At Completion of a Multidisciplinary Treatment Program, Are Psychophysical Variables Associated with a VAS Improvement of 30% or More, a Minimal Clinically Important Difference, or an Absolute VAS Score Improvement of 1.5 cm or More?

David A Fishbain, Jinrun Gao, John E Lewis, Lei Zhang

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

OBJECTIVES: Objectives were to determine at completion of a multidisciplinary pain program: 1) what percentage of chronic low back pain (CLBP) patients had improved at 30% or more (minimal clinically important difference [MCID]) and by 1.5 cm or more (minimal important change [MIC]) on the visual analog scale (VAS) and 2) whether that improvement is associated with pain matching (PM), pain threshold (PTRE), and pain tolerance (PTOL) improvements.

METHODS: One hundred and six CLBP patients had admission and discharge scores for VAS, PM, PTRE, and PTOL. Improvement was determined by absolute, MCID, and MIC VAS improvement. Logistic regression analysis controlling for age, gender, race, education, psychoactive substance dependence, and depression was utilized to develop models for the dependent variables of improvement of overall VAS; of MCID of 50% or more; and of MIC with PM, PTOL, and PTRE as independent variables.

RESULTS: Thirty-two percent and 35% of the CLBP patients were at MCID and MIC, respectively, at discharge (68% and 65% not at MCID and MIC, respectively), and 54.7% were improved overall. Of the improved patients, 59% were at MCID and 63.7% at MIC. PM was associated with overall VAS improvement, while PTRE and PM were associated with MCID improvement. MIC and 50% or above models could not be estimated.

LIMITATIONS: The VAS was treated as a ratio scale.

CONCLUSIONS: A significant percentage of CLBP patients were at MCID and at MIC at completion of multidisciplinary treatment. PM was associated with overall VAS improvement, while PTRE and PM were associated with MCID.

Original languageEnglish (US)
Pages (from-to)781-789
Number of pages9
JournalPain medicine (Malden, Mass.)
Volume17
Issue number4
DOIs
StatePublished - Apr 1 2016

Fingerprint

Visual Analog Scale
Pain
Pain Threshold
Low Back Pain
Therapeutics
Minimal Clinically Important Difference
Patient Discharge
Patient Admission
Pain Measurement
Substance-Related Disorders
Logistic Models
Regression Analysis
Depression
Education

Keywords

  • Chronic Low Back Pain
  • Minimal Clinically Important Difference
  • Pain Matching
  • Pain Threshold
  • Pain Tolerance
  • Psychophysical Testing

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

@article{b8e43f2233274a7c950b37e2cb40be33,
title = "At Completion of a Multidisciplinary Treatment Program, Are Psychophysical Variables Associated with a VAS Improvement of 30{\%} or More, a Minimal Clinically Important Difference, or an Absolute VAS Score Improvement of 1.5 cm or More?",
abstract = "OBJECTIVES: Objectives were to determine at completion of a multidisciplinary pain program: 1) what percentage of chronic low back pain (CLBP) patients had improved at 30{\%} or more (minimal clinically important difference [MCID]) and by 1.5 cm or more (minimal important change [MIC]) on the visual analog scale (VAS) and 2) whether that improvement is associated with pain matching (PM), pain threshold (PTRE), and pain tolerance (PTOL) improvements.METHODS: One hundred and six CLBP patients had admission and discharge scores for VAS, PM, PTRE, and PTOL. Improvement was determined by absolute, MCID, and MIC VAS improvement. Logistic regression analysis controlling for age, gender, race, education, psychoactive substance dependence, and depression was utilized to develop models for the dependent variables of improvement of overall VAS; of MCID of 50{\%} or more; and of MIC with PM, PTOL, and PTRE as independent variables.RESULTS: Thirty-two percent and 35{\%} of the CLBP patients were at MCID and MIC, respectively, at discharge (68{\%} and 65{\%} not at MCID and MIC, respectively), and 54.7{\%} were improved overall. Of the improved patients, 59{\%} were at MCID and 63.7{\%} at MIC. PM was associated with overall VAS improvement, while PTRE and PM were associated with MCID improvement. MIC and 50{\%} or above models could not be estimated.LIMITATIONS: The VAS was treated as a ratio scale.CONCLUSIONS: A significant percentage of CLBP patients were at MCID and at MIC at completion of multidisciplinary treatment. PM was associated with overall VAS improvement, while PTRE and PM were associated with MCID.",
keywords = "Chronic Low Back Pain, Minimal Clinically Important Difference, Pain Matching, Pain Threshold, Pain Tolerance, Psychophysical Testing",
author = "Fishbain, {David A} and Jinrun Gao and Lewis, {John E} and Lei Zhang",
year = "2016",
month = "4",
day = "1",
doi = "10.1093/pm/pnv006",
language = "English (US)",
volume = "17",
pages = "781--789",
journal = "Pain Medicine",
issn = "1526-2375",
publisher = "Wiley-Blackwell",
number = "4",

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TY - JOUR

T1 - At Completion of a Multidisciplinary Treatment Program, Are Psychophysical Variables Associated with a VAS Improvement of 30% or More, a Minimal Clinically Important Difference, or an Absolute VAS Score Improvement of 1.5 cm or More?

AU - Fishbain, David A

AU - Gao, Jinrun

AU - Lewis, John E

AU - Zhang, Lei

PY - 2016/4/1

Y1 - 2016/4/1

N2 - OBJECTIVES: Objectives were to determine at completion of a multidisciplinary pain program: 1) what percentage of chronic low back pain (CLBP) patients had improved at 30% or more (minimal clinically important difference [MCID]) and by 1.5 cm or more (minimal important change [MIC]) on the visual analog scale (VAS) and 2) whether that improvement is associated with pain matching (PM), pain threshold (PTRE), and pain tolerance (PTOL) improvements.METHODS: One hundred and six CLBP patients had admission and discharge scores for VAS, PM, PTRE, and PTOL. Improvement was determined by absolute, MCID, and MIC VAS improvement. Logistic regression analysis controlling for age, gender, race, education, psychoactive substance dependence, and depression was utilized to develop models for the dependent variables of improvement of overall VAS; of MCID of 50% or more; and of MIC with PM, PTOL, and PTRE as independent variables.RESULTS: Thirty-two percent and 35% of the CLBP patients were at MCID and MIC, respectively, at discharge (68% and 65% not at MCID and MIC, respectively), and 54.7% were improved overall. Of the improved patients, 59% were at MCID and 63.7% at MIC. PM was associated with overall VAS improvement, while PTRE and PM were associated with MCID improvement. MIC and 50% or above models could not be estimated.LIMITATIONS: The VAS was treated as a ratio scale.CONCLUSIONS: A significant percentage of CLBP patients were at MCID and at MIC at completion of multidisciplinary treatment. PM was associated with overall VAS improvement, while PTRE and PM were associated with MCID.

AB - OBJECTIVES: Objectives were to determine at completion of a multidisciplinary pain program: 1) what percentage of chronic low back pain (CLBP) patients had improved at 30% or more (minimal clinically important difference [MCID]) and by 1.5 cm or more (minimal important change [MIC]) on the visual analog scale (VAS) and 2) whether that improvement is associated with pain matching (PM), pain threshold (PTRE), and pain tolerance (PTOL) improvements.METHODS: One hundred and six CLBP patients had admission and discharge scores for VAS, PM, PTRE, and PTOL. Improvement was determined by absolute, MCID, and MIC VAS improvement. Logistic regression analysis controlling for age, gender, race, education, psychoactive substance dependence, and depression was utilized to develop models for the dependent variables of improvement of overall VAS; of MCID of 50% or more; and of MIC with PM, PTOL, and PTRE as independent variables.RESULTS: Thirty-two percent and 35% of the CLBP patients were at MCID and MIC, respectively, at discharge (68% and 65% not at MCID and MIC, respectively), and 54.7% were improved overall. Of the improved patients, 59% were at MCID and 63.7% at MIC. PM was associated with overall VAS improvement, while PTRE and PM were associated with MCID improvement. MIC and 50% or above models could not be estimated.LIMITATIONS: The VAS was treated as a ratio scale.CONCLUSIONS: A significant percentage of CLBP patients were at MCID and at MIC at completion of multidisciplinary treatment. PM was associated with overall VAS improvement, while PTRE and PM were associated with MCID.

KW - Chronic Low Back Pain

KW - Minimal Clinically Important Difference

KW - Pain Matching

KW - Pain Threshold

KW - Pain Tolerance

KW - Psychophysical Testing

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U2 - 10.1093/pm/pnv006

DO - 10.1093/pm/pnv006

M3 - Article

C2 - 26814242

AN - SCOPUS:85007114488

VL - 17

SP - 781

EP - 789

JO - Pain Medicine

JF - Pain Medicine

SN - 1526-2375

IS - 4

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