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临床验证将颈部疼痛的保守治疗方法进行分组,用于网络荟萃分析:德尔菲共识研究。

Clinical validation of grouping conservative treatments in neck pain for use in a network meta-analysis: a Delphi consensus study.

机构信息

Graduate School of Health, Discipline of Physiotherapy, University of Technology Sydney, 100 Broadway, Ultimo, 2007, Australia.

School of Allied Health Exercise and Sports Sciences, Charles Sturt University, Port Macquarie, NSW, Australia.

出版信息

Eur Spine J. 2024 Jan;33(1):166-175. doi: 10.1007/s00586-023-08025-4. Epub 2023 Nov 9.


DOI:10.1007/s00586-023-08025-4
PMID:37943373
Abstract

BACKGROUND: A network meta-analysis aims to help clinicians make clinical decisions on the most effective treatment for a certain condition. Neck pain is multifactorial, with various classification systems and treatment options. Classifying patients and grouping interventions in clinically relevant treatment nodes for a NMA is essential, but this process is poorly defined. OBJECTIVE: Our aim is to obtain consensus among experts on neck pain classifications and the grouping of interventions into nodes for a future network meta-analysis. DESIGN: A Delphi consensus study involving neck pain experts worldwide. METHODS: We invited authors of neck pain clinical practice guidelines published from 2014 onwards. The Delphi baseline questionnaire was developed based on the findings of a scoping review, including four items on classifications and 19 nodes. Participants were asked to record their level of agreement on a seven-point Likert scale or using Yes/No/Not sure answer options for the various statements. We used descriptive analysis to summarise the responses on each statement with content analysis of the free-text comments. RESULTS: In total, 18/80 experts (22.5%) agreed to participate in one or more Delphi rounds. We needed three rounds to reach consensus for two classification of neck pain: one based on aetiology and one on duration. In addition, we also reached consensus on the grouping of interventions, including a definition of each node, with the number of nodes reduced to 17. CONCLUSION: With this consensus we clinically validated two neck pain classifications and grouped conservative treatments into 17 well-defined and clinically relevant nodes.

摘要

背景:网络荟萃分析旨在帮助临床医生针对特定病症做出最有效的治疗决策。颈部疼痛是多因素的,有多种分类系统和治疗选择。对患者进行分类并将干预措施分组到 NMA 的治疗节点中是至关重要的,但这一过程尚未得到明确界定。

目的:我们旨在就颈部疼痛分类以及将干预措施分组为未来网络荟萃分析的节点问题达成专家共识。

设计:这是一项涉及全球颈部疼痛专家的德尔菲共识研究。

方法:我们邀请了 2014 年以来发表的颈部疼痛临床实践指南的作者参与。德尔菲基线问卷是根据范围综述的结果制定的,包括四项分类和 19 个节点的内容。参与者被要求在七点李克特量表上记录他们的同意程度,或使用是/否/不确定的答案选项来回答各种陈述。我们使用描述性分析来总结每个陈述的回答情况,并对自由文本评论进行内容分析。

结果:共有 18/80 名专家(22.5%)同意参与一轮或多轮德尔菲调查。我们需要三轮才能就两种颈部疼痛分类达成共识:一种基于病因,另一种基于持续时间。此外,我们还就干预措施的分组达成了共识,包括为每个节点定义了干预措施的分组,节点数量减少到 17 个。

结论:通过这次共识,我们对两种颈部疼痛分类进行了临床验证,并将保守治疗分组为 17 个明确和具有临床意义的节点。

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本文引用的文献

[1]
Treatment classifications and interventions for neck pain: a scoping review.

J Clin Epidemiol. 2023-7

[2]
A clinician's guide to network meta-analysis.

Eye (Lond). 2022-8

[3]
Neck pain: global epidemiology, trends and risk factors.

BMC Musculoskelet Disord. 2022-1-3

[4]
Methodological review to develop a list of bias items used to assess reviews incorporating network meta-analysis: protocol and rationale.

BMJ Open. 2021-6-24

[5]
Physiotherapy management of neck pain.

J Physiother. 2021-1

[6]
Psychological interventions for chronic non-specific low back pain: protocol of a systematic review with network meta-analysis.

BMJ Open. 2020-9-17

[7]
Comparison of CPG's for the diagnosis, prognosis and management of non-specific neck pain: a systematic review.

BMC Musculoskelet Disord. 2019-2-14

[8]
Node-making processes in network meta-analysis of nonpharmacological interventions should be well planned and reported.

J Clin Epidemiol. 2018-9

[9]
Comparing interventions with network meta-analysis.

J Physiother. 2018-4

[10]
Node-making process in network meta-analysis of nonpharmacological treatment are poorly reported.

J Clin Epidemiol. 2017-11-28

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