A Decision Support System to Enhance Self-Management of Low Back Pain: Protocol for the selfBACK Project

selfBACK Consortium, Andreas Holtermann (Member of author group), Mette Jensen Stochkendahl (Member of author group), Karen Søgaard (Member of author group), Jan Hartvigsen (Member of author group), Per Kjaer (Member of author group), Louise Fleng Sandal (Member of author group), Gisela Sjøgaard (Member of author group)

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Abstract

BACKGROUND: Low back pain (LBP) is a leading cause of disability worldwide. Most patients with LBP encountered in primary care settings have nonspecific LBP, that is, pain with an unknown pathoanatomical cause. Self-management in the form of physical activity and strength and flexibility exercises along with patient education constitute the core components of the management of nonspecific LBP. However, the adherence to a self-management program is challenging for most patients, especially without feedback and reinforcement. Here we outline a protocol for the design and implementation of a decision support system (DSS), selfBACK, to be used by patients themselves to promote self-management of LBP.

OBJECTIVE: The main objective of the selfBACK project is to improve self-management of nonspecific LBP to prevent chronicity, recurrence and pain-related disability. This is achieved by utilizing computer technology to develop personalized self-management plans based on individual patient data.

METHODS: The decision support is conveyed to patients via a mobile phone app in the form of advice for self-management. Case-based reasoning (CBR), a technology that utilizes knowledge about previous cases along with data about the current patient case, is used to tailor the advice to the current patient, enabling a patient-centered intervention based on what has and has not been successful in previous patient cases. The data source for the CBR system comprises initial patient data collected by a Web-based questionnaire, weekly patient reports (eg, symptom progression), and a physical activity-detecting wristband. The effectiveness of the selfBACK DSS will be evaluated in a multinational, randomized controlled trial (RCT), targeting care-seeking patients with nonspecific LBP. A process evaluation will be carried out as an integral part of the RCT to document the implementation and patient experiences with selfBACK.

RESULTS: The selfBACK project was launched in January 2016 and will run until the end of 2020. The final version of the selfBACK DSS will be completed in 2018. The RCT will commence in February 2019 with pain-related disability at 3 months as the primary outcome. The trial results will be reported according to the CONSORT statement and the extended CONSORT-EHEALTH checklist. Exploitation of the results will be ongoing throughout the project period based on a business plan developed by the selfBACK consortium. Tailored digital support has been proposed as a promising approach to improve self-management of chronic disease. However, tailoring self-management advice according to the needs, motivation, symptoms, and progress of individual patients is a challenging task. Here we outline a protocol for the design and implementation of a stand-alone DSS based on the CBR technology with the potential to improve self-management of nonspecific LBP.

CONCLUSIONS: The selfBACK project will provide learning regarding the implementation and effectiveness of an app-based DSS for patients with nonspecific LBP.

REGISTERED REPORT IDENTIFIER: RR1-10.2196/9379.

Original languageEnglish
Article numbere167
JournalJ M I R Research Protocols
Volume7
Issue number7
Number of pages13
ISSN1929-0748
DOIs
Publication statusPublished - 20. Jul 2018

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Low Back Pain
Randomized Controlled Trials
Exercise
Mobile Applications
Information Storage and Retrieval
Patient Education
Checklist
Primary Health Care

Keywords

  • Case-based reasoning
  • Computer technology
  • Digital health
  • EHealth
  • Exercise
  • MHealth
  • Machine learning
  • Physical activity
  • Primary care
  • Smartphone

Cite this

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title = "A Decision Support System to Enhance Self-Management of Low Back Pain: Protocol for the selfBACK Project",
abstract = "BACKGROUND: Low back pain (LBP) is a leading cause of disability worldwide. Most patients with LBP encountered in primary care settings have nonspecific LBP, that is, pain with an unknown pathoanatomical cause. Self-management in the form of physical activity and strength and flexibility exercises along with patient education constitute the core components of the management of nonspecific LBP. However, the adherence to a self-management program is challenging for most patients, especially without feedback and reinforcement. Here we outline a protocol for the design and implementation of a decision support system (DSS), selfBACK, to be used by patients themselves to promote self-management of LBP.OBJECTIVE: The main objective of the selfBACK project is to improve self-management of nonspecific LBP to prevent chronicity, recurrence and pain-related disability. This is achieved by utilizing computer technology to develop personalized self-management plans based on individual patient data.METHODS: The decision support is conveyed to patients via a mobile phone app in the form of advice for self-management. Case-based reasoning (CBR), a technology that utilizes knowledge about previous cases along with data about the current patient case, is used to tailor the advice to the current patient, enabling a patient-centered intervention based on what has and has not been successful in previous patient cases. The data source for the CBR system comprises initial patient data collected by a Web-based questionnaire, weekly patient reports (eg, symptom progression), and a physical activity-detecting wristband. The effectiveness of the selfBACK DSS will be evaluated in a multinational, randomized controlled trial (RCT), targeting care-seeking patients with nonspecific LBP. A process evaluation will be carried out as an integral part of the RCT to document the implementation and patient experiences with selfBACK.RESULTS: The selfBACK project was launched in January 2016 and will run until the end of 2020. The final version of the selfBACK DSS will be completed in 2018. The RCT will commence in February 2019 with pain-related disability at 3 months as the primary outcome. The trial results will be reported according to the CONSORT statement and the extended CONSORT-EHEALTH checklist. Exploitation of the results will be ongoing throughout the project period based on a business plan developed by the selfBACK consortium. Tailored digital support has been proposed as a promising approach to improve self-management of chronic disease. However, tailoring self-management advice according to the needs, motivation, symptoms, and progress of individual patients is a challenging task. Here we outline a protocol for the design and implementation of a stand-alone DSS based on the CBR technology with the potential to improve self-management of nonspecific LBP.CONCLUSIONS: The selfBACK project will provide learning regarding the implementation and effectiveness of an app-based DSS for patients with nonspecific LBP.REGISTERED REPORT IDENTIFIER: RR1-10.2196/9379.",
keywords = "Case-based reasoning, Computer technology, Digital health, EHealth, Exercise, MHealth, Machine learning, Physical activity, Primary care, Smartphone",
author = "Mork, {Paul Jarle} and Kerstin Bach and {selfBACK Consortium} and Andreas Holtermann and Stochkendahl, {Mette Jensen} and Karen S{\o}gaard and Jan Hartvigsen and Per Kjaer and Sandal, {Louise Fleng} and Gisela Sj{\o}gaard",
note = "{\circledC}Paul Jarle Mork, Kerstin Bach. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 20.07.2018.",
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day = "20",
doi = "10.2196/resprot.9379",
language = "English",
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issn = "1929-0748",
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TY - JOUR

T1 - A Decision Support System to Enhance Self-Management of Low Back Pain

T2 - Protocol for the selfBACK Project

AU - Mork, Paul Jarle

AU - Bach, Kerstin

AU - selfBACK Consortium

A2 - Holtermann, Andreas

A2 - Stochkendahl, Mette Jensen

A2 - Søgaard, Karen

A2 - Hartvigsen, Jan

A2 - Kjaer, Per

A2 - Sandal, Louise Fleng

A2 - Sjøgaard, Gisela

N1 - ©Paul Jarle Mork, Kerstin Bach. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 20.07.2018.

PY - 2018/7/20

Y1 - 2018/7/20

N2 - BACKGROUND: Low back pain (LBP) is a leading cause of disability worldwide. Most patients with LBP encountered in primary care settings have nonspecific LBP, that is, pain with an unknown pathoanatomical cause. Self-management in the form of physical activity and strength and flexibility exercises along with patient education constitute the core components of the management of nonspecific LBP. However, the adherence to a self-management program is challenging for most patients, especially without feedback and reinforcement. Here we outline a protocol for the design and implementation of a decision support system (DSS), selfBACK, to be used by patients themselves to promote self-management of LBP.OBJECTIVE: The main objective of the selfBACK project is to improve self-management of nonspecific LBP to prevent chronicity, recurrence and pain-related disability. This is achieved by utilizing computer technology to develop personalized self-management plans based on individual patient data.METHODS: The decision support is conveyed to patients via a mobile phone app in the form of advice for self-management. Case-based reasoning (CBR), a technology that utilizes knowledge about previous cases along with data about the current patient case, is used to tailor the advice to the current patient, enabling a patient-centered intervention based on what has and has not been successful in previous patient cases. The data source for the CBR system comprises initial patient data collected by a Web-based questionnaire, weekly patient reports (eg, symptom progression), and a physical activity-detecting wristband. The effectiveness of the selfBACK DSS will be evaluated in a multinational, randomized controlled trial (RCT), targeting care-seeking patients with nonspecific LBP. A process evaluation will be carried out as an integral part of the RCT to document the implementation and patient experiences with selfBACK.RESULTS: The selfBACK project was launched in January 2016 and will run until the end of 2020. The final version of the selfBACK DSS will be completed in 2018. The RCT will commence in February 2019 with pain-related disability at 3 months as the primary outcome. The trial results will be reported according to the CONSORT statement and the extended CONSORT-EHEALTH checklist. Exploitation of the results will be ongoing throughout the project period based on a business plan developed by the selfBACK consortium. Tailored digital support has been proposed as a promising approach to improve self-management of chronic disease. However, tailoring self-management advice according to the needs, motivation, symptoms, and progress of individual patients is a challenging task. Here we outline a protocol for the design and implementation of a stand-alone DSS based on the CBR technology with the potential to improve self-management of nonspecific LBP.CONCLUSIONS: The selfBACK project will provide learning regarding the implementation and effectiveness of an app-based DSS for patients with nonspecific LBP.REGISTERED REPORT IDENTIFIER: RR1-10.2196/9379.

AB - BACKGROUND: Low back pain (LBP) is a leading cause of disability worldwide. Most patients with LBP encountered in primary care settings have nonspecific LBP, that is, pain with an unknown pathoanatomical cause. Self-management in the form of physical activity and strength and flexibility exercises along with patient education constitute the core components of the management of nonspecific LBP. However, the adherence to a self-management program is challenging for most patients, especially without feedback and reinforcement. Here we outline a protocol for the design and implementation of a decision support system (DSS), selfBACK, to be used by patients themselves to promote self-management of LBP.OBJECTIVE: The main objective of the selfBACK project is to improve self-management of nonspecific LBP to prevent chronicity, recurrence and pain-related disability. This is achieved by utilizing computer technology to develop personalized self-management plans based on individual patient data.METHODS: The decision support is conveyed to patients via a mobile phone app in the form of advice for self-management. Case-based reasoning (CBR), a technology that utilizes knowledge about previous cases along with data about the current patient case, is used to tailor the advice to the current patient, enabling a patient-centered intervention based on what has and has not been successful in previous patient cases. The data source for the CBR system comprises initial patient data collected by a Web-based questionnaire, weekly patient reports (eg, symptom progression), and a physical activity-detecting wristband. The effectiveness of the selfBACK DSS will be evaluated in a multinational, randomized controlled trial (RCT), targeting care-seeking patients with nonspecific LBP. A process evaluation will be carried out as an integral part of the RCT to document the implementation and patient experiences with selfBACK.RESULTS: The selfBACK project was launched in January 2016 and will run until the end of 2020. The final version of the selfBACK DSS will be completed in 2018. The RCT will commence in February 2019 with pain-related disability at 3 months as the primary outcome. The trial results will be reported according to the CONSORT statement and the extended CONSORT-EHEALTH checklist. Exploitation of the results will be ongoing throughout the project period based on a business plan developed by the selfBACK consortium. Tailored digital support has been proposed as a promising approach to improve self-management of chronic disease. However, tailoring self-management advice according to the needs, motivation, symptoms, and progress of individual patients is a challenging task. Here we outline a protocol for the design and implementation of a stand-alone DSS based on the CBR technology with the potential to improve self-management of nonspecific LBP.CONCLUSIONS: The selfBACK project will provide learning regarding the implementation and effectiveness of an app-based DSS for patients with nonspecific LBP.REGISTERED REPORT IDENTIFIER: RR1-10.2196/9379.

KW - Case-based reasoning

KW - Computer technology

KW - Digital health

KW - EHealth

KW - Exercise

KW - MHealth

KW - Machine learning

KW - Physical activity

KW - Primary care

KW - Smartphone

U2 - 10.2196/resprot.9379

DO - 10.2196/resprot.9379

M3 - Journal article

C2 - 30030208

VL - 7

JO - J M I R Research Protocols

JF - J M I R Research Protocols

SN - 1929-0748

IS - 7

M1 - e167

ER -