The George Institute for Global Health, University of Sydney, Sydney, New South Wales, Australia.
J Clin Epidemiol. 2013 Dec;66(12):1397-404. doi: 10.1016/j.jclinepi.2013.02.018. Epub 2013 Sep 8.
The aim of this study was to determine the smallest worthwhile effects of two treatments for nonspecific low back pain (LBP).
The benefit-harm trade-off method was used to estimate the smallest worthwhile effect of nonsteroidal anti-inflammatory drugs (NSAIDs) and physiotherapy for LBP. Patients seeking care for chronic LBP were interviewed by telephone before treatment commenced and 4 weeks later.
Patients need to see a median of 30% (interquartile range [IQR]: 10-40) more improvement in pain and 20% (IQR: 10-40) more improvement in disability than would occur without intervention to perceive the effect of NSAIDs are worthwhile. They would need to see 20% (IQR: 0-30) more improvement on pain and disability over natural recovery to perceive that the effect of physiotherapy was worthwhile. There was no difference in estimates of the smallest worthwhile effect elicited at baseline and 4 weeks later.
People with chronic back pain need to see larger effects on pain of NSAIDS than physiotherapy to consider the effects of these interventions worthwhile. These estimates of the smallest worthwhile effect can be used to interpret the findings of clinical trials and to design adequately powered clinical trials.
本研究旨在确定两种治疗非特异性下腰痛（LBP）方法的最小有意义疗效。
采用效益-危害权衡法来评估非甾体抗炎药（NSAIDs）和物理治疗对 LBP 的最小有意义疗效。在开始治疗前和 4 周后，通过电话对寻求慢性 LBP 治疗的患者进行访谈。
患者需要看到疼痛改善中位数为 30%（四分位距[IQR]：10-40），残疾改善中位数为 20%（IQR：10-40），才能认为 NSAIDs 的疗效是值得的。与自然恢复相比，他们需要看到疼痛和残疾改善 20%（IQR：0-30），才能认为物理治疗的效果是值得的。在基线和 4 周后得出的最小有意义疗效估计值没有差异。
患有慢性腰痛的人需要看到 NSAIDs 在疼痛方面的效果比物理治疗更大，才会认为这些干预措施的效果是值得的。这些最小有意义疗效的估计值可用于解释临床试验结果，并设计出具有足够效力的临床试验。
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