Prognostic Models for Chronic Low Back Pain Outcomes in Primary Care Are at High Risk of Bias and Lack Validation—High-Quality Studies Are Needed: A Systematic Review: A Systematic Review

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Titel: Prognostic Models for Chronic Low Back Pain Outcomes in Primary Care Are at High Risk of Bias and Lack Validation—High-Quality Studies Are Needed: A Systematic Review: A Systematic Review
Autoren: Fu, Yanyan, Feller, Daniel, Koes, Bart, Chiarotto, Alessandro
Quelle: Journal of Orthopaedic & Sports Physical Therapy. 54:302-314
Verlagsinformationen: Journal of Orthopaedic & Sports Physical Therapy (JOSPT), 2024.
Publikationsjahr: 2024
Schlagwörter: Primary Health Care, Chronic Pain/therapy, prediction models, Prognosis, 3. Good health, primary care, Bias, Low Back Pain/therapy, chronic low back pain, Quality of Life, Humans, prognosis, Chronic Pain, 10. No inequality, Low Back Pain, Pain Measurement
Beschreibung: OBJECTIVE: To provide an updated overview of available prognostic models for people with chronic low back pain (LBP) in primary care. DESIGN: Prognosis systematic review LITERATURE SEARCH: We searched for relevant studies on MEDLINE, Embase, Web of Science, and CINAHL databases (up to July 13, 2022), and performed citation tracking in Web of Science. STUDY SELECTION CRITERIA: We included observational (cohort or nested case-control) studies and randomized controlled trials that developed or validated prognostic models for adults with chronic LBP in primary care. The outcomes of interest were physical functioning, pain intensity, and health-related quality of life at any follow-up time-point. DATA SYNTHESIS: Data were extracted using the CHecklist for critical Appraisal and data extraction for systematic Reviews of prediction Modelling Studies (CHARMS), and the Prediction model Risk of Bias Assessment Tool (PROBAST) tool was used to evaluate the risk of bias of the models. Due to the number of studies retrieved and the heterogeneity, we reported the results descriptively. RESULTS: Ten studies (out of 5593 hits screened) with 34 models met our inclusion criteria, of which six are development studies and four are external validation studies. Five studies reported the area under the curve of the models (ranging from 0.48 to 0.84), whereas no study reported calibration indices. The most promising model is the Örebro Musculoskeletal Pain Screening Questionnaire Short-Form. CONCLUSIONS: Given the high risk of bias and lack of external validation, we cannot recommend that clinicians use prognostic models for patients with chronic LBP in primary care settings. J Orthop Sports Phys Ther 2024;54(5):302-314. Epub 15 February 2024. doi:10.2519/jospt.2024.12081
Publikationsart: Article
Sprache: English
ISSN: 1938-1344
0190-6011
DOI: 10.2519/jospt.2024.12081
Zugangs-URL: https://pubmed.ncbi.nlm.nih.gov/38356405
https://portal.findresearcher.sdu.dk/da/publications/e3d5278d-8f59-43f7-a3fb-9976b3f0b6c6
https://doi.org/10.2519/jospt.2024.12081
Dokumentencode: edsair.doi.dedup.....7f610ce1b5aca1779458ae96c7534b9e
Datenbank: OpenAIRE
Beschreibung
Abstract:OBJECTIVE: To provide an updated overview of available prognostic models for people with chronic low back pain (LBP) in primary care. DESIGN: Prognosis systematic review LITERATURE SEARCH: We searched for relevant studies on MEDLINE, Embase, Web of Science, and CINAHL databases (up to July 13, 2022), and performed citation tracking in Web of Science. STUDY SELECTION CRITERIA: We included observational (cohort or nested case-control) studies and randomized controlled trials that developed or validated prognostic models for adults with chronic LBP in primary care. The outcomes of interest were physical functioning, pain intensity, and health-related quality of life at any follow-up time-point. DATA SYNTHESIS: Data were extracted using the CHecklist for critical Appraisal and data extraction for systematic Reviews of prediction Modelling Studies (CHARMS), and the Prediction model Risk of Bias Assessment Tool (PROBAST) tool was used to evaluate the risk of bias of the models. Due to the number of studies retrieved and the heterogeneity, we reported the results descriptively. RESULTS: Ten studies (out of 5593 hits screened) with 34 models met our inclusion criteria, of which six are development studies and four are external validation studies. Five studies reported the area under the curve of the models (ranging from 0.48 to 0.84), whereas no study reported calibration indices. The most promising model is the Örebro Musculoskeletal Pain Screening Questionnaire Short-Form. CONCLUSIONS: Given the high risk of bias and lack of external validation, we cannot recommend that clinicians use prognostic models for patients with chronic LBP in primary care settings. J Orthop Sports Phys Ther 2024;54(5):302-314. Epub 15 February 2024. doi:10.2519/jospt.2024.12081
ISSN:19381344
01906011
DOI:10.2519/jospt.2024.12081