Center for General Practice at Aalborg University, Aalborg, Denmark.
BMJ Open. 2019 Jul 18;9(7):e024921. doi: 10.1136/bmjopen-2018-024921.
To identify baseline patient characteristics that are (1) associated with a poor outcome on follow-up regardless of which treatment was provided (prognosis) or (2) associated with a successful outcome to a specific treatment (treatment effect modifiers).
Systematic literature review according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines.
Medline, Embase, Cinahl, Web of Science, Cochrane, SportDiscus, OT Seeker and PsychInfo were searched for prospective cohort studies up to February 2019 without limitation in publication date.
Prospective cohort studies reporting either prognostic factors or treatment effect modifiers on persistent musculoskeletal pain in 0-year-old to 19-year-old children and adolescents. Pain caused by tumours, fractures, infections, systemic and neurological conditions were excluded.
Our primary outcome was musculoskeletal pain at follow-up and identification of any baseline characteristics that were associated with this outcome (prognostic factors). No secondary outcomes were declared.
Two reviewers independently screened abstracts and titles. We included prospective cohort studies investigating the prognosis or treatment effect modifiers of 0-year-old to 19-year-old children and adolescents with self-reported musculoskeletal pain. Risk of bias assessment was conducted with the Quality in Prognostic Studies tool.
Twenty-six studies yielding a total of 111 unique prognostic factors were included. Female sex and psychological symptoms were the most frequent investigated prognostic factors. Increasing age, generalised pain, longer pain duration and smoking were other identified prognostic factors. No treatment effect modifiers were identified.
Several prognostic factors are associated with a poor prognosis in children and adolescents with musculoskeletal pain. These prognostic factors may help guide clinical practice and shared decision-making. None of the included studies was conducted within a general practice setting which highlights an area in need of research.
CRD42016041378.
确定基线患者特征，这些特征（1）与随访时的不良预后相关（预后），或者（2）与特定治疗的成功结局相关（治疗效果修饰因素），无论提供哪种治疗。
根据系统评价和荟萃分析报告的首选条目进行系统文献回顾。
截至 2019 年 2 月，检索了 Medline、Embase、Cinahl、Web of Science、Cochrane、SportDiscus、OT Seeker 和 PsychInfo 中的前瞻性队列研究，未对出版日期进行限制。
报告 0 岁至 19 岁儿童和青少年持续性肌肉骨骼疼痛的预后因素或治疗效果修饰因素的前瞻性队列研究。排除由肿瘤、骨折、感染、全身和神经系统疾病引起的疼痛。
我们的主要结局是随访时的肌肉骨骼疼痛，并确定与该结局相关的任何基线特征（预后因素）。未宣布次要结局。
两名审查员独立筛选摘要和标题。我们纳入了调查 0 岁至 19 岁儿童和青少年自我报告肌肉骨骼疼痛的预后或治疗效果修饰因素的前瞻性队列研究。使用预后研究质量工具进行偏倚风险评估。
纳入了 26 项研究，共产生了 111 个独特的预后因素。女性性别和心理症状是最常见的预后因素。年龄增长、全身性疼痛、疼痛持续时间延长和吸烟是其他确定的预后因素。未确定治疗效果修饰因素。
一些预后因素与儿童和青少年肌肉骨骼疼痛的不良预后相关。这些预后因素可能有助于指导临床实践和共同决策。纳入的研究中没有一项是在一般实践环境中进行的，这突显了需要研究的领域。
PROSPERO 注册号：CRD42016041378。
