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Development and internal validation of prognostic models for recovery in patients with non-specific neck pain presenting in primary care.
- Source :
-
Physiotherapy [Physiotherapy] 2021 Dec; Vol. 113, pp. 61-72. Date of Electronic Publication: 2021 Jun 12. - Publication Year :
- 2021
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Abstract
- Objectives: Development and internal validation of prognostic models for post-treatment and 1-year recovery in patients with neck pain in primary care.<br />Design: Prospective cohort study.<br />Setting: Primary care manual therapy practices.<br />Participants: Patients with non-specific neck pain of any duration (n=1193).<br />Intervention: Usual care manual therapy.<br />Outcome Measures: Recovery defined in terms of pain intensity, disability, and global perceived improvement directly post-treatment and at 1-year follow-up.<br />Results: All post-treatment models exhibited acceptable discriminative performance after derivation (AUC≥0.7). The developed post-treatment disability model exhibited the best overall performance (R <superscript>2</superscript> =0.24; IQR, 0.22-0.26), discrimination (AUC=0.75; 95% CI, 0.63-0.84), and calibration (slope 0.92; IQR, 0.91-0.93). After internal validation and penalization, this model retained acceptable discriminative performance (AUC=0.74). The five other models, including those predicting 1-year recovery, did not reach acceptable discriminative performance after internal validation. Baseline pain duration, disability, and pain intensity were consistent predictors across models.<br />Conclusion: A post-treatment prognostic model for disability was successfully developed and internally validated. This model has potential to inform primary care clinicians about a patient's individual prognosis after treatment, but external validation is required before clinical use can be recommended.<br /> (Copyright © 2021 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Details
- Language :
- English
- ISSN :
- 1873-1465
- Volume :
- 113
- Database :
- MEDLINE
- Journal :
- Physiotherapy
- Publication Type :
- Academic Journal
- Accession number :
- 34563916
- Full Text :
- https://doi.org/10.1016/j.physio.2021.05.011