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A PROPOSAL FOR A MINIMAL COMPREHENSIVE LIST OF FACTORS FOR PROSPECTIVE COHORTS IN BACK PAIN; THE MULTINATIONAL MUSCULOSKELETAL INCEPTION COHORT STUDY STATEMENT



Abstract

Objective: To improve the quality of prospective cohorts studying the transition from early stages of back pain to persistent problems, in order to allow researchers to improve the predictive quality, and pool data from multi-centre studies.

Summary of background: The progress from early stages of back pain to persistent problems is poorly understood, and only a fraction of the variance at outcome can be accounted for by current prospective cohorts. Standardization of a core set of factors would allow pooling and facilitate comparison between studies.

Method: Teams from 12 nations with expertise in clinical practice, prospective cohorts, epidemiology, social sciences, and health services were appointed.

The steering committee produced checklists of predictors and outcomes based on systematic reviews and a Delphi focus group. The international teams of experts coded each item for inclusion or exclusion, and recommended new items. This process was iterated twice to resolve disagreement between teams, and to receive scores for new items. The steering committee carried out a consensus synthesis and produced the final lists for predictors and outcome. Finally, the measurements for each factor were selected based on:

  1. original systematic review

  2. recommendations from existing systematic review

  3. Recommendations from consensus statements and narrative reviews

  4. consultation with independent experts.

Results: The checklist for predictors include information about demographics, clinical status, psychosocial status, work, and the first consultation for back pain. The recommendation for outcomes include pain, disability, return to work and sick leave, satisfaction, psychological factors, health care utilization and treatment over the follow up period.

Correspondence should be addressed to: Mr John O’ Dowd, SBPR, c/o BOA, The Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE.