External validation and updating of prognostic models for predicting recovery of disability in people with (sub)acute neck pain was successful: broad external validation in a new prospective cohort
Question: Can existing post-treatment prognostic models for predicting neck pain recovery (primarily in terms of disability and secondarily in terms of pain intensity and perceived improvement) be externally validated and updated at the end of the treatment period and at 6 and 12 weeks of follow-up...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2023-04-01
|
| Series: | Journal of Physiotherapy |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1836955323000036 |
| _version_ | 1797851280859725824 |
|---|---|
| author | Roel W Wingbermühle Alessandro Chiarotto Emiel van Trijffel Martijn S Stenneberg Ronald Kan Bart W Koes Martijn W Heymans |
| author_facet | Roel W Wingbermühle Alessandro Chiarotto Emiel van Trijffel Martijn S Stenneberg Ronald Kan Bart W Koes Martijn W Heymans |
| author_sort | Roel W Wingbermühle |
| collection | DOAJ |
| description | Question: Can existing post-treatment prognostic models for predicting neck pain recovery (primarily in terms of disability and secondarily in terms of pain intensity and perceived improvement) be externally validated and updated at the end of the treatment period and at 6 and 12 weeks of follow-up in a new Dutch cohort of people with neck pain treated with guideline-based usual care physiotherapy? Design: External validation and model updating in a new prospective cohort of three previously developed prognostic models. Participants: People with (sub)acute neck pain and registered for primary care physiotherapy treatment. Outcome measures: Recovery of disability, pain intensity, and perceived recovery at 6 and 12 weeks and at the end of the treatment period. Results: Discriminative performance (c-statistic) of the disability model at 6 weeks was 0.73 (95% CI 0.69 to 0.77) and reasonably well calibrated after intercept recalibration. The disability model at 12 weeks and at the end of the treatment period showed discriminative c-statistic performance values of 0.69 (95% CI 0.64 to 0.73) and 0.68 (95% CI 0.63 to 0.72), respectively, and was well calibrated. Pain models and perceived recovery models did not reach acceptable performance. Cervical mobility added value to the disability models and pain catastrophising to the disability and pain models at 6 weeks. Discussion: Broad external validation of the disability model was successful in people with (sub)acute neck pain and clinicians may use this model in clinical practice with reasonable accuracy. Further research is required to assess the disability model’s clinical impact and generalisability, and to identify additional valuable model predictors. Registration: https://osf.io/a6r3k/ |
| first_indexed | 2024-04-09T19:15:23Z |
| format | Article |
| id | doaj.art-1440bad11aa94c1280be4b3a33a0273e |
| institution | Directory Open Access Journal |
| issn | 1836-9553 |
| language | English |
| last_indexed | 2024-04-09T19:15:23Z |
| publishDate | 2023-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Physiotherapy |
| spelling | doaj.art-1440bad11aa94c1280be4b3a33a0273e2023-04-06T06:10:43ZengElsevierJournal of Physiotherapy1836-95532023-04-01692100107External validation and updating of prognostic models for predicting recovery of disability in people with (sub)acute neck pain was successful: broad external validation in a new prospective cohortRoel W Wingbermühle0Alessandro Chiarotto1Emiel van Trijffel2Martijn S Stenneberg3Ronald Kan4Bart W Koes5Martijn W Heymans6SOMT University of Physiotherapy, Amersfoort, The Netherlands; Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, The Netherlands; Correspondence: Roel W Wingbermühle, SOMT University of Physiotherapy, The Netherlands.Department of General Practice, Erasmus MC, University Medical Center, Rotterdam, The NetherlandsZiekenhuisgroep Twente, ZGT Academy, The NetherlandsSOMT University of Physiotherapy, Amersfoort, The Netherlands; Department of Physiotherapy, Human Physiology and Anatomy, Experimental Anatomy Research Department, Vrije Universiteit Brussel, BelgiumSOMT University of Physiotherapy, Amersfoort, The NetherlandsDepartment of General Practice, Erasmus MC, University Medical Center, Rotterdam, The Netherlands; Department of Sports Science and Clinical Biomechanics, Faculty of Health Sciences, University of Southern Denmark, Odense, DenmarkDepartment of Epidemiology and Data Science, Amsterdam University Medical Center, VU University Medical Center, Amsterdam, the NetherlandsQuestion: Can existing post-treatment prognostic models for predicting neck pain recovery (primarily in terms of disability and secondarily in terms of pain intensity and perceived improvement) be externally validated and updated at the end of the treatment period and at 6 and 12 weeks of follow-up in a new Dutch cohort of people with neck pain treated with guideline-based usual care physiotherapy? Design: External validation and model updating in a new prospective cohort of three previously developed prognostic models. Participants: People with (sub)acute neck pain and registered for primary care physiotherapy treatment. Outcome measures: Recovery of disability, pain intensity, and perceived recovery at 6 and 12 weeks and at the end of the treatment period. Results: Discriminative performance (c-statistic) of the disability model at 6 weeks was 0.73 (95% CI 0.69 to 0.77) and reasonably well calibrated after intercept recalibration. The disability model at 12 weeks and at the end of the treatment period showed discriminative c-statistic performance values of 0.69 (95% CI 0.64 to 0.73) and 0.68 (95% CI 0.63 to 0.72), respectively, and was well calibrated. Pain models and perceived recovery models did not reach acceptable performance. Cervical mobility added value to the disability models and pain catastrophising to the disability and pain models at 6 weeks. Discussion: Broad external validation of the disability model was successful in people with (sub)acute neck pain and clinicians may use this model in clinical practice with reasonable accuracy. Further research is required to assess the disability model’s clinical impact and generalisability, and to identify additional valuable model predictors. Registration: https://osf.io/a6r3k/http://www.sciencedirect.com/science/article/pii/S1836955323000036External validationNeck painClinical prediction modelPrognosisPrognostic modelRecovery |
| spellingShingle | Roel W Wingbermühle Alessandro Chiarotto Emiel van Trijffel Martijn S Stenneberg Ronald Kan Bart W Koes Martijn W Heymans External validation and updating of prognostic models for predicting recovery of disability in people with (sub)acute neck pain was successful: broad external validation in a new prospective cohort Journal of Physiotherapy External validation Neck pain Clinical prediction model Prognosis Prognostic model Recovery |
| title | External validation and updating of prognostic models for predicting recovery of disability in people with (sub)acute neck pain was successful: broad external validation in a new prospective cohort |
| title_full | External validation and updating of prognostic models for predicting recovery of disability in people with (sub)acute neck pain was successful: broad external validation in a new prospective cohort |
| title_fullStr | External validation and updating of prognostic models for predicting recovery of disability in people with (sub)acute neck pain was successful: broad external validation in a new prospective cohort |
| title_full_unstemmed | External validation and updating of prognostic models for predicting recovery of disability in people with (sub)acute neck pain was successful: broad external validation in a new prospective cohort |
| title_short | External validation and updating of prognostic models for predicting recovery of disability in people with (sub)acute neck pain was successful: broad external validation in a new prospective cohort |
| title_sort | external validation and updating of prognostic models for predicting recovery of disability in people with sub acute neck pain was successful broad external validation in a new prospective cohort |
| topic | External validation Neck pain Clinical prediction model Prognosis Prognostic model Recovery |
| url | http://www.sciencedirect.com/science/article/pii/S1836955323000036 |
| work_keys_str_mv | AT roelwwingbermuhle externalvalidationandupdatingofprognosticmodelsforpredictingrecoveryofdisabilityinpeoplewithsubacuteneckpainwassuccessfulbroadexternalvalidationinanewprospectivecohort AT alessandrochiarotto externalvalidationandupdatingofprognosticmodelsforpredictingrecoveryofdisabilityinpeoplewithsubacuteneckpainwassuccessfulbroadexternalvalidationinanewprospectivecohort AT emielvantrijffel externalvalidationandupdatingofprognosticmodelsforpredictingrecoveryofdisabilityinpeoplewithsubacuteneckpainwassuccessfulbroadexternalvalidationinanewprospectivecohort AT martijnsstenneberg externalvalidationandupdatingofprognosticmodelsforpredictingrecoveryofdisabilityinpeoplewithsubacuteneckpainwassuccessfulbroadexternalvalidationinanewprospectivecohort AT ronaldkan externalvalidationandupdatingofprognosticmodelsforpredictingrecoveryofdisabilityinpeoplewithsubacuteneckpainwassuccessfulbroadexternalvalidationinanewprospectivecohort AT bartwkoes externalvalidationandupdatingofprognosticmodelsforpredictingrecoveryofdisabilityinpeoplewithsubacuteneckpainwassuccessfulbroadexternalvalidationinanewprospectivecohort AT martijnwheymans externalvalidationandupdatingofprognosticmodelsforpredictingrecoveryofdisabilityinpeoplewithsubacuteneckpainwassuccessfulbroadexternalvalidationinanewprospectivecohort |