Featured Research

from universities, journals, and other organizations

Standards for research on chronic low back pain proposed

Date:
June 3, 2014
Source:
Wolters Kluwer Health: Lippincott Williams Array Wilkins
Summary:
Standardized research methods are needed to make greater progress toward reducing the high burden and costs of chronic low back pain (cLBP), according to a Task Force report. Chronic low back pain one of the most important and costly of all public health conditions affecting the U.S. is a major cause of pain and disability, with high costs for health care and the economy at large.

Standardized research methods are needed to make greater progress toward reducing the high burden and costs of chronic low back pain (cLBP), according to a Task Force report in the June 15 issue of Spine.The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

The article introduces a set of proposed research standards to help in comparing the results of cLBP studies. The recommendations were developed by a Research Task Force convened by the NIH Pain Consortium. The Task Force co-chairs were Drs. Richard A. Deyo of Oregon Health and Science University, Portland; and Samuel F. Dworkin of University of Washington, Seattle.

Standards Seek to Promote Consistency in cLBP Research

Chronic low back pain one of the most important and costly of all public health conditions affecting the U.S. is a major cause of pain and disability, with high costs for health care and the economy at large. Many different treatments for cLBP have been developed and tested -- but few have consistently shown substantial, long-term reduction in pain with improvement in functioning. "Researchers use varied inclusion criteria, definitions, baseline assessments, and outcome measures, which impede comparisons and consensus," according to the Task Force report.

To address this issue, the Task Force followed a structured approach to developing a set of standards for cLBP research. Key issues included defining the problem of cLBP, assessing its impact on patients' lives, identifying the minimum dataset that should be collected in cLBP research, and defining the best outcomes to evaluate treatment effectiveness.

Definition. Research consistency begins with a standard definition of the problem. The Task Force recommends that cLBP be defined as back pain lasting at least three months, and causing pain on at least half of days over the past six months. The definition does not include ratings of pain severity.

Impact. Rather, the Task Force recommends focusing on how back pain is affecting patients' lives. The recommendations suggest a nine-item cLBP "Impact Score," incorporating ratings of pain intensity, interference with normal activities, and functional ability.

Minimum Dataset. A key task was to define a minimum set of data to be gathered in any study of cLBP. The recommended dataset included legal or workers compensation issues, previous treatments, and important contributing factors -- especially smoking, obesity, substance abuse, and widespread pain.

The recommendations emphasize the importance of assessing the patient's medical history -- even more so than the physical examination. In contrast, the Task Force specified no standard laboratory or imaging tests, citing the lack of association with patient symptoms or functioning. Assessments of physical functioning, depression, sleep disturbance, and catastrophic thinking were rated important for all groups of patients with cLBP.

Outcomes. The Task Force sought to define the most important outcomes to be evaluated in cLBP studies. However, they concluded that there was no agreed-on definition of what degree of improvement should be considered "clinically important." Neither was there any consensus as to the use of combined outcome measures, time frames for improvement, or adverse effects.

Future Research. Developing and testing new combined outcome measures was identified as an important are for future research. Other included approaches to predicting treatment results and studies to evaluate and improve the minimum dataset.

The Task Force members hope their recommended standards reflect the "complex, intertwined factors" affecting the development and clinical course of cLBP. They write, "As adopted by NIH, these recommendations have the potential to standardize methods for identifying cLBP research cases, describing research subjects, and comparing published reports." But they emphasize that the recommendations should be regarded as a "dynamic document" -- in need of further validation and refinement in the years ahead.


Story Source:

The above story is based on materials provided by Wolters Kluwer Health: Lippincott Williams Array Wilkins. Note: Materials may be edited for content and length.


Journal Reference:

  1. Richard A. Deyo, Samuel F. Dworkin, Dagmar Amtmann, Gunnar Andersson, David Borenstein, Eugene Carragee, John Carrino, Roger Chou, Karon Cook, Anthony DeLitto, Christine Goertz, Partap Khalsa, John Loeser, Sean Mackey, James Panagis, James Rainville, Tor Tosteson, Dennis Turk, Michael Von Korff, Debra K. Weiner. Report of the NIH Task Force on Research Standards for Chronic Low Back Pain. Spine, 2014; 1 DOI: 10.1097/BRS.0000000000000434

Cite This Page:

Wolters Kluwer Health: Lippincott Williams Array Wilkins. "Standards for research on chronic low back pain proposed." ScienceDaily. ScienceDaily, 3 June 2014. <www.sciencedaily.com/releases/2014/06/140603103406.htm>.
Wolters Kluwer Health: Lippincott Williams Array Wilkins. (2014, June 3). Standards for research on chronic low back pain proposed. ScienceDaily. Retrieved September 15, 2014 from www.sciencedaily.com/releases/2014/06/140603103406.htm
Wolters Kluwer Health: Lippincott Williams Array Wilkins. "Standards for research on chronic low back pain proposed." ScienceDaily. www.sciencedaily.com/releases/2014/06/140603103406.htm (accessed September 15, 2014).

Share This



More Health & Medicine News

Monday, September 15, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Respiratory Virus Spreads To Northeast, Now In 21 States

Respiratory Virus Spreads To Northeast, Now In 21 States

Newsy (Sep. 14, 2014) The respiratory virus Enterovirus D68, which targets children, has spread from the Midwest to 21 states. Video provided by Newsy
Powered by NewsLook.com
Shocker: Journalists Are Utterly Addicted To Coffee

Shocker: Journalists Are Utterly Addicted To Coffee

Newsy (Sep. 13, 2014) A U.K. survey found that journalists consumed the most amount of coffee, but that's only the tip of the coffee-related statistics iceberg. Video provided by Newsy
Powered by NewsLook.com
Contagious Respiratory Illness Continues to Spread Across U.S.

Contagious Respiratory Illness Continues to Spread Across U.S.

Reuters - US Online Video (Sep. 12, 2014) Hundreds of children in several states have been stricken by a serious respiratory illness that is spreading across the U.S. Linda So reports. Video provided by Reuters
Powered by NewsLook.com
Ebola Batters Sierra Leone Economy Too

Ebola Batters Sierra Leone Economy Too

Reuters - Business Video Online (Sep. 12, 2014) The World Health Organisation warns that local health workers in West Africa can't keep up with Ebola - and among those countries hardest hit by the outbreak, the economic damage is coming into focus, too. As David Pollard reports, Sierra Leone admits that growth in one of the poorest economies in the region is taking a beating. Video provided by Reuters
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

    Technology News



    Save/Print:
    Share:

    Free Subscriptions


    Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

    Get Social & Mobile


    Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

    Have Feedback?


    Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
    Mobile: iPhone Android Web
    Follow: Facebook Twitter Google+
    Subscribe: RSS Feeds Email Newsletters
    Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins