Assessing clinically meaningful change following a programme for managing chronic pain
Bibliographic record
Abstract
OBJECTIVES: (1) To identify criteria for clinically meaningful change scores in commonly used measures of pain and related disability, using Goal Attainment Scaling as an external indicator of success. (2) To investigate the chances of achieving these scores following a pain management programme versus remaining on the waiting list. DESIGN: Participants were assessed on entry to waiting list, on admission and at follow-up from the pain management programme. Three groups of Goal Attainment Scaling scores (-1.0, +1) were created from final Goal Attainment Scaling achievements. Mean scores on other measures were analysed in relation to Goal Attainment Scaling score groups by ANOVA. Differences in numbers achieving clinically meaningful changes when on the pain management programme or waiting list were compared. SUBJECTS: Chronic musculoskeletal pain participants (N = 73) attending a rehabilitation centre, mean age (range) 44.8 (24-70) years, mean age (range) 44.8 (24-70), mean pain duration 7.7 (1-32) years. INTERVENTION: Three-week (15-day) pain management programme based on cognitive behavioural principles. MEASURES: McGill Pain Questionnaire, 0-10 Pain Intensity Numerical Rating Scale (NRS), Oswestry Disability Questionnaire (ODQ), General Health Questionnaire (GHQ), 5 minute walk, 1 minute sit/stand, 1 minute stair-climbing, and Goal Attainment Scaling (GAS). RESULTS: Mean change scores differed significantly for three GAS groups and were highest in the most successful (+1) group. These scores were used to define clinically meaningful changes on the NRS (-3), ODQ (-12), walk (+87) and stairs (+14). Significantly more participants on the pain management programme achieved these scores than those on the waiting list. CONCLUSION: Using GAS as a criterion of patient-perceived improvement enabled identification of clinically meaningful changes on some other common measures. These successfully differentiated achievement between patients on the pain management programme and those on the waiting list.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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 source (direct Gemma or distilled Codex), 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".