Few promising multivariable prognostic models exist for recovery of people with non-specific neck pain in musculoskeletal primary care: a systematic review
| Autor: | Bart W. Koes, Arianne P. Verhagen, Roel W. Wingbermühle, Emiel van Trijffel, Paul M Nelissen |
|---|---|
| Přispěvatelé: | General Practice |
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Multivariate statistics Physical Therapy Sports Therapy and Rehabilitation Primary care 03 medical and health sciences 0302 clinical medicine Non specific Discriminative model Risk Factors Neck pain medicine Humans 030212 general & internal medicine Prognostic models Neck Pain Primary Health Care business.industry Multivariable calculus Rehabilitation lcsh:RM1-950 Area under the curve Recovery of Function Prognosis lcsh:Therapeutics. Pharmacology Physical therapy Systematic review Multivariable prognostic models medicine.symptom business 030217 neurology & neurosurgery |
| Zdroj: | Journal of Physiotherapy, 64(1), 16-23. Australian Physiotherapy Association Journal of Physiotherapy, Vol 64, Iss 1, Pp 16-23 (2018) |
| ISSN: | 1836-9553 |
| Popis: | © 2017 Australian Physiotherapy Association Question Which multivariable prognostic model(s) for recovery in people with neck pain can be used in primary care? Design Systematic review of studies evaluating multivariable prognostic models. Participants People with non-specific neck pain presenting at primary care. Determinants Baseline characteristics of the participants. Outcome measures Recovery measured as pain reduction, reduced disability, or perceived recovery at short-term and long-term follow-up. Results Fifty-three publications were included, of which 46 were derivation studies, four were validation studies, and three concerned combined studies. The derivation studies presented 99 multivariate models, all of which were at high risk of bias. Three externally validated models generated usable models in low risk of bias studies. One predicted recovery in non-specific neck pain, while two concerned participants with whiplash-associated disorders (WAD). Discriminative ability of the non-specific neck pain model was area under the curve (AUC) 0.65 (95% CI 0.59 to 0.71). For the first WAD model, discriminative ability was AUC 0.85 (95% CI 0.79 to 0.91). For the second WAD model, specificity was 99% (95% CI 93 to 100) and sensitivity was 44% (95% CI 23 to 65) for prediction of non-recovery, and 86% (95% CI 73 to 94) and 55% (95% CI 41 to 69) for prediction of recovery, respectively. Initial Neck Disability Index scores and age were identified as consistent prognostic factors in these three models. Conclusion Three externally validated models were found to be usable and to have low risk of bias, of which two showed acceptable discriminative properties for predicting recovery in people with neck pain. These three models need further validation and evaluation of their clinical impact before their broad clinical use can be advocated. Registration PROSPERO CRD42016042204. [Wingbermühle RW, van Trijffel E, Nelissen PM, Koes B, Verhagen AP (2018) Few promising multivariable prognostic models exist for recovery of people with non-specific neck pain in musculoskeletal primary care: a systematic review. Journal of Physiotherapy 64: 16–23] |
| Databáze: | OpenAIRE |
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