Dagfinrud H, Storheim K, Magnussen L H, Ødegaard T, Hoftaniska I, Larsen L G, Ringstad P O, Hatlebrekke F, Grotle M
Dept of Rheumatology, Diakonhjemmet Hospital, Diakonveien 12, 0370 Oslo, Norway.
Man Ther. 2013 Apr;18(2):124-9. doi: 10.1016/j.math.2012.08.002. Epub 2012 Sep 25.
The purpose of this study was to compare the predictive ability of the standardised screening tool Örebro Musculoskeletal Pain Questionnaire (ÖMPQ) and the clinicians' prognostic assessment in identifying patients with low back pain (LBP) and neck pain at risk for persistent pain and disability at eight weeks follow-up. Patients seeking care for LBP or neck pain were recruited by 19 manual therapists in Norway. Patients completed the ÖMPQ and the low back- or neck specific Oswestry Disability Index/Neck Disability Index at baseline and 8 weeks after first consultation. The manual therapists filled in their assessment of patient's prognosis immediately after the first consultation, blinded for patient's answers to the questionnaire. A total of 157 patients (81with neck pain and 76 with LBP) were included. The best odds for predicting the outcome for LBP patients was found for the clinicians' assessment of prognosis (LR+ = 2.1 and LR- = 0.55), whereas the likelihood ratios were similar for the two tools in the neck group. For LBP patients, both the clinicians' assessment and the ÖMPQ contributed significantly in the separate regression models (p = 0.02 and p = 0.002, resp), whereas none of the tools where significant contributors for neck patients (p = 0.67 and 0.07). Neither of the two methods showed high precision in their predictions of follow-up at eight weeks. However, for LBP patients, the ÖMPQ and the clinicians' prognostic assessment contributed significantly in the prediction of functional outcome 8 weeks after the initial assessment of manual therapist, whereas the prediction for neck patients was unsure.
本研究旨在比较标准化筛查工具厄勒布鲁肌肉骨骼疼痛问卷(ÖMPQ)与临床医生的预后评估在识别腰痛(LBP)和颈痛患者方面的预测能力,这些患者在随访8周时有持续疼痛和残疾的风险。挪威的19名手法治疗师招募了因腰痛或颈痛寻求治疗的患者。患者在基线时以及首次咨询后8周完成了ÖMPQ和针对腰痛或颈痛的特定Oswestry残疾指数/颈部残疾指数。手法治疗师在首次咨询后立即填写他们对患者预后的评估,对患者的问卷答案不知情。总共纳入了157名患者(81名颈痛患者和76名腰痛患者)。对于腰痛患者,临床医生的预后评估预测结果的最佳比值比(LR+ = 2.1,LR- = 0.55),而在颈部疼痛组中,两种工具的似然比相似。对于腰痛患者,临床医生的评估和ÖMPQ在各自的回归模型中均有显著贡献(分别为p = 0.02和p = 0.002),而对于颈部疼痛患者,两种工具均无显著贡献(p = 0.67和0.07)。两种方法在预测8周随访时均未显示出高精度。然而,对于腰痛患者,ÖMPQ和临床医生的预后评估在手法治疗师首次评估后8周对功能结局的预测中均有显著贡献,而对于颈部疼痛患者的预测则不确定。