The Natural History of Disability and Its Determinants in Adults with Lower Limb Musculoskeletal Pain
Bibliographic record
Abstract
OBJECTIVE: To investigate determinants of deterioration or improvement in disability in people with chronic hip and knee pain. METHODS: We analyzed data from the Somerset and Avon Survey of Health, a longitudinal, community-based cohort study containing data collected in 1994-95 and again in 2002-03. The Medical Outcomes Study Short-Form 36 was completed by subjects at both timepoints, and used to categorize people as disabled or not. Baseline data were used to explore possible determinants of change in functional status over the 8-year time period. Adjusted odds ratios (OR) were derived from a multivariate, multinomial logistic model. RESULTS: Data were available on 1072 subjects, all of whom reported chronic hip and/or knee pain at baseline. At baseline, 56.8% of women and 42.0% of men were disabled. Of 545 people with disabilities at baseline, 107 (19.6%) reported no disability at followup; of 527 with no disability at baseline, 177 (33.6%) became disabled. The development of disability was significantly associated with older age (OR 2.1), living in the most deprived areas (2.4), the presence of 3 or more comorbidities (3.6), more problems with physical function at baseline (2.0), and more severe pain (2.4). The determinants of improvement mirrored those of deterioration. The data suggest a "threshold effect" at which recovery becomes unlikely. CONCLUSION: Of people presenting with hip or knee pain, healthcare professionals should be most concerned about those who are older, of lower socioeconomic status, with comorbidities, and who have more severe pain. Much longstanding disability might be preventable.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".