Study protocol

Development of a screening tool predicting the transition from acute to chronic low back pain for patients in a GP setting: Protocol of a multinational prospective cohort study

Markus Melloh¹ , Nikolaus Aebli² , Achim Elfering³ , Christoph Röder⁴ , Thomas Zweig⁴ , Thomas Barz⁵ , Peter Herbison⁶ , Paul Hendrick⁷ , Suraj Bajracharya¹ , Kirsten Stout¹ and Jean-Claude Theis¹

¹  Section of Orthopaedic Surgery, Department of Medical and Surgical Sciences, Dunedin School of Medicine, University of Otago, Private Bag 1921, Dunedin 9054, New Zealand

²  Department of Surgery and Orthopaedics, Swiss Paraplegic Centre, Guido A. Zäch Strasse 1, 6207 Nottwil, Switzerland

³  Department of Work and Organizational Psychology, Institute for Psychology, University of Berne, Muesmattstrasse 45, 3000 Berne 9, Switzerland

⁴  MEM Research Center for Orthopaedic Surgery, University of Berne, Stauffacherstrasse 78, 3014 Berne, Switzerland

⁵  Department of Orthopaedic Surgery, Asklepios Klinikum Uckermark, Auguststrasse 23, 16303 Schwedt/Oder, Germany

⁶  Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, PO Box 913, Dunedin 9054, New Zealand

⁷  School of Physiotherapy, University of Otago, PO Box 56, Dunedin 9054, New Zealand

author email corresponding author email

BMC Musculoskeletal Disorders 2008, 9:167doi:10.1186/1471-2474-9-167

Published:	19 December 2008

Abstract

Background

Low back pain (LBP) is by far the most prevalent and costly musculoskeletal problem in our society today. Following the recommendations of the Multinational Musculoskeletal Inception Cohort Study (MMICS) Statement, our study aims to define outcome assessment tools for patients with acute LBP and the time point at which chronic LBP becomes manifest and to identify patient characteristics which increase the risk of chronicity.

Methods

Patients with acute LBP will be recruited from clinics of general practitioners (GPs) in New Zealand (NZ) and Switzerland (CH). They will be assessed by postal survey at baseline and at 3, 6, 12 weeks and 6 months follow-up. Primary outcome will be disability as measured by the Oswestry Disability Index (ODI); key secondary endpoints will be general health as measured by the acute SF-12 and pain as measured on the Visual Analogue Scale (VAS). A subgroup analysis of different assessment instruments and baseline characteristics will be performed using multiple linear regression models.

This study aims to examine

1. Which biomedical, psychological, social, and occupational outcome assessment tools are identifiers for the transition from acute to chronic LBP and at which time point this transition becomes manifest

2. Which psychosocial and occupational baseline characteristics like work status and period of work absenteeism influence the course from acute to chronic LBP

3. Differences in outcome assessment tools and baseline characteristics of patients in NZ compared with CH.

Discussion

This study will develop a screening tool for patients with acute LBP to be used in GP clinics to access the risk of developing chronic LBP. In addition, biomedical, psychological, social, and occupational patient characteristics which influence the course from acute to chronic LBP will be identified. Furthermore, an appropriate time point for follow-ups will be given to detect this transition. The generalizability of our findings will be enhanced by the international perspective of this study.

Trial registration

[Clinical Trial Registration Number, ACTRN12608000520336]