Use of health status measures in patients with low back pain in clinical settings. Comparison of specific, generic and preference‐based instruments
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Notice bibliographique
Résumé
OBJECTIVE: To evaluate the discriminative performance over time of specific, generic and preference-based instruments in patients with low back pain (LBP) in clinical settings. METHODS: Forty-six consecutive patients with LBP participated in the study. Self-response questionnaires were administered at baseline and 3 and 6 months, including the following instruments: Oswestry (specific for LBP), SF-36 (generic), EuroQol (EQ-5D) and Health Utilities Index (HUI) (preference-based). EQ-5D and HUI weights were derived from previously published evaluations in the general population. Patients were asked to compare their health status with their baseline health and were categorized on the basis of an ordinal scale as: (a) improved; (b) stable; or (c) worse. Changes in the instruments were evaluated by rescaling the instruments over the same scale interval and by estimating standardized effect sizes between two time points for the three categories of change. RESULTS: Thirty-seven patients (80%) completed both the baseline and the 3-month questionnaire and 34 the baseline and 6-month questionnaires (74%). Overall, at both time points, approximately half of the patients reported no changes in their health status. Correlations between instruments were generally low, suggesting that they measure different health domains. The scales which discriminated best between patients who improved and those who deteriorated at 3 months were the Oswestry, the HUI, the EQ-5D and the SF-36 bodily pain and emotional role subscales. The SF-36 subscales appeared to have a floor effect for those patients who had deteriorated. CONCLUSIONS: Most SF-36 subscales did not adequately reflect changes in the health status of patients with LBP, mostly for those who reported deterioration. Preference-derived quality-of-life scores appeared to discriminate among patients who improved and those who deteriorated, although not as consistently as the disease-specific measure (Oswestry). Additional research is needed to evaluate the role of generic measures of quality of life in the assessment of patients with LBP before they can be widely implemented in clinical settings or outcomes research.
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Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,010 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découle