Gold Coast University Hospital, Gold Coast Hospital and Health Service, Gold Coast, Australia.
School of Medical Science, Griffith University, Gold Coast, Australia.
BMJ Open. 2019 Aug 10;9(8):e028747. doi: 10.1136/bmjopen-2018-028747.
Prognostic screening of people with low back pain (LBP) improves utilisation of primary healthcare resources. Whether this also applies to secondary healthcare remains unclear. Therefore, this study aims to develop prognostic models to determine at baseline which patients with persistent LBP are likely to have a good and poor outcome to a 5-week programme of combined education and exercise ('UPLIFT') delivered in a secondary healthcare setting.
A prospective cohort study of 246 people with persistent LBP will be conducted in a secondary healthcare outpatient setting. Patients will be recruited from a physiotherapy-led neurosurgical screening clinic. Demographic data, medical history and psychosocial characteristics will be recorded at baseline. Fear avoidance beliefs, pain self-efficacy, LBP treatment beliefs, pain catastrophising, perceived injustice, depression, anxiety and stress, disability level, pain intensity and interference, health status and social connectedness will be considered as potential prognostic variables, which will be assessed using self-reported questionnaires. Participants will attend the UPLIFT programme, consisting of weekly 90 min group sessions that combine interactive education sessions and a graded exercise programme. The outcome measure to identify good and poor outcome is the Global Rating of Change scale, assessed at completion of the UPLIFT programme and at 6 months follow-up. Multiple imputation analyses will be performed for missing values. Prognostic models will be developed using multivariable logistic regression analyses, with bootstrapping techniques for internal validation. We will calculate the explained variance of the models and the area under the receiver operating characteristic curve. Furthermore, we will determine whether participation in the UPLIFT programme is associated with changes in psychosocial characteristics.
Gold Coast Health Service Human Research Ethics Committee (HREC/18/QGC/41) and the Griffith University Human Research Ethics Committee (GU Ref No: 2018/408) approved the study. Dissemination of findings will occur via peer-reviewed publications and conference presentations.
ACTRN12618001525279.
对腰痛（LBP）患者进行预后筛查可改善初级医疗保健资源的利用。但这是否也适用于二级医疗保健尚不清楚。因此，本研究旨在制定预后模型，以确定基线时哪些持续性 LBP 患者有可能在二级医疗保健环境中接受为期 5 周的综合教育和运动（“UPLIFT”）方案后获得良好和不良结局。
这是一项在二级医疗保健门诊环境中进行的前瞻性队列研究，共纳入 246 名持续性 LBP 患者。患者将从物理治疗主导的神经外科筛查诊所招募。在基线时记录人口统计学数据、病史和社会心理特征。将恐惧回避信念、疼痛自我效能、LBP 治疗信念、疼痛灾难化、感知不公正、抑郁、焦虑和压力、残疾程度、疼痛强度和干扰、健康状况和社交联系视为潜在的预后变量，并使用自我报告问卷进行评估。参与者将参加 UPLIFT 方案，该方案每周进行一次 90 分钟的小组会议，结合互动教育课程和分级运动计划。确定良好和不良结局的结局测量是总体变化评分量表，在完成 UPLIFT 方案和 6 个月随访时进行评估。对于缺失值，将进行多重插补分析。预后模型将使用多变量逻辑回归分析进行开发，并使用自举技术进行内部验证。我们将计算模型的解释方差和受试者工作特征曲线下的面积。此外，我们将确定参加 UPLIFT 方案是否与社会心理特征的变化相关。
黄金海岸卫生服务人体研究伦理委员会（HREC/18/QGC/41）和格里菲斯大学人体研究伦理委员会（GU 参考号：2018/408）批准了该研究。研究结果将通过同行评议的出版物和会议报告进行传播。
ACTRN12618001525279。
