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Clinical prediction guide
An algorithm comprising 7 baseline variables predicted the 2 year work disability status in non-specific back pain

https://doi.org/10.1136/ebm.10.6.187

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    Dionne CE, Bourbonnais R, Fremont P, et al. A clinical return-to-work rule for patients with back pain. CMAJ 2005;172:1559–67.
    OpenUrlAbstract/FREE Full Text

    
 
 Q In patients with non-specific back pain associated with ⩾1 day’s absence from work, what variable or set of variables best predicts the 2 year work disability status?

    Clinical impact ratings GP/FP/Primary care ★★★★★☆☆

    METHODS

    Embedded ImageDesign:

    a cohort study (Recherche sur les Affections Musculo-Squelettiques [RAMS]- Prognosis Study) with a qualitative phase to identify additional predictors, and a quantitative phase for prediction analysis. More than 100 potential predictors were measured at baseline and at 6 and 12 weeks. Predictive models of 2 year outcome were developed with recursive partitioning on a 40% random sample of the cohort, and validated in the rest.

    Embedded ImageSetting:

    7 primary care settings in Quebec City, Quebec, Canada.

    Embedded ImagePatients:

    860 adult workers (mean age 39 y, 58% men) who consulted for non-specific back pain associated with ⩾1 day’s absence from work.

    Embedded ImageDescription of prediction guide:

    the final model had 7 questions pertaining to patients’ recovery expectations, radiating pain, previous back surgery, …

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    Footnotes

    • For correspondence: Dr C E Dionne, Hôpital du Saint-Sacrement, Québec, Québec, Canada. clermont.dionne{at}uresp.ulaval.ca

    • Source of funding: Quebec Institute for Occupational Safety and Health.