Department of Interdisciplinary Health Sciences, Institute of Health and Society, University of Oslo, Blindern, P.O. Box 1089, 0317, Oslo, Norway.
Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.
BMC Musculoskelet Disord. 2022 Jul 14;23(1):673. doi: 10.1186/s12891-022-05558-5.
Health domains like pain, disability, and health-related quality of life are commonly used outcomes for musculoskeletal disorders. Most prognostic studies include only one outcome, and it is unknown if prognostic factors and models may be generic across different outcomes. The objectives of this study were to examine the correlation among commonly used outcomes for neck pain (pain intensity, disability, and health-related quality of life) and to explore how the predictive performance of a prognostic model differs across commonly used outcomes.
We conducted an observational prospective cohort study with data from patients with neck pain aged 18-84 years consulting Norwegian chiropractors. We used three different outcomes: pain intensity (Numeric Pain Rating Scale), the Neck Disability Index (NDI), and health-related quality of Life (EQ-5D). We assessed associations between change in outcome scores at 12-weeks follow-up with Pearson's correlation coefficient. We used multivariable linear regression models to explore differences in explained variance and relationship between predictors and outcomes.
The study sample included 1313 patients and 941 (72%) completed follow-up at 12 weeks. The strongest correlation was between NDI and EQ-5D (r = 0.57) while the weakest correlation was between EQ-5D and pain intensity (r = 0.39). The correlation between NDI and pain intensity was moderate (r = 0.53) In the final regression models, the explained variance ranged from adjusted R of 0.26 to 0.60, highest with NDI and lowest with pain intensity as outcome. The predictive contributions of the included predictors were similar across outcomes. Among the investigated predictors, pain patterns and the baseline measure of the corresponding outcome measure contributed the most to explained variance across all outcomes.
The highest correlation was found between NDI and EQ-5D and the lowest with pain intensity. The same prognostic model showed highest predictive performance with NDI as outcome and poorest with pain intensity as outcome. These results suggest that we need more knowledge on the reasons for the differences in predictive performance variation across outcomes.
健康领域，如疼痛、残疾和健康相关生活质量，常用于肌肉骨骼疾病的结局评估。大多数预后研究仅包含一个结局，尚不清楚预后因素和模型是否可用于不同结局。本研究的目的是检验颈痛（疼痛强度、残疾和健康相关生活质量）常用结局之间的相关性，并探讨预后模型的预测性能在不同结局间的差异。
我们进行了一项观察性前瞻性队列研究，数据来自挪威脊医就诊的 18-84 岁颈痛患者。我们使用了三个不同的结局：疼痛强度（数字疼痛评分量表）、颈部残疾指数（NDI）和健康相关生活质量（EQ-5D）。我们使用 Pearson 相关系数评估 12 周随访时结局评分变化之间的相关性。我们使用多变量线性回归模型探索解释方差和预测因子与结局之间的关系的差异。
研究样本包括 1313 例患者，941 例（72%）在 12 周时完成了随访。NDI 和 EQ-5D 之间的相关性最强（r=0.57），而 EQ-5D 和疼痛强度之间的相关性最弱（r=0.39）。NDI 和疼痛强度之间的相关性为中度（r=0.53）。在最终的回归模型中，调整后的 R²范围从 0.26 到 0.60，以 NDI 为结局的模型解释方差最高，以疼痛强度为结局的模型解释方差最低。纳入预测因子的预测贡献在所有结局中相似。在所研究的预测因子中，疼痛模式和相应结局测量的基线测量对所有结局的解释方差贡献最大。
NDI 和 EQ-5D 之间的相关性最高，与疼痛强度的相关性最低。具有相同预后模型的 NDI 结局的预测性能最高，疼痛强度的预测性能最差。这些结果表明，我们需要更多关于不同结局间预测性能变化差异原因的知识。
