Recognition of Treatment Effect Modifiers in the STarT Back Trial

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Recognition of Treatment Effect Modifiers in the STarT Back Trial

One of the foremost low back pain (LBP) research priority is the depiction of patient characteristics influencing treatment outcomes. The patient characteristics associated with treatment response have not yet been discovered; however, the outcomes from the STarT Back trial support the effectiveness of prognostic stratified care for LBP in contrast to the current best care.

Beneciuk J M and colleagues conducted a secondary analysis to identify the treatment effect modifiers within the STarT Back trial at 4-month follow-up (n = 688). Using the Roland-Morris Disability Questionnaire (≥7), the treatment response was dichotomized using back-specific physical disability. The previous literature was used to recognize the candidate modifiers. These were estimated using logistic regression with statistical interaction terms to supply preliminary evidence of treatment effect modification. The socioeconomic status (SES) was recognised as an effect modifier for disability outcomes (odds ratio [OR] = 1.71, P = .028). High SES patients getting prognostic stratified care were 2.5 times less likely to have a poor outcome compared with low SES patients getting principal current care (OR =.40, P = .006). Education level (OR = 1.33, P=0.109) and number of pain medications (OR=0.64, P =0.140) met the standards for effect modification with weaker confirmation (.20 > p≥ 0.05). These discoveries supplement preliminary evidence for SES, education, and the number of pain medications as treatment effect modifiers of prognostic stratified care furnished in the STarT Back Trial.

Hence, this analysis provides preliminary exploratory findings of the characteristics of patients who might least likely advantage from targeted treatment via prognostic stratified care for LBP.

Source:

Science Direct

Link to the source:

http://www.jpain.org/article/S1526-5900(16)30259-0/abstract

The original title of the article:

Identifying Treatment Effect Modifiers in the STarT Back Trial: A Secondary Analysis

Authors

Jason M. Beneciuk et al.

SearchTags: 
Exploratory, Low Back Pain, Spine, Secondary Analysis, Roland-Morris Disability Questionnaire, Odds Ratio
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