Is this what your patients look like? Statistical identification of ‘patient-profiles’ based on first visit characteristics

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Abstract

Objective
Chiropractors provide care for many low back pain (LBP) patients and often report very positive effects from chiropractic treatment. However, randomized controlled trials show only small effects and one possible explanation is that the benefit of treatment varies across different subgroups. There are a number of methodological approaches to identifying subgroups of patients with similar profiles. The aim of this project was to use a novel method to subgroup LBP patients into distinct clinically recognizable patient-profiles based on diverse patient characteristics.

Methods
LBP patients from 17 chiropractic clinics in Denmark responded to a comprehensive baseline questionnaire (LBP history, pain intensity, activity limitation, psychological factors, general health and social factors) and underwent a standardized physical examination including range of motion, tests for pain centralization, sacroiliac joint tests and neurological examination. A computerized clustering technique combining all the data will be used to identify subgroups of patients with specific profiles. The planned analysis includes health domains (psychological, pain, physical impairment, activity, participation and contextual factors) and thereby takes into account the whole bio-psycho-social aspect of LBP. Resultant baseline subgroups will be described along with the feature of each subgroup that distinguishes it from the others, and a judgment will be made of how clinically recognizable each subgroup is.

Results
This study included 928 patients aged 18-65 years. A total of 71 variables were collected and classified into 6 health domains. The statistical analysis will be performed late 2014 and the resulting patient-profiles described afterwards.

Conclusion
As this subgroup analysis is more comprehensive than traditional subgrouping methods and more likely to accommodate any complex interplay between patient characteristics, it may show previously unrecognized subgroups. The resulting subgroups will be presented at the conference and will subsequently be tested for their association with patient outcomes.

Original languageEnglish
JournalJournal of Chiropractic Medicine
Volume14
Issue number2
Pages (from-to)140
Number of pages1
ISSN1556-3707
Publication statusPublished - Jun 2015
EventWFC's 13th Biennial Congress/ECU Convention - Athens, Greece
Duration: 13. May 201516. May 2015

Conference

ConferenceWFC's 13th Biennial Congress/ECU Convention
CountryGreece
CityAthens
Period13/05/201516/05/2015

Keywords

  • Low back pain
  • adults

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