Patient acceptable symptom state for patient-reported outcomes in 2 populations of patients with non-specific chronic low back pain: A secondary analysis of 2 randomized trials - 15/07/18
Résumé |
Introduction/Background |
We aimed to estimate and compare patient acceptable symptom state (PASS) at 1 month for 4 patient-reported outcomes (PROs) between 2 populations of patients with non-specific chronic low back pain (cLBP) and to determine which baseline variables contribute to having an acceptable symptom state at 1 month.
Material and method |
Two hundred and fifty-six patients were included: 135 patients with cLBP and an active disc disease participated in a randomized controlled trial assessing the efficacy on pain at 1 month of a single glucocorticoid intradiscal injection, and 121 patients with cLBP and without an active disc disease participated in a randomized controlled trial assessing the efficacy on pain at 4 months of 12 sessions of immersive virtual reality. Self-rated health status at 1 month was assessed by using an external anchoring question from the Medical Outcomes Study 36-Item Short Form. Patients who self-rated their health as “excellent”, “very good” or “good” were considered as having an acceptable symptom state. PASS for PROs was estimated using the 75th percentile method. Estimates were compared between the 2 populations using bootstrap resampling. Logistic regression was used to determine baseline variables contributing to PASS achievement.
Results |
At 1 month, 137/256 (53.52%) participants self-rated their health as acceptable. In the whole population, PASS (95% IC) were 47.50 (40.00 to 50.00) for the lumbar-pain VAS, 30.50 (30.00 to 40.00) for the radicular-pain VAS, 39.27 (33.60 to 45.26) for the QUEBEC score, 9.95 (9.16 to 10.00) for the HAD Anxiety subscale, and 6.70 (6.00 to 8.00) for the HAD Depression subscale. PASS estimates did not differ between the 2 populations. Symptom intensity was the only baseline variable contributing to having an acceptable symptom state at 1 month.
Conclusion |
Our study provides PASS thresholds for commonly used PROs in cLBP. Our findings can be useful in interpreting the clinical relevance of PROs values.
ClinicalTrials.gov. NCT01407653 and NCT00804531.
Le texte complet de cet article est disponible en PDF.Keywords : Low back pain, Patient acceptable symptom state, Patient-reported outcomes
Plan
Vol 61 - N° S
P. e15 - juillet 2018 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.