Dionne Clermont E, Dunn Kate M, Croft Peter R, Nachemson Alf L, Buchbinder Rachelle, Walker Bruce F, Wyatt Mary, Cassidy J David, Rossignol Michel, Leboeuf-Yde Charlotte, Hartvigsen Jan, Leino-Arjas Päivi, Latza Ute, Reis Shmuel, Gil Del Real Maria Teresa, Kovacs Francisco M, Oberg Birgitta, Cedraschi Christine, Bouter Lex M, Koes Bart W, Picavet H Susan J, van Tulder Maurits W, Burton Kim, Foster Nadine E, Macfarlane Gary J, Thomas Elaine, Underwood Martin, Waddell Gordon, Shekelle Paul, Volinn Ernest, Von Korff Michael
Population Health Research Unit, (URESP) Research Centre of the Laval University Affiliated Hospital, Québec, QC, Canada.
Spine (Phila Pa 1976). 2008 Jan 1;33(1):95-103. doi: 10.1097/BRS.0b013e31815e7f94.
A modified Delphi study conducted with 28 experts in back pain research from 12 countries.
To identify standardized definitions of low back pain that could be consistently used by investigators in prevalence studies to provide comparable data.
Differences in the definition of back pain prevalence in population studies lead to heterogeneity in study findings, and limitations or impossibilities in comparing or summarizing prevalence figures from different studies.
Back pain definitions were identified from 51 articles reporting population-based prevalence studies, and dissected into 77 items documenting 7 elements. These items were submitted to a panel of experts for rating and reduction, in 3 rounds (participation: 76%). Preliminary results were presented and discussed during the Amsterdam Forum VIII for Primary Care Research on Low Back Pain, compared with scientific evidence and confirmed and fine-tuned by the panel in a fourth round and the preparation of the current article.
Two definitions were agreed on a minimal definition (with 1 question covering site of low back pain, symptoms observed, and time frame of the measure, and a second question on severity of low back pain) and an optimal definition that is made from the minimal definition and add-ons (covering frequency and duration of symptoms, an additional measure of severity, sciatica, and exclusions) that can be adapted to different needs.
These definitions provide standards that may improve future comparisons of low back pain prevalence figures by person, place and time characteristics, and offer opportunities for statistical summaries.
对来自12个国家的28位背痛研究专家进行了一项改良德尔菲研究。
确定在患病率研究中调查人员可一致使用的下背痛标准化定义，以提供可比数据。
人群研究中背痛患病率定义的差异导致研究结果的异质性，以及在比较或汇总不同研究的患病率数据时存在局限性或无法进行比较。
从51篇报告基于人群的患病率研究的文章中确定背痛定义，并将其分解为记录7个要素的77项内容。这些项目分三轮提交给专家小组进行评分和精简（参与率：76%）。在阿姆斯特丹第八届原发性下背痛研究论坛上展示并讨论了初步结果，并与科学证据进行了比较，专家小组在第四轮以及撰写本文时对结果进行了确认和微调。
就最低限度定义（一个问题涵盖下背痛部位、观察到的症状和测量的时间范围，另一个问题涉及下背痛的严重程度）和由最低限度定义及附加内容（涵盖症状的频率和持续时间、严重程度的额外测量、坐骨神经痛和排除标准）组成的最佳定义达成了一致，该最佳定义可根据不同需求进行调整。
这些定义提供了标准，可能会改善未来按人员、地点和时间特征对下背痛患病率数据进行的比较，并为统计汇总提供机会。
