Clustering patients on the basis of their individual course of low back pain over a six month period

<p>Abstract</p> <p>Background</p> <p>Several researchers have searched for subgroups in the heterogeneous population of patients with non-specific low back pain (LBP). To date, subgroups have been identified based on psychological profiles and the variation of pain.<...

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Main Authors: Rosenbaum Annika, Lövgren Peter W, Lange Fredrik, Halasz Laszlo, Bergström Gunnar, Bodin Lennart, Axén Iben, Leboeuf-Yde Charlotte, Jensen Irene
Format: Article
Language:English
Published: BMC 2011-05-01
Series:BMC Musculoskeletal Disorders
Online Access:http://www.biomedcentral.com/1471-2474/12/99
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spelling doaj-1d4421d583374a958c4fd4b4c10c7b4d2020-11-24T22:12:30ZengBMCBMC Musculoskeletal Disorders1471-24742011-05-011219910.1186/1471-2474-12-99Clustering patients on the basis of their individual course of low back pain over a six month periodRosenbaum AnnikaLövgren Peter WLange FredrikHalasz LaszloBergström GunnarBodin LennartAxén IbenLeboeuf-Yde CharlotteJensen Irene<p>Abstract</p> <p>Background</p> <p>Several researchers have searched for subgroups in the heterogeneous population of patients with non-specific low back pain (LBP). To date, subgroups have been identified based on psychological profiles and the variation of pain.</p> <p>Methods</p> <p>This multicentre prospective observational study explored the 6- month clinical course with measurements of bothersomeness that were collected from weekly text messages that were sent by 176 patients with LBP. A hierarchical cluster analysis, Ward's method, was used to cluster patients according to the development of their pain.</p> <p>Results</p> <p>Four clusters with distinctly different clinical courses were described and further validated against clinical baseline variables and outcomes. Cluster 1, a "stable" cluster, where the course was relatively unchanged over time, contained young patients with good self- rated health. Cluster 2, a group of "fast improvers" who were very bothered initially but rapidly improved, consisted of patients who rated their health as relatively poor but experienced the fewest number of days with bothersome pain of all the clusters. Cluster 3 was the "typical patient" group, with medium bothersomeness at baseline and an average improvement over the first 4-5 weeks. Finally, cluster 4 contained the "slow improvers", a group of patients who improved over 12 weeks. This group contained older individuals who had more LBP the previous year and who also experienced most days with bothersome pain of all the clusters.</p> <p>Conclusions</p> <p>It is possible to define clinically meaningful clusters of patients based on their individual course of LBP over time. Future research should aim to reproduce these clusters in different populations, add further clinical variables to distinguish the clusters and test different treatment strategies for them.</p> http://www.biomedcentral.com/1471-2474/12/99
collection DOAJ
language English
format Article
sources DOAJ
author Rosenbaum Annika
Lövgren Peter W
Lange Fredrik
Halasz Laszlo
Bergström Gunnar
Bodin Lennart
Axén Iben
Leboeuf-Yde Charlotte
Jensen Irene
spellingShingle Rosenbaum Annika
Lövgren Peter W
Lange Fredrik
Halasz Laszlo
Bergström Gunnar
Bodin Lennart
Axén Iben
Leboeuf-Yde Charlotte
Jensen Irene
Clustering patients on the basis of their individual course of low back pain over a six month period
BMC Musculoskeletal Disorders
author_facet Rosenbaum Annika
Lövgren Peter W
Lange Fredrik
Halasz Laszlo
Bergström Gunnar
Bodin Lennart
Axén Iben
Leboeuf-Yde Charlotte
Jensen Irene
author_sort Rosenbaum Annika
title Clustering patients on the basis of their individual course of low back pain over a six month period
title_short Clustering patients on the basis of their individual course of low back pain over a six month period
title_full Clustering patients on the basis of their individual course of low back pain over a six month period
title_fullStr Clustering patients on the basis of their individual course of low back pain over a six month period
title_full_unstemmed Clustering patients on the basis of their individual course of low back pain over a six month period
title_sort clustering patients on the basis of their individual course of low back pain over a six month period
publisher BMC
series BMC Musculoskeletal Disorders
issn 1471-2474
publishDate 2011-05-01
description <p>Abstract</p> <p>Background</p> <p>Several researchers have searched for subgroups in the heterogeneous population of patients with non-specific low back pain (LBP). To date, subgroups have been identified based on psychological profiles and the variation of pain.</p> <p>Methods</p> <p>This multicentre prospective observational study explored the 6- month clinical course with measurements of bothersomeness that were collected from weekly text messages that were sent by 176 patients with LBP. A hierarchical cluster analysis, Ward's method, was used to cluster patients according to the development of their pain.</p> <p>Results</p> <p>Four clusters with distinctly different clinical courses were described and further validated against clinical baseline variables and outcomes. Cluster 1, a "stable" cluster, where the course was relatively unchanged over time, contained young patients with good self- rated health. Cluster 2, a group of "fast improvers" who were very bothered initially but rapidly improved, consisted of patients who rated their health as relatively poor but experienced the fewest number of days with bothersome pain of all the clusters. Cluster 3 was the "typical patient" group, with medium bothersomeness at baseline and an average improvement over the first 4-5 weeks. Finally, cluster 4 contained the "slow improvers", a group of patients who improved over 12 weeks. This group contained older individuals who had more LBP the previous year and who also experienced most days with bothersome pain of all the clusters.</p> <p>Conclusions</p> <p>It is possible to define clinically meaningful clusters of patients based on their individual course of LBP over time. Future research should aim to reproduce these clusters in different populations, add further clinical variables to distinguish the clusters and test different treatment strategies for them.</p>
url http://www.biomedcentral.com/1471-2474/12/99
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