Deakin University, Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Faculty of Health, Geelong, Australia; Orygen, Parkville, Australia; Centre for Youth Mental Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia.
Hochschule für Gesundheit (University of Applied Sciences), Department of Applied Health Sciences, Division of Physiotherapy, Bochum, Germany.
J Pain. 2024 Apr;25(4):857-861. doi: 10.1016/j.jpain.2023.10.014. Epub 2023 Oct 21.
Biopsychosocial factors are associated with pain, but they can be difficult to compare. One way of comparing them is to use standardized mean differences. Previously, these effects sizes have been termed as small, medium, or large, if they are bigger than or equal to, respectively, .2, .5, or .8. These cut-offs are arbitrary and recent evidence showed that they need to be reconsidered. We argue it is necessary to determine cut-offs for each biopsychosocial factor. To achieve this, we propose 3 potential approaches: 1) examining, for each factor, how the effect size differs depending upon disease severity; 2) using an existing minimum clinically important difference to anchor the large effect size; and 3) define cut-offs by comparing data from people with and without pain. This is important for pain research, as exploring these methodologies has potential to improve comparability of biopsychosocial factors and lead to more directed treatments. We note assumptions and limitations of these methods that should also be considered. PERSPECTIVE: Standardized mean differences can estimate effect sizes between groups and could theoretically allow for comparison of biopsychosocial factors. However, common thresholds to define effect sizes are arbitrary and likely differ based on outcome. We propose methods that could overcome this and be used to derive biopsychosocial outcome-specific effect sizes.
生物心理社会因素与疼痛有关，但它们可能难以比较。一种比较它们的方法是使用标准化均数差值。以前，如果这些效应大小大于或等于分别为.2、.5 或.8，则将其称为小、中或大。这些截止值是任意的，最近的证据表明需要重新考虑。我们认为有必要为每个生物心理社会因素确定截止值。为此，我们提出了 3 种潜在的方法：1）对于每个因素，检查其效应大小随疾病严重程度的变化；2）使用现有的最小临床重要差异来锚定大效应大小；3）通过比较有疼痛和无疼痛的人群的数据来定义截止值。这对于疼痛研究很重要，因为探索这些方法有可能提高生物心理社会因素的可比性，并导致更有针对性的治疗。我们注意到这些方法的假设和局限性也应予以考虑。观点：标准化均数差值可以估计组间的效应大小，并且理论上可以允许比较生物心理社会因素。然而，定义效应大小的常见阈值是任意的，并且可能基于结果而有所不同。我们提出了可以克服这一问题并用于得出生物心理社会特定结果的效应大小的方法。
