Characterizing the Course of Low Back Pain: A Latent Class Analysis

From the April 15 issue of the American Journal of Epidemiology:

Kate M. Dunn, Kelvin Jordan and Peter R. Croft. Characterizing the Course of Low Back Pain: A Latent Class Analysis. American Journal of Epidemiology 2006 163(8):754-761; http://dx.doi.org/10.1093/aje/kwj100

From the Primary Care Sciences Research Centre, Keele University, Keele, United Kingdom
Correspondence to Dr. Kate M. Dunn, Primary Care Sciences Research Centre, Keele University, Keele, Staffordshire, ST5 5BG, United Kingdom
(e-mail: k.m.dunn@cphc.keele.ac.uk).

Understanding the course of back pain is important for clinicians and researchers, but analyses of longitudinal data from multiple time points are lacking. A prospective cohort study of consecutive back pain consulters from five general practices in the
United Kingdom was carried out between 2001 and 2003 to identify groups defined by their pain pathways. Patients were sent monthly questionnaires for a year. Longitudinal latent class analysis was performed by using pain intensity scores for 342 consulters. Analysis yielded four clusters representing different pathways of back pain. Cluster 1 ("persistent mild"; n = 122) patients had stable, low levels of pain. Patients in cluster 2 ("recovering"; n = 104) started with mild pain, progressing quickly to no pain. Cluster 3 ("severe chronic"; n = 71) patients had permanently high pain. For patients in cluster 4 ("fluctuating"; n = 45), pain varied between mild and high levels. Distinctive patterns for each cluster were maintained throughout follow-up. Clusters showed statistically significant differences in disability, psychological status, and work absence (p < 0.001). This is the first time, to the authors' knowledge, that latent class analysis has been applied to longitudinal data on back pain patients. Identification of four distinct groups of patients improves understanding of the course of back pain and may provide a basis of classification for intervention. classification; cohort studies; longitudinal studies; low back pain; primary health care; prospective studies; statistics
Abbreviations: RMDQ, Roland-Morris Disability Questionnaire

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2 Responses

  1. Hi Anne,

    Thanks for this article. It’s an interesting one.
    By the way, I didn’t have a chance to congratulate you on your new initiative earlier. And I must say, that’s a gorgeous picture you’ve included!

    Regards,

    Steve

  2. Thanks Steve. I am rather photogenic, aren't I? This is the outfit I wear when I am conducting literature searches for systematic reviews.
    -ATV

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