Lack of Prognostic Model Validation in Low Back Pain Prediction Studies: A Systematic Review

The objective of this study was to investigate the frequency with which prediction studies for low back pain outcomes utilize prospective methods of prognostic model validation. Method: Searches of Medline and Embase for terms “predict/predictor,” “prognosis,” or “prognostic factor.” The search was limited to studies conducted in humans and reported in the English language. Included articles were all those published in 2 Spine specialty journals (Spine and The Spine Journal) over a 13-month period, January 2013 to January 2014. Conference papers, reviews, and letters were excluded. The initial screen identified 55 potential studies (44 in Spine, 11 in The Spine Journal); 34 were excluded because they were not primary data collection prediction studies; 23 were not prediction studies and 11 were review articles. This left 21 prognosis papers for review, 19 in Spine, 2 in The Spine Journal. Results: None of the 21 studies provided validation for the predictors that they documented (neither internal or external validation). On the basis of the study designs and lack of validation, only 2 studies used the correct terminology for describing associations/relationships between independent and dependent variables. Discussion: Unless researchers and clinicians consider sophisticated and rigorous methods of statistical/external validity for prediction/prognostic findings they will make incorrect assumptions and draw invalid conclusions regarding treatment effects a...
Source: The Clinical Journal of Pain - Category: Anesthesiology Tags: Review Articles Source Type: research