Articles: low-back-pain.
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Pain medicine is an advanced medical subspecialty incorporating trainees from diverse primary disciplines. A curriculum that does not assess or promote the trainees' differential expertise developed from their primary specialties may silo instead of promoting collaborative learning in a multidisciplinary subspecialty. ⋯ We created a novel note-taking and knowledge-sharing platform, anchored by a well-established case-based educational strategy, to improve the learning environment and knowledge retention for multidisciplinary trainees with heterogeneous baseline knowledge.
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Low back pain is one of the main causes of medical consultation worldwide, with heterogeneous management in the request for complementary methods. This study sought to determine the frequency and clinical and imaging characteristics of patients with low back pain in a tertiary hospital, considering the presence or absence of red flags. ⋯ The first consultation for low back pain represented 1.8% of consultations, with acute low back pain being more frequent. Obesity was the most common comorbidity. About half of the patients had red flags according to AHCPR and 21% according to ACR.
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The transition from acute to chronic low back pain (LBP) in community settings is not well understood. The purpose of this study was to assess the feasibility of recruitment and estimate the transition and continuation of chronic LBP. We also explored characteristics associated with this transition to chronic LBP. ⋯ Acute LBP is a common condition in the community and frequently transitions to chronic LBP, suggesting the potential for substantial burden in the community. PERSPECTIVE: This article presents the feasibility of conducting a community-based study to describe the transition, continuation, and psychosocial predictors of acute to chronic low back pain. These findings could help identify community participants at high risk of incident and continued chronic low back pain.
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Chronic low back pain (cLBP) remains a major health crisis worldwide. Current conceptualizations of cLBP utilize the biopsychosocial model, yet research on social factors remains limited. Adverse childhood experiences (ACEs) are a risk factor for a variety of chronic health problems, including cLBP. ⋯ People from disadvantaged backgrounds may experience numerous psychosocial stressors that hinder CPM, making it difficult to assess the specific impact of ACEs on CPM. TRIAL REGISTRATION: This study utilized baseline data collected as part of a parent trial titled "Examining Racial and SocioEconomic Disparities in Chronic Low Back Pain" (ERASED - ClinicalTrials.gov ID: NCT03338192). PERSPECTIVE: This study demonstrates that early life adversity is associated with abnormal endogenous pain modulation, particularly for participants who live in neighborhoods characterized by less deprivation.
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Comparative Study Observational Study
Evaluating the representativeness of a cohort study of low back pain: Using electronic health record data to make direct comparisons of study participants with non-participants from the study population.
Representativeness is an important component of generalizability. Few studies have rigorously examined the representativeness of randomized trials or observational studies of pain or musculoskeletal conditions with regards to a wide range of factors beyond age, sex, race, and ethnicity. We conducted the first study of a pain condition that uses individual-level data to directly compare the enrolled study sample to the population from which it was drawn. ⋯ This approach can be considered as a standard method to examine the representativeness of study samples in pain research. PERSPECTIVE: This article illustrates how electronic health record data can be used to directly compare the representativeness of participants in a study of pain to the study population from which participants were selected. This approach should be considered as a standard method to examine the representativeness of study samples during reporting.