Department of Physiotherapy, HES-SO, University of Applied Sciences Western Switzerland, Leukerbad, Switzerland.
Eur Spine J. 2012 Aug;21 Suppl 6(Suppl 6):S773-84. doi: 10.1007/s00586-011-1910-7. Epub 2011 Jul 26.
A small proportion of individuals with non-specific low back pain (NSLBP) develop persistent problems. Up to 80% of the total costs for NSLBP are owing to chronic NSLBP. Psychosocial factors have been described to be important in the transition from acute to chronic NSLBP. Guidelines recommend the use of the Acute Low Back Pain Screening Questionnaire (ALBPSQ) and the Örebro Musculoskeletal Pain Screening Questionnaire (ÖMPSQ) to identify individuals at risk of developing persistent problems, such as long-term absence of work, persistent restriction in function or persistent pain. These instruments can be used with a cutoff value, where patients with values above the threshold are further assessed with a more comprehensive examination.
We systematically reviewed studies evaluating the accuracy of the ALBPSQ and ÖMPSQ to predict persistent problems.
The 13 included studies used different cutoff values for the screening questionnaires ranging from 68 to 147. The pooled sensitivity was 0.59 (0.43-0.74), while the pooled specificity was 0.77 (0.66-0.86). Heterogeneity (I (2)) was 90.02% for sensitivity and 95.41% for specificity.
Thus, we do not recommend the use of one cutoff value, but the use of a prediction model with all the individual items.
一小部分非特异性下腰痛(NSLBP)患者会发展为持续性问题。高达 80%的 NSLBP 总费用归因于慢性 NSLBP。心理社会因素已被描述为从急性 NSLBP 向慢性 NSLBP 转变的重要因素。指南建议使用急性下腰痛筛查问卷(ALBPSQ)和Örebro 肌肉骨骼疼痛筛查问卷(ÖMPSQ)来识别有发展为持续性问题风险的个体,例如长期缺勤、持续功能受限或持续疼痛。这些工具可以使用截断值,超过阈值的患者需要进一步进行更全面的检查。
我们系统地回顾了评估 ALBPSQ 和 ÖMPSQ 预测持续性问题准确性的研究。
13 项纳入的研究为筛查问卷使用了不同的截断值,范围为 68 至 147。汇总敏感性为 0.59(0.43-0.74),而汇总特异性为 0.77(0.66-0.86)。敏感性的异质性(I ²)为 90.02%,特异性的异质性为 95.41%。
因此,我们不建议使用单一的截断值,而是使用包含所有个体项目的预测模型。