simcoe St. N., Oshawa, ON, L1H 7K4, Canada
- Canadian Memorial Chiropractic College (CMCC), 6100 Leslie Street, Toronto, ON, M2H 3J1, Canada
- Faculty of Health Sciences, University of Ontario Institute of Technology (UOIT), 2000 Simcoe St. N., Oshawa, ON, L1H 7K4, Canada
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15
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Van Liew C, Standridge K, Leon G, Cronan TA. A longitudinal analysis of pain experience and recall in fibromyalgia. Int J Rheum Dis 2018; 22:497-506. [PMID: 30398031 DOI: 10.1111/1756-185x.13415] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 08/06/2018] [Accepted: 09/14/2018] [Indexed: 11/30/2022]
Abstract
AIM To evaluate pain experiences and memories in fibromyalgia (FM) patients over time. METHOD Participants included 572 females who were members of a large health maintenance organization who had a diagnosis of FM syndrome (FMS) and met inclusion criteria for the study. Recruitment was for an intervention study that tested the effects of social support and education treatment arms, but there were no treatment effects. Reports of experiential pain (EP), historical peak pain (HPP), and historical valley pain (HVP) for FM were collected. Differences between HPP and EP and EP and HVP (bias) were calculated to determine whether HPP and HVP were distributed evenly around EP over time across participants. Models were performed to assess personal history and psychosocial factors that affect EP, HPP, HVP, and bias. RESULTS There was systematic tendency for HPP to be significantly larger than EP relative to EP vs HVP. EP and HPP decreased significantly over time, but not HVP. There were significant predictors of EP, HPP, HVP, and bias, including depression, self-efficacy, and sleep quality, among others. CONCLUSION The experiences and recollections of pain in FM appear to provide a unique means of understanding the maintenance of chronic pain-including factors that affect this process.
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Affiliation(s)
- Charles Van Liew
- Department of Psychology, San Diego State University, San Diego, California.,Department of Psychology, Grand Canyon University, Phoenix, Arizona
| | | | - Gabriel Leon
- Department of Psychology, Grand Canyon University, Phoenix, Arizona
| | - Terry A Cronan
- Department of Psychology, San Diego State University, San Diego, California
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16
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Moll LT, Jensen OK, Schiøttz-Christensen B, Stapelfeldt CM, Christiansen DH, Nielsen CV, Labriola M. Return to Work in Employees on Sick Leave due to Neck or Shoulder Pain: A Randomized Clinical Trial Comparing Multidisciplinary and Brief Intervention with One-Year Register-Based Follow-Up. J Occup Rehabil 2018; 28:346-356. [PMID: 28836120 PMCID: PMC5978826 DOI: 10.1007/s10926-017-9727-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Purpose The aim of this study was to evaluate the effect of a multidisciplinary intervention (MDI) compared to a brief intervention (BI) with respect to return to work (RTW), pain and disability in workers on sick leave because of neck or shoulder pain. Methods 168 study participants with sickness absence for 4-16 weeks due to neck or shoulder pain were enrolled in a hospital-based clinical study and randomized to either MDI or BI. The primary outcome was RTW obtained by a national registry on public transfer payments. Secondary outcomes were self-reported pain and disability levels. One-year follow-up RTW rates were estimated by Cox proportional hazard regression adjusted for gender, age, sick leave prior to inclusion, part-time sick leave and clinical diagnosis. Secondary outcomes were analysed using logistic and linear regression analysis for pain and disability, respectively. Results In the MDI group, 50 participants (59%) experienced four or more continuous weeks of RTW while 48 (58%) returned to work in the BI group during the 1 year of follow-up. Results showed a statistically non significant tendency towards a lower rate of RTW in the MDI group than in the BI group (adjusted HR = 0.84, 95% CI 0.54, 1.31). There were no statistically significant differences in secondary outcomes between the MDI and BI groups. Conclusion The brief and the multidisciplinary interventions performed equally with respect to both primary and secondary outcomes. The added focus on RTW in the multidisciplinary group did not improve RTW rates in this group.
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Affiliation(s)
- Line Thorndal Moll
- DEFACTUM, Central Denmark Region, P.P. Oerums Gade 11, bygn. 1B, 8000, Aarhus C, Denmark.
- Section of Clinical Social Medicine and Rehabilitation, Department of Public Health, Aarhus University, P.P. Oerums Gade 9-11, bygn. 1B, 8000, Aarhus C, Denmark.
- Spine Centre, Diagnostic Centre, Silkeborg Regional Hospital, Falkevej 1-3, 8600, Silkeborg, Denmark.
| | - Ole Kudsk Jensen
- Spine Centre, Diagnostic Centre, Silkeborg Regional Hospital, Falkevej 1-3, 8600, Silkeborg, Denmark
| | - Berit Schiøttz-Christensen
- Spine Centre of Southern Denmark, Hospital Lillebaelt Middelfart and Institute of Regional Health Research, University of Southern Denmark, Oestre Hougvej 55, 5500, Middelfart, Denmark
| | - Christina Malmose Stapelfeldt
- DEFACTUM, Central Denmark Region, P.P. Oerums Gade 11, bygn. 1B, 8000, Aarhus C, Denmark
- Section of Clinical Social Medicine and Rehabilitation, Department of Public Health, Aarhus University, P.P. Oerums Gade 9-11, bygn. 1B, 8000, Aarhus C, Denmark
| | - David Høyrup Christiansen
- Department of Occupational Medicine, University Research Clinic, Regional Hospital West Jutland, Gl. Landevej 61, 7400, Herning, Denmark
| | - Claus Vinther Nielsen
- DEFACTUM, Central Denmark Region, P.P. Oerums Gade 11, bygn. 1B, 8000, Aarhus C, Denmark
- Section of Clinical Social Medicine and Rehabilitation, Department of Public Health, Aarhus University, P.P. Oerums Gade 9-11, bygn. 1B, 8000, Aarhus C, Denmark
| | - Merete Labriola
- DEFACTUM, Central Denmark Region, P.P. Oerums Gade 11, bygn. 1B, 8000, Aarhus C, Denmark
- Section of Clinical Social Medicine and Rehabilitation, Department of Public Health, Aarhus University, P.P. Oerums Gade 9-11, bygn. 1B, 8000, Aarhus C, Denmark
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Avian A, Messerer B, Meissner W, Sandner-Kiesling A, Kammel J, Labugger M, Weinberg A, Berghold A. Using a worst pain intensity measure in children and adolescents. J Adv Nurs 2017; 73:1873-1883. [DOI: 10.1111/jan.13271] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2017] [Indexed: 11/26/2022]
Affiliation(s)
- Alexander Avian
- Institute for Medical Informatics Statistics and Documentation; Medical University of Graz; Graz Austria
| | - Brigitte Messerer
- Division of Anesthesiology for Cardiovascular Surgery and Intensive Care Medicine; Medical University of Graz; Graz Austria
| | - Winfried Meissner
- Department of Anesthesiology and Intensive Care; Jena University Hospital; Germany
| | - Andreas Sandner-Kiesling
- Division of Anesthesiology for Cardiovascular Surgery and Intensive Care Medicine; Medical University of Graz; Graz Austria
| | - Julian Kammel
- Institute for Medical Informatics Statistics and Documentation; Medical University of Graz; Graz Austria
| | - Marlies Labugger
- Division of Anesthesiology for Cardiovascular Surgery and Intensive Care Medicine; Medical University of Graz; Graz Austria
| | - Annelie Weinberg
- Department of Orthopedics and Orthopedic Surgery; Medical University of Graz; Austria
| | - Andrea Berghold
- Institute for Medical Informatics Statistics and Documentation; Medical University of Graz; Graz Austria
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18
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Clement RC, Welander A, Stowell C, Cha TD, Chen JL, Davies M, Fairbank JC, Foley KT, Gehrchen M, Hagg O, Jacobs WC, Kahler R, Khan SN, Lieberman IH, Morisson B, Ohnmeiss DD, Peul WC, Shonnard NH, Smuck MW, Solberg TK, Stromqvist BH, Hooff MLV, Wasan AD, Willems PC, Yeo W, Fritzell P. A proposed set of metrics for standardized outcome reporting in the management of low back pain. Acta Orthop 2015; 86:523-33. [PMID: 25828191 PMCID: PMC4564773 DOI: 10.3109/17453674.2015.1036696] [Citation(s) in RCA: 107] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND AND PURPOSE Outcome measurement has been shown to improve performance in several fields of healthcare. This understanding has driven a growing interest in value-based healthcare, where value is defined as outcomes achieved per money spent. While low back pain (LBP) constitutes an enormous burden of disease, no universal set of metrics has yet been accepted to measure and compare outcomes. Here, we aim to define such a set. PATIENTS AND METHODS An international group of 22 specialists in several disciplines of spine care was assembled to review literature and select LBP outcome metrics through a 6-round modified Delphi process. The scope of the outcome set was degenerative lumbar conditions. RESULTS Patient-reported metrics include numerical pain scales, lumbar-related function using the Oswestry disability index, health-related quality of life using the EQ-5D-3L questionnaire, and questions assessing work status and analgesic use. Specific common and serious complications are included. Recommended follow-up intervals include 6, 12, and 24 months after initiating treatment, with optional follow-up at 3 months and 5 years. Metrics for risk stratification are selected based on pre-existing tools. INTERPRETATION The outcome measures recommended here are structured around specific etiologies of LBP, span a patient's entire cycle of care, and allow for risk adjustment. Thus, when implemented, this set can be expected to facilitate meaningful comparisons and ultimately provide a continuous feedback loop, enabling ongoing improvements in quality of care. Much work lies ahead in implementation, revision, and validation of this set, but it is an essential first step toward establishing a community of LBP providers focused on maximizing the value of the care we deliver.
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Affiliation(s)
- R Carter Clement
- Department of Orthopaedic Surgery, University of North Carolina Hospitals, Chapel Hill, NC, USA
| | | | - Caleb Stowell
- International Consortium for Health Outcomes Measurement, Boston, MA, USA
| | - Thomas D Cha
- Department of Orthopaedics, Massachusetts General Hospital, Boston, MA, USA
| | - John L Chen
- Department of Orthopaedic Surgery, Singapore General Hospital, Singapore
| | | | | | - Kevin T Foley
- Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Martin Gehrchen
- Department of Orthopaedic Surgery, Spine Section, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark
| | - Olle Hagg
- Spine Center Göteborg, Gothenburg, Sweden
| | - Wilco C Jacobs
- Department of Neurosurgery, Leiden University Medical Center, Leiden, the Netherlands
| | | | - Safdar N Khan
- Department of Orthopaedics, Division of Spine, Ohio State University, Wexner Medical Center, Columbus, OH, USA
| | | | | | | | - Wilco C Peul
- Department of Neurosurgery, Leiden University Medical Center and Medical Center Haaglanden, Leiden and The Hague, the Netherlands
| | - Neal H Shonnard
- Director, Spine SCOAP Collaborative, Rainier Orthopedic Institute, Puyallup, WA, US
| | - Matthew W Smuck
- Department of Orthopaedic Surgery, PM&R Section, Stanford University, Palo Alto, CA, USA
| | - Tore K Solberg
- Department of Ophthalmology and Neurosurgery, University Hospital of Northern Norway, Tromsø, Norway,The Norwegian Registry for Spine Surgery (NORspine), Northern Norway Regional Health Authority, Tromsø, Norway
| | - Bjorn H Stromqvist
- Department of Orthopedics, Clinical Sciences Lund, Lund University Hospital, Lund, Sweden
| | | | - Ajay D Wasan
- Department of Anesthesiology, University of Pittsburgh Medical Center Pittsburgh, PA, USA
| | - Paul C Willems
- Maastricht University Medical Center, Maastricht, the Netherlands
| | - William Yeo
- Orthopaedic Diagnostic Centre, Singapore General Hospital, Singapore
| | - Peter Fritzell
- Department of Orthopaedic Surgery, Ryhov Hospital, Jönköping, Sweden,Registry Manager, Swespine
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19
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Blödt S, Pach D, Roll S, Witt CM. Effectiveness of app-based relaxation for patients with chronic low back pain (Relaxback) and chronic neck pain (Relaxneck): study protocol for two randomized pragmatic trials. Trials 2014; 15:490. [PMID: 25511185 PMCID: PMC4301893 DOI: 10.1186/1745-6215-15-490] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Accepted: 12/04/2014] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Chronic low back pain (LBP) and neck pain (NP) are highly prevalent conditions resulting in high economic costs. Treatment guidelines recommend relaxation techniques, such as progressive muscle relaxation, as adjuvant therapies. Self-care interventions could have the potential to reduce costs in the health care system, but their effectiveness, especially in a usual care setting, is unclear. The aim of these two pragmatic randomized studies is to evaluate whether an additional app-delivered relaxation is more effective in the reduction of chronic LBP or NP than usual care alone. METHODS/DESIGN Each pragmatic randomized two-armed study aims to include a total of 220 patients aged 18 to 65 years with chronic (>12 weeks) LBP or NP and an average pain intensity of ≥ 4 on a numeric rating scale (NRS) in the 7 days before recruitment. The participants will be randomized into an intervention and a usual care group. The intervention group will be instructed to practice one of these 3 relaxation techniques on at least 5 days/week for 15 minutes/day over a period of 6 months starting on the day of randomization: autogenic training, mindfulness meditation, or guided imagery. Instructions and exercises will be provided using a smartphone app, baseline information will be collected using paper and pencil. Follow-up information (daily, weekly, and after 3 and 6 months) will be collected using electronic diaries and questionnaires included in the app. The primary outcome measure will be the mean LBP or NP intensity during the first 3 months of intervention based on daily pain intensity measurements on a NRS (0 = no pain, 10 = worst possible pain). The secondary outcome parameters will include the mean pain intensity during the first 6 months after randomization based on daily measurements, the mean pain intensity measured weekly as the average pain intensity of the previous 7 days over 3 and 6 months, pain acceptance, 'LBP- and NP-related' stress, sick leave days, pain medication intake, adherence, suspected adverse reaction, and serious adverse events. DISCUSSION The designed studies reflect a usual self-care setting and will provide evidence on a pragmatic self-care intervention that is easy to combine with care provided by medical professionals. TRIAL REGISTRATION ClinicalTrials.gov identifier Relaxback NCT02019498, Relaxneck NCT02019134 registered on 18 December 2013.
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Affiliation(s)
- Susanne Blödt
- />Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin - Berlin, Berlin, Germany
| | - Daniel Pach
- />Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin - Berlin, Berlin, Germany
| | - Stephanie Roll
- />Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin - Berlin, Berlin, Germany
| | - Claudia M Witt
- />Institute for Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin - Berlin, Berlin, Germany
- />Institute for Complementary and Integrative Medicine, University Hospital Zurich and University Zurich, Zurich, Switzerland
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20
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Lechmann M, Peterson CK, Pfirrmann CW, Hodler J. Lumbar nerve root injections: a prospective cohort outcomes study comparing age- and gender-matched patients who returned an outcomes-based postal questionnaire with patients who did not return the postal questionnaire. Skeletal Radiol 2013; 42:1429-35. [PMID: 23857420 DOI: 10.1007/s00256-013-1673-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Revised: 05/22/2013] [Accepted: 06/09/2013] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The purpose of this study is to investigate if relying on postal questionnaires returned by patients provides an accurate representation of reported outcomes from patients receiving imaging-guided lumbar nerve root injections (NRIs). MATERIALS AND METHODS Patients who received imaging-guided transforaminal lumbar NRIs were given short questionnaires inquiring about pain level [numerical rating scale (NRS)] and overall improvement [Patient's Global Impression of Change (PGIC)]. Those who did not return the questionnaires (non-responders) were telephoned and asked about pain level and overall change in condition. Age and gender matching of responders and non-responders resulted in 97 patients in each group. The proportion of patients reporting clinically relevant "improvement" or "worsening" in each group was calculated and the Chi-square test was used to detect differences. NRS and PGIC scores for responders and non-responders were compared using Student's t test and the Mann-Whitney U test, respectively. RESULTS A higher proportion of non-responders reported clinically relevant improvement (53.6 %) compared to responders (42.6 %) and responders reported significantly higher levels of worsening of condition (p = 0.01). Both responders and non-responders had significant (p ≤ 0.05) improvement on the 20-30-min and 1-month NRS scores compared to their pre-injection baseline scores. Non-responders had significantly higher baseline NRS scores but no significant difference at the 20-30-min and 1-month NRS scores compared to responders. CONCLUSIONS Patients returning postal questionnaires reported less favorable outcomes compared to those who did not return their questionnaires.
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21
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Jensen MP, Hu X, Potts SL, Gould EM. Single vs composite measures of pain intensity: Relative sensitivity for detecting treatment effects. Pain 2013; 154:534-538. [DOI: 10.1016/j.pain.2012.12.017] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2012] [Revised: 11/16/2012] [Accepted: 12/12/2012] [Indexed: 11/25/2022]
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22
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Jensen MP, Wang W, Potts SL, Gould EM. Reliability and validity of individual and composite recall pain measures in patients with cancer. Pain Med 2012; 13:1284-91. [PMID: 22925436 DOI: 10.1111/j.1526-4637.2012.01470.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To evaluate and compare the validity and reliability of individual and composite recall pain intensity measures. DESIGN Secondary analyses using data from a published 14-day open-label crossover clinical trial comparing two active treatments. SETTING Multiple settings. PARTICIPANTS Fifty-two adults with a history of chronic cancer pain. MEASURES Recall ratings of least, worst, and average pain during the past 2 days; composite score representing recalled characteristic pain in the past 2 days; and daily diary ratings of pain intensity from which "actual" least, worst, and average pain scores were derived. RESULTS Recall ratings of least and average pain, and a composite score representing recalled characteristic pain were accurate (differed no more than three points from "actual" scores on a 0-100 scale). Although the recall rating of worst pain significantly (P < 0.05) overestimated actual worst pain, the differences were minor (i.e., seven to eight points on a 0-100 scale). All of the recall measures demonstrated validity via their strong associations with the measures of actual pain intensity. The recall measures also demonstrated excellent test-retest stability, although the diary-derived measures tended to be more stable than the recall measures did. The composite measure of recalled characteristic pain demonstrated a high level of internal consistency (Cronbach's α = 0.90). CONCLUSIONS Individual recall ratings and a composite score representing recalled characteristic pain intensity are reliable and valid measures of actual pain in patients with cancer. The findings support their use as outcome measures in clinical trials.
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Affiliation(s)
- Mark P Jensen
- Department of Rehabilitation Medicine, University of Washington, Harborview Medical Center, 325 Ninth Avenue, Seattle, WA 98104, USA.
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23
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Kremer S, Pfirrmann CW, Hodler J, Peterson CK. Imaging-guided lumbar facet injections: is there a difference in outcomes between low back pain patients who remember to return a postal questionnaire and those who do not? Insights Imaging 2012; 3:411-8. [PMID: 22695954 DOI: 10.1007/s13244-012-0178-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2012] [Revised: 05/09/2012] [Accepted: 05/16/2012] [Indexed: 12/02/2022] Open
Abstract
Objectives To determine whether data obtained from patients returning postal questionnaires accurately reflect how patients receiving imaging-guided lumbar facet injections respond. Methods Seventy-eight patients receiving lumbar facet joint injections who returned an outcomes questionnaire (responders) were age and gender matched with 78 patients who did not return the postal questionnaire (non-responders) after facet joint injections. Baseline numerical rating scale (NRS) pain data were collected. NRS and Patients’ Global Impression of Change (PGIC) data were collected 1 month after injection by postal questionnaire or telephone interview. Differences in NRS scores were calculated using the unpaired t-test. One level injection patients were compared to patients having ≥2 levels injected using the paired and unpaired t-test. The proportion of patients reporting significant improvement in each group was calculated. Results NRS scores were significantly improved compared to baseline (p = 0.0001). Thirty-eight percent of responders were significantly improved compared to 50 % of non-responders. Patients having ≥2 levels injected reported significantly higher baseline NRS scores, but by 1 month there was no difference in NRS scores between groups. Conclusions Patients returning postal questionnaires report a less favourable outcome. Telephone interview patients having injections at more than one level have better outcomes. Main messages • Patients returning postal questionnaires report worse outcomes after facet injection. • Method of data collection should be considered when reporting treatment outcomes. • Patients receiving facet injections at more than one level report greater levels of pain reduction.
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Kolberg C, Horst A, Moraes MS, Kolberg A, Belló-klein A, Partata WA. Effect of High-Velocity, Low-Amplitude Treatment on Superoxide Dismutase and Glutathione Peroxidase Activities in Erythrocytes From Men With Neck Pain. J Manipulative Physiol Ther 2012; 35:295-300. [DOI: 10.1016/j.jmpt.2012.04.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2011] [Revised: 11/21/2011] [Accepted: 01/25/2012] [Indexed: 12/21/2022]
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Soklic M, Peterson C, Humphreys BK. Translation and validation of the German version of the Bournemouth Questionnaire for Neck Pain. Chiropr Man Therap 2012; 20:2. [PMID: 22273038 PMCID: PMC3398331 DOI: 10.1186/2045-709x-20-2] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2011] [Accepted: 01/25/2012] [Indexed: 01/10/2023] Open
Abstract
Background Clinical outcome measures are important tools to monitor patient improvement during treatment as well as to document changes for research purposes. The short-form Bournemouth questionnaire for neck pain patients (BQN) was developed from the biopsychosocial model and measures pain, disability, cognitive and affective domains. It has been shown to be a valid and reliable outcome measure in English, French and Dutch and more sensitive to change compared to other questionnaires. The purpose of this study was to translate and validate a German version of the Bournemouth questionnaire for neck pain patients. Methods German translation and back translation into English of the BQN was done independently by four persons and overseen by an expert committee. Face validity of the German BQN was tested on 30 neck pain patients in a single chiropractic practice. Test-retest reliability was evaluated on 31 medical students and chiropractors before and after a lecture. The German BQN was then assessed on 102 first time neck pain patients at two chiropractic practices for internal consistency, external construct validity, external longitudinal construct validity and sensitivity to change compared to the German versions of the Neck Disability Index (NDI) and the Neck Pain and Disability Scale (NPAD). Results Face validity testing lead to minor changes to the German BQN. The Intraclass Correlation Coefficient for the test-retest reliability was 0.99. The internal consistency was strong for all 7 items of the BQN with Cronbach α's of .79 and .80 for the pre and post-treatment total scores. External construct validity and external longitudinal construct validity using Pearson's correlation coefficient showed statistically significant correlations for all 7 scales of the BQN with the other questionnaires. The German BQN showed greater responsiveness compared to the other questionnaires for all scales. Conclusions The German BQN is a valid and reliable outcome measure that has been successfully translated and culturally adapted. It is shorter, easier to use, and more responsive to change than the NDI and NPAD.
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Affiliation(s)
- Marina Soklic
- University of Zürich and Orthopaedic University Hospital Balgrist, Forchstrasse 340, 8008 Zürich Switzerland.
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