Factors predicting the transition from acute to persistent pain in people with 'sciatica': the FORECAST longitudinal prognostic factor cohort study protocol

<p><strong>Introduction:</strong>&nbsp;Sciatica is a common condition and is associated with higher levels of pain, disability, poorer quality of life, and increased use of health resources compared with low back pain alone. Although many patients recover, a third develop persi...

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Main Authors: Schmid, AB, Ridgway, L, Hailey, L, Tachrount, M, Probert, F, Martin, KR, Scott, W, Crombez, G, Price, C, Robinson, C, Koushesh, S, Ather, S, Tampin, B, Barbero, M, Nanz, D, Clare, S, Fairbank, J, Baskozos, G
Format: Journal article
Language:English
Published: BMJ Publishing Group 2023
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author Schmid, AB
Ridgway, L
Hailey, L
Tachrount, M
Probert, F
Martin, KR
Scott, W
Crombez, G
Price, C
Robinson, C
Koushesh, S
Ather, S
Tampin, B
Barbero, M
Nanz, D
Clare, S
Fairbank, J
Baskozos, G
author_facet Schmid, AB
Ridgway, L
Hailey, L
Tachrount, M
Probert, F
Martin, KR
Scott, W
Crombez, G
Price, C
Robinson, C
Koushesh, S
Ather, S
Tampin, B
Barbero, M
Nanz, D
Clare, S
Fairbank, J
Baskozos, G
author_sort Schmid, AB
collection OXFORD
description <p><strong>Introduction:</strong>&nbsp;Sciatica is a common condition and is associated with higher levels of pain, disability, poorer quality of life, and increased use of health resources compared with low back pain alone. Although many patients recover, a third develop persistent sciatica symptoms. It remains unclear, why some patients develop persistent sciatica as none of the traditionally considered clinical parameters (eg, symptom severity, routine MRI) are consistent prognostic factors.</p> <p>The FORECAST study (factors predicting the transition from acute to persistent pain in people with &lsquo;sciatica&rsquo;) will take a different approach by exploring mechanism-based subgroups in patients with sciatica and investigate whether a mechanism-based approach can identify factors that predict pain persistence in patients with sciatica.</p> <p><strong>Methods and analysis:</strong>&nbsp;We will perform a prospective longitudinal cohort study including 180 people with acute/subacute sciatica. N=168 healthy participants will provide normative data. A detailed set of variables will be assessed within 3 months after sciatica onset. This will include self-reported sensory and psychosocial profiles, quantitative sensory testing, blood inflammatory markers and advanced neuroimaging. We will determine outcome with the Sciatica Bothersomeness Index and a Numerical Pain Rating Scale for leg pain severity at 3 and 12 months.</p> <p>We will use principal component analysis followed by clustering methods to identify subgroups. Univariate associations and machine learning methods optimised for high dimensional small data sets will be used to identify the most powerful predictors and model selection/accuracy.</p> <p>The results will provide crucial information about the pathophysiological drivers of sciatica symptoms and may identify prognostic factors of pain persistence.</p> <p><strong>Ethics and dissemination:</strong>&nbsp;The FORECAST study has received ethical approval (South Central Oxford C, 18/SC/0263). The dissemination strategy will be guided by our patient and public engagement activities and will include peer-reviewed publications, conference presentations, social media and podcasts.</p> <p><strong>Trial registration number:</strong>&nbsp;ISRCTN18170726; Pre-results.</p>
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spelling oxford-uuid:88c073d1-e56a-421c-8cd0-e1a80b414f5c2023-08-21T12:40:55ZFactors predicting the transition from acute to persistent pain in people with 'sciatica': the FORECAST longitudinal prognostic factor cohort study protocolJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:88c073d1-e56a-421c-8cd0-e1a80b414f5cEnglishSymplectic ElementsBMJ Publishing Group2023Schmid, ABRidgway, LHailey, LTachrount, MProbert, FMartin, KRScott, WCrombez, GPrice, CRobinson, CKoushesh, SAther, STampin, BBarbero, MNanz, DClare, SFairbank, JBaskozos, G<p><strong>Introduction:</strong>&nbsp;Sciatica is a common condition and is associated with higher levels of pain, disability, poorer quality of life, and increased use of health resources compared with low back pain alone. Although many patients recover, a third develop persistent sciatica symptoms. It remains unclear, why some patients develop persistent sciatica as none of the traditionally considered clinical parameters (eg, symptom severity, routine MRI) are consistent prognostic factors.</p> <p>The FORECAST study (factors predicting the transition from acute to persistent pain in people with &lsquo;sciatica&rsquo;) will take a different approach by exploring mechanism-based subgroups in patients with sciatica and investigate whether a mechanism-based approach can identify factors that predict pain persistence in patients with sciatica.</p> <p><strong>Methods and analysis:</strong>&nbsp;We will perform a prospective longitudinal cohort study including 180 people with acute/subacute sciatica. N=168 healthy participants will provide normative data. A detailed set of variables will be assessed within 3 months after sciatica onset. This will include self-reported sensory and psychosocial profiles, quantitative sensory testing, blood inflammatory markers and advanced neuroimaging. We will determine outcome with the Sciatica Bothersomeness Index and a Numerical Pain Rating Scale for leg pain severity at 3 and 12 months.</p> <p>We will use principal component analysis followed by clustering methods to identify subgroups. Univariate associations and machine learning methods optimised for high dimensional small data sets will be used to identify the most powerful predictors and model selection/accuracy.</p> <p>The results will provide crucial information about the pathophysiological drivers of sciatica symptoms and may identify prognostic factors of pain persistence.</p> <p><strong>Ethics and dissemination:</strong>&nbsp;The FORECAST study has received ethical approval (South Central Oxford C, 18/SC/0263). The dissemination strategy will be guided by our patient and public engagement activities and will include peer-reviewed publications, conference presentations, social media and podcasts.</p> <p><strong>Trial registration number:</strong>&nbsp;ISRCTN18170726; Pre-results.</p>
spellingShingle Schmid, AB
Ridgway, L
Hailey, L
Tachrount, M
Probert, F
Martin, KR
Scott, W
Crombez, G
Price, C
Robinson, C
Koushesh, S
Ather, S
Tampin, B
Barbero, M
Nanz, D
Clare, S
Fairbank, J
Baskozos, G
Factors predicting the transition from acute to persistent pain in people with 'sciatica': the FORECAST longitudinal prognostic factor cohort study protocol
title Factors predicting the transition from acute to persistent pain in people with 'sciatica': the FORECAST longitudinal prognostic factor cohort study protocol
title_full Factors predicting the transition from acute to persistent pain in people with 'sciatica': the FORECAST longitudinal prognostic factor cohort study protocol
title_fullStr Factors predicting the transition from acute to persistent pain in people with 'sciatica': the FORECAST longitudinal prognostic factor cohort study protocol
title_full_unstemmed Factors predicting the transition from acute to persistent pain in people with 'sciatica': the FORECAST longitudinal prognostic factor cohort study protocol
title_short Factors predicting the transition from acute to persistent pain in people with 'sciatica': the FORECAST longitudinal prognostic factor cohort study protocol
title_sort factors predicting the transition from acute to persistent pain in people with sciatica the forecast longitudinal prognostic factor cohort study protocol
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