Article

Low back pain is a common, disabling condition with high personal and economic
costs. Despite clinical guidelines, there have not been tangible reductions in
the population prevalence of back pain or its serious long-term consequences. One
reason for this might be that the 'one-size fits all approach' advocated by many
guidelines fails to target treatments at patients who might benefit the most,
thus diluting their potential benefits. Identifying subgroups of patients for
whom different treatments are superior has been referred to as the 'Holy Grail'
of low back pain research. Maximising the potential for targeted interventions is
predicated on better understanding of the prognostic factors that are causally
related to clinical outcome and identifying which are a) most predictive of
outcome and b) most likely to be modifiable. Systematic identification of key
obstacles to recovery in primary care back pain patients from high quality
epidemiological studies can inform the development of early, targeted
interventions. Only then can closer matching of treatments to patient
characteristics be a clinical reality. This paper critically reviews progress in
subgrouping for targeted treatment for patients with low back pain, identifies
the key arguments for and against subgrouping and highlights the attributes of
robust approaches in this field.
CI - Copyright (c) 2010 Elsevier Ltd. All rights reserved.

Langue : ANGLAIS