Kate M. Dunn|Paul Campbell|Martyn Lewis|Jonathan Hill|Daniëlle A. van der Windt|Ebenezer Afolabi|Joanne Protheroe|Simon Wathall|Sue Jowett|Raymond Oppong|Christian Mallen|Elaine M. Hay|Nadine E Foster
Refinement and validation of a tool for stratifying patients with musculoskeletal pain
Versus Arthritis|Keele University|Versus Arthritis|Keele University|Versus Arthritis|Keele University|Versus Arthritis|Keele University|Versus Arthritis|Keele University|Versus Arthritis|Keele University|Versus Arthritis|Keele University|Versus Arthritis|Keele University|University of Birmingham|University of Birmingham|Versus Arthritis|Keele University|Versus Arthritis|Keele University|Versus Arthritis|Keele University
patients musculoskeletal pain different body sites share common prognostic factors using prognosis stratify treatment match clinically costeffective aimed refine validate keele start msk tool prognostic stratification musculoskeletal pain patientstool refinement validity tested prospective cohort study external validity examined pilot cluster randomized controlled trial rct study population comprised 2414 adults visiting uk primary care back neck knee shoulder multisite pain returning postal questionnaires cohort 1890 40 response trial 524 cohort baseline questionnaires included draft tool plus refinement items trial baseline questionnaires included keele start msk tool physical health sf36 physical component score pcs pain intensity assessed 2 6month cohort followup pain intensity measured 6month trial followupthe tool refined replacing 3 adding 3 removing 2 items resulting 10item tool model fit r2 0422 0430 discrimination c statistic 0839 0822 predicting 6month cohort pcs pain respectively tool classified 249 cohort participants low 417 medium 334 high risk clearly discriminating subgroups tool demonstrated model fit 0224 discrimination 073 trial participants multiple imputation confirmed robustness findingsthe keele start msk tool demonstrates good validity acceptable predictive performance clearly identifies groups musculoskeletal pain patients different characteristics prognosis using prognostic information stratification treatment matching may clinicallycosteffectivethe paper presents first musculoskeletal pain prognostic stratification tool specifically use among primary care patients five common musculoskeletal pain presentations back neck knee shoulder multisite pain keele start msk tool identifies groups musculoskeletal pain patients clearly different characteristics prognosis using tool stratification treatment matching may clinically costeffective