[article] in Journal of Orthopaedic & Sports Physical Therapy > vol. 47, 8 (Aout 2017) . - p.518-529 Titre : | Clinical Prediction Models for Patients With Nontraumatic Knee Pain in Primary Care: A Systematic Review and Internal Validation Study | Type de document : | article de périodique | Auteurs : | Guus Panken, Auteur ; [et al.], Auteur | Année de publication : | 2017 | Article en page(s) : | p.518-529 | Langues : | Anglais (eng) | Descripteurs (mots clés) : | [Thésaurus Mesh]Arthrose [Thésaurus Mesh]Genou [Thésaurus Mesh]Revue de la littérature
| Résumé : | Systematic review and validation study.Background
Many prognostic models of knee pain outcomes have been developed for use in primary care. Variability among published studies with regard to patient population, outcome measures, and relevant prognostic factors hampers the generalizability and implementation of these models.
Objectives
To summarize existing prognostic models in patients with knee pain in a primary care setting and to develop and internally validate new summary prognostic models.
Methods
After a sensitive search strategy, 2 reviewers independently selected prognostic models for patients with nontraumatic knee pain and assessed the methodological quality of the included studies. All predictors of the included studies were evaluated, summarized, and classified. The predictors assessed in multiple studies of sufficient quality are presented in this review. Using data from the Musculoskeletal System Study (BAS) cohort of patients with a new episode of knee pain, recruited consecutively by Dutch general medical practitioners (n = 372), we used predictors with a strong level of evidence to develop new prognostic models for each outcome measure and internally validated these models.
Results
Sixteen studies were eligible for inclusion. We considered 11 studies to be of sufficient quality. None of these studies validated their models. Five predictors with strong evidence were related to function and 6 to recovery, and were used to compose 2 prognostic models for patients with knee pain at 1 year. Running these new models in another data set showed explained variances (R2) of 0.36 (function) and 0.33 (recovery). The area under the curve of the recovery model was 0.79. After internal validation, the adjusted R2 values of the models were 0.30 (function) and 0.20 (recovery), and the area under the curve was 0.73.
Conclusion
We developed 2 valid prognostic models for function and recovery for patients with nontraumatic knee pain, based on predictors with strong evidence. A longer duration of complaints predicted poorer function but did not adequately predict chance of recovery.
Level of Evidence
Prognosis, levels 1a and 1b | Permalink : | https://bibliotheque.helb-prigogine.be/opac_css/index.php?lvl=notice_display&id= |
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