腰痛分类的诊断性临床预测规则:一项系统综述。

IF 1.5 Q3 RHEUMATOLOGY Musculoskeletal Care Pub Date : 2023-12-01 Epub Date: 2023-10-09 DOI:10.1002/msc.1816
Charles James Hill, Anirban Banerjee, Jonathan Hill, Claire Stapleton
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引用次数: 0

摘要

背景:腰痛(LBP)是一种常见的复杂疾病,其具体诊断很难确定。已知诊断性临床预测规则(CPR)可以改善临床决策。Haskins等人对LBP诊断CPR的综述。(2015)在开发的衍生阶段确定了六个诊断CPR,其中一个工具已准备好实施。这些工具的最新进展尚不清楚。因此,本综述旨在调查LBP诊断CPR的发展,并评估其实施准备情况。方法:对五个数据库(Medline、Amed、Cochrane Library、PsycInfo和CINAHL)进行系统综述,结合手工搜索和引文追踪,以确定符合条件的研究。研究和工具质量评估了偏倚风险(诊断准确性研究的质量评估-2)、方法质量(使用公认的CPR方法标准的检查表)和CPR工具评估(GRade和ASsess Predictive)。结果:在筛选的5021项研究中,确定了11项诊断CPR。在之前已知的六个中,有三个已经过外部验证,但尚未进行影响分析。自Haskin等人。(2015);所有这些都还处于衍生阶段。最有效的诊断CPR包括用于识别腰椎狭窄的腰椎管狭窄症自我管理自述病史问卷和诊断支持工具,以及区分根性和轴性LBP的StEP工具。结论:对LBP诊断CPR的最新审查发现了五种新工具,均处于开发的早期阶段。三种以前已知的工具现已得到外部验证,但在进行影响评估研究之前应谨慎使用。未来的资金应侧重于外部验证和评估现有CPR对临床决策的影响。
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Diagnostic clinical prediction rules for categorising low back pain: A systematic review.

Background: Low back pain (LBP) is a common complex condition, where specific diagnoses are hard to identify. Diagnostic clinical prediction rules (CPRs) are known to improve clinical decision-making. A review of LBP diagnostic-CPRs by Haskins et al. (2015) identified six diagnostic-CPRs in derivation phases of development, with one tool ready for implementation. Recent progress on these tools is unknown. Therefore, this review aimed to investigate developments in LBP diagnostic-CPRs and evaluate their readiness for implementation.

Methods: A systematic review was performed on five databases (Medline, Amed, Cochrane Library, PsycInfo, and CINAHL) combined with hand-searching and citation-tracking to identify eligible studies. Study and tool quality were appraised for risk of bias (Quality Assessment of Diagnostic Accuracy Studies-2), methodological quality (checklist using accepted CPR methodological standards), and CPR tool appraisal (GRade and ASsess Predictive).

Results: Of 5021 studies screened, 11 diagnostic-CPRs were identified. Of the six previously known, three have been externally validated but not yet undergone impact analysis. Five new tools have been identified since Haskin et al. (2015); all are still in derivation stages. The most validated diagnostic-CPRs include the Lumbar-Spinal-Stenosis-Self-Administered-Self-Reported-History-Questionnaire and Diagnosis-Support-Tool-to-Identify-Lumbar-Spinal-Stenosis, and the StEP-tool which differentiates radicular from axial-LBP.

Conclusions: This updated review of LBP diagnostic CPRs found five new tools, all in the early stages of development. Three previously known tools have now been externally validated but should be used with caution until impact evaluation studies are undertaken. Future funding should focus on externally validating and assessing the impact of existing CPRs on clinical decision-making.

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来源期刊
Musculoskeletal Care
Musculoskeletal Care RHEUMATOLOGY-
CiteScore
2.30
自引率
7.70%
发文量
88
期刊介绍: Musculoskeletal Care is a peer-reviewed journal for all health professionals committed to the clinical delivery of high quality care for people with musculoskeletal conditions and providing knowledge to support decision making by professionals, patients and policy makers. This journal publishes papers on original research, applied research, review articles and clinical guidelines. Regular topics include patient education, psychological and social impact, patient experiences of health care, clinical up dates and the effectiveness of therapy.
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