The Comparative Prognostic Value of Directional Preference and Centralization: A Useful Tool for Front-Line Clinicians?
The Comparative Prognostic Value of Directional Preference and Centralization: A Useful Tool for Front-Line Clinicians?
复制标题
DOI：
10.1179/106698108790818332
复制
发表时间：
2008-01-01
影响因子：
2
通讯作者：
Fung, Tak
中科院分区：
文献类型：
--
作者：
Long, Audrey;May, Stephen;Fung, Tak
A large number of prognostic factors have been associated with recovery from an episode of hack pain, and much emphasis has been placed on psychosocial prognostic factors. "the large number of prognostic factors and the lack of comparative analysis of different factors make use of these difficult in clinical practice. The aim of this study was to evaluate the comparative usefulness of a range of factors to predict outcome using data from a randomized controlled trial (RCT) in which 312 patients with sub-acute to chronic hack pain received a mechanical evaluation and were sub-grouped based on the presence or absence of directional preference (DP). Patients were then randomized to treatment that was matched or unmatched to that DR Patients with a minimal reduction of 30% in Roland Morris Disability Questionnaire (RMDQ) score were defined as the good outcome group. Seventeen baseline variables were entered into a step-wise logistic regression analysis for the ability to predict a good outcome. Of the patients, 84 menthe good outcome criteria and had a mean RMDQ decrease of 58.2% (9.8 points) in 4 visits. Leg pain, work status, depression, pain location, chronicity, and treatment assignment were significant predictors of outcome in univariate analysis. Only leg bothersomeness rating and treatment assignment survived multivariate analysis. Subjects with DP/centralization who received matched treatment had a 7.8 times greater likelihood of a good outcome. Matching patients to their DP is a stronger predictor of outcome than a range of other biopsycho social factors.
