School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Quebec, Canada.
Physical Therapy Division, Duke University, Durham, North Carolina.
J Eval Clin Pract. 2020 Feb;26(1):316-325. doi: 10.1111/jep.13190. Epub 2019 Jul 3.
We recently proposed the Pain and Disability Drivers Management (PDDM) model, which was designed to outline comprehensive factors driving pain and disability in low back pain (LBP). Although we have hypothesized and proposed 41 elements, which make up the model's five domains, we have yet to assess the external validity of the PDDM's elements by expert consensus.
This study aimed to reach consensus among experts regarding the different elements that should be included in each domain of the PDDM model.
The PDDM may assist clinicians and researchers in the delivery of targeted care and ultimately enhance treatment outcomes in LBP.
Using a modified Delphi survey, a two-round online questionnaire was administered to a group of experts in musculoskeletal pain management. Participants were asked to rate the relevance of each element proposed within the model. Participants were also invited to add and rate new elements. Consensus was defined by a greater than or equal to 75% level of agreement.
A total of 47 (round 1) and 33 (round 2) participants completed the survey. Following the first round, 38 of 41 of the former model elements reached consensus, and 10 new elements were proposed and later rated in the second round. Following this second round, consensus was reached for all elements (10 new + 3 from first round), generating a final model composed of 51 elements.
This expert consensus-derived list of clinical elements related to the management of LBP represents a first step in the validation of the PDDM model.
我们最近提出了疼痛和残疾驱动因素管理（PDDM）模型，旨在概述导致腰痛（LBP）疼痛和残疾的综合因素。尽管我们已经假设并提出了构成模型五个领域的 41 个要素，但我们尚未通过专家共识评估 PDDM 要素的外部有效性。
本研究旨在就 PDDM 模型各领域应包含的不同要素达成专家共识。
PDDM 可以帮助临床医生和研究人员提供有针对性的护理，并最终改善 LBP 的治疗效果。
使用改良 Delphi 调查，对一组肌肉骨骼疼痛管理专家进行了两轮在线问卷调查。参与者被要求对模型中提出的每个要素的相关性进行评分。参与者还被邀请添加和评分新的要素。共识定义为大于或等于 75%的同意水平。
共有 47 名（第一轮）和 33 名（第二轮）参与者完成了调查。第一轮后，前模型的 41 个要素中有 38 个达到了共识，提出了 10 个新的要素，并在第二轮进行了评估。经过第二轮，所有要素（10 个新要素+第一轮的 3 个要素）都达成了共识，生成了一个由 51 个要素组成的最终模型。
这份基于专家共识的与 LBP 管理相关的临床要素列表代表了对 PDDM 模型进行验证的第一步。
