Using few and scattered time points for analysis of a variable course of pain can be misleading: an example using weekly text message data |
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| Authors: | Iben Axén Gunnar Bergström Lennart Bodin |
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| Institution: | 1. Faculty of Science, Health and Education, Centre for Healthy Activities, Sport and Exercise, University of the Sunshine Coast, Sippy Downs Dve, Sippy Downs, Sunshine Coast Qld 4556 Australia;2. Department of Psychiatry and Physiotherapy, Faculty of Medicine, Malaga University, SpainAvenida Estación de el Palo, Málaga, 29017 Spain;3. Educational and Counseling Psychology, University of Louisville, 2323 S Brook St, Louisville, KY, 40208 USA;4. Centre for Medical Research (CMR), Faculty of Medicine, Dentistry and Health Sciences, The University of Western Australia, 35 Stirling Highway, Crawley WA 6009, Perth, Australia;1. Department of Anesthesiology, Children''s Hospital Colorado, University of Denver, 13123 E. 16th Ave., Box B090, Aurora, CO 80045, USA;2. Department of Orthopaedics, University of Utah School of Medicine, 590 Wakara Way, Salt Lake City, UT 84108, USA;3. Colorado School of Public Health, University of Colorado Denver, Colorado Biostatistics Consortium, 12477 E. 19th Ave., Building 406, Room 100, Aurora, CO 80045, USA;4. Department of Anesthesiology, The University of Kansas Medical Center, 3901 Rainbow Blvd, Mailstop 1034, Kansas City, KS 66160, USA;5. Department of Orthopedic Surgery, Musculoskeletal Research Center, Children''s Hospital Colorado, University of Colorado Denver, 13123 E. 16th Ave., Box 060, Aurora, CO 80045, USA;1. College of Medicine, Biology and Environment, Australian National University, Australia;2. Rehabilitation Studies Unit, Sydney Medical School, University of Sydney, Australia;3. Trauma and Orthopaedic Research Unit, Canberra Hospital, Australia;1. Department of Orthopedics, Wuhan General Hospital of Guangzhou Command, 627 Wuluo Rd, Wuhan 430070, China;2. Department of Anatomy, Southern Medical University, 1838 N. Guangzhou Ave., Guangzhou 510515, China |
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| Abstract: | Background contextBecause low back pain (LBP) is a fluctuating condition, the diversity in the prediction literature may be due to when the outcome is measured.PurposeThe objective of this study was to investigate the prediction of LBP using an outcome measured at several time points.Study design/settingA multicenter clinical observational study in Sweden.Patient sampleData were collected on 244 subjects with nonspecific LBP. The mean age of the subjects was 44 years, the mean pain score at inclusion was 4.4/10, and 51% of the sample had experienced LBP for more than 30 days the previous year.Outcome measuresThe outcome used in this study was the “number of days with bothersome pain” collected with weekly text messages for 6 months.MethodsIn subjects with nonspecific LBP, weekly data were available for secondary analyses. A few baseline variables were chosen to investigate prediction at different time points: pain intensity, the presence of leg pain, duration of LBP the previous year, and self-rated health at baseline. Age and gender acted as additional covariates.ResultsIn the multilevel models, the predictive variables interacted with time. Thus, the risk of experiencing a day with bothersome LBP varied over time. In the logistic regression analyses, the predictive variable's previous duration showed a consistent predictive ability for all the time points. However, the variables pain intensity, leg pain, and self-rated health showed inconsistent predictive patterns.ConclusionsAn outcome based on frequently measured data described the variability in the prediction of future LBP over time. Prediction depended on when the outcome was measured. These results may explain the diversity of the results of the predictor studies in the literature. |
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| Keywords: | Frequent data collection Low back pain Bothersomeness Text messages Prediction Retrospective Study |
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