Schellingerhout et al reported a prediction rule for a patient with nonspecific neck pain. This can help to identify a patient who is likely to have symptoms persisting at 6 months. The authors are from Erasmus Medical Centre, VU University and Keele University.
Patient selection: nonspecific neck pain, presumable of recent onset
Outcome: persistent neck complaints at 6 months
Parameters:
(1) age in years
(2) accompanying low back pain
(3) traumatic cause neck complaints
(4) health status (from 0 to 100, with 0 worst and 100 best)
(5) accompanying headache
(6) radiation of pain to elbow/shoulder
(7) previous neck complaints
(8) paid employment
(9) pain intensity (from 0 to 10)
|
Parameter
|
Finding
|
Points
|
|
age
|
|
7 * INT((age)/10)
|
|
low back pain
|
no
|
0
|
|
|
yes
|
21
|
|
traumatic cause
|
no
|
0
|
|
|
yes
|
6
|
|
headache
|
no
|
0
|
|
|
yes
|
5
|
|
health status
|
|
(-3*INT((status)/25)
|
where:
• An alternative implementation is not to use INT function for age and health status.
|
Parameter
|
Finding
|
Without Headache
|
With Headache
|
|
radiation to elbow or shoulder
|
no
|
0
|
0
|
|
|
yes
|
-14
|
-4
|
|
previous neck complaint
|
no
|
0
|
0
|
|
|
yes
|
13
|
4
|
|
paid employment
|
no
|
0
|
0
|
|
|
yes
|
9
|
-11
|
|
pain intensity
|
|
(-1) * (intensity)
|
2 * (intensity)
|
total score =
= SUM(points for all of the parameters)
Interpretation:
• The higher the score the greater the probability of persistent pain,
|
Score
|
Probability Persistent Neck Pain at 6 Months
|
|
< 10
|
0-20%
|
|
10 to 34
|
20-40%
|
|
35 to 54
|
40-60%
|
|
55 to 79
|
60-80%
|
|
> 79
|
80-100%
|
Performance:
• The area under the ROC curve is 0.66.
