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[慢性背痛治疗效果的测量。慢性背痛患者整个样本中的总体效果能否转化为个体的特定效果?]

[Measurement of success of treatment for chronic back pain. Can general effects in an entire sample of patients with chronic back pain be transferred to specific effects in individuals?].

作者信息

Meier S, Neubauer E, Schiltenwolf M

机构信息

Orthopädische Universitätsklinik Heidelberg, Oberbettringer Str. 200, 73525 Schwäbisch-Gmünd, Deutschland.

出版信息

Schmerz. 2009 Feb;23(1):54-8. doi: 10.1007/s00482-008-0731-z.

Abstract

BACKGROUND

The multimodal therapy has proved to be useful for the treatment of patients with chronic back pain. The aim of this methodical study was to test whether specific effects for the individual can be inferred from general effects of the entire sample, in order to define criteria for the success of treatment. These could be helpful when deciding to which patients the multimodal therapy can best be applied.

PATIENTS AND METHODS

A total of 408 patients with chronic back pain took part in a 3-week multimodal therapy program in a day hospital. The patients were questioned regarding parameters such as pain intensity, depression, functional back capacity and quality of life before therapy as well as 6 months after therapy.

RESULTS

On average, a significant improvement of all parameters could be shown after 6 months. However, scatterplots and correlations showed that general results of the entire sample should not be transferred to the individual patient

CONCLUSION

Taking into account principles of classical test theory this study showed that sufficient systematic coherence of the data must be proven before changes can be calculated. As long as neither an adequate systematic nor useful criteria can be found, there seems to be no reason to exclude any patient from multimodal therapy using pre-selection criteria.

摘要

背景

多模式疗法已被证明对慢性背痛患者的治疗有效。这项方法学研究的目的是测试是否可以从整个样本的总体效果推断出个体的特定效果,以便确定治疗成功的标准。这在决定多模式疗法最适合应用于哪些患者时可能会有所帮助。

患者与方法

共有408名慢性背痛患者参加了日间医院为期3周的多模式治疗项目。在治疗前以及治疗后6个月,对患者就疼痛强度、抑郁、背部功能能力和生活质量等参数进行了询问。

结果

平均而言,6个月后所有参数均有显著改善。然而,散点图和相关性表明,整个样本的总体结果不应应用于个体患者。

结论

考虑到经典测试理论的原则,本研究表明,在计算变化之前,必须证明数据具有足够的系统一致性。只要找不到适当的系统性或有用的标准,似乎就没有理由使用预选标准将任何患者排除在多模式治疗之外。

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