For a study, the researchers sought to define clinical symptom classes of patients attending a spine clinic based on 4 PROMIS categories and compare demographic and clinical characteristics between classes. An observational cross-sectional study of patients determined at a large health system’s spine centers. Adult patients with low back pain who were caught in a spine center between November 14, 2018, and February 14, 2019, completed patient-reported outcomes as part of regular care. PROMIS physical function, pain interference, social roles, activities enjoyment, and exhaustion. The latent class analysis produced symptom scores based on PROMIS domain scores of 1 standard deviation worse (meaningfully worse) than the general population. A multivariable multinomial logistic regression model was developed to assess differences in symptom classes based on demographics and socioeconomic factors. Finally, using the modified Oswestry Disability Questionnaire (ODI), the profiles’ ability to differentiate among levels of disability was assessed. The study comprised 7,144 adult patients (age 58.7±15.9, 54% female) who visited spine clinics with a primary complaint of LBP and completed all 4 PROMIS domains. There were 3 separate classes discovered. For all parts, PROMIS scores for Class 1 (“Significant Symptoms,” n=3,238) were significantly lower than the population average. Physical function and pain interference were substantially worse in Class 2 (“Mixed Symptoms,” n=1,366), while other domains were average. All parts had average ratings for Class 3 (“Mild Symptoms,” n=2,540). Patients in Class 2 were more likely to be older than the ones in Class 3, and those in Classes 1 and 2 were more likely to be divorced, have a lower household income, and be unemployed. The average (SD) ODI for Classes 1-3 was 53.4 (14.3), 39.9 (12.5), and 22.9 (12.1), respectively, with a significant difference between them (P<0.01).
Link:www.thespinejournalonline.com/article/S1529-9430(22)00066-3/fulltext
