Patient classification, a key to evaluate pain treatment: a psychological study in chronic low back pain patients
Talo, S.; Rytökoski, U.; Puukka, P.
Spine 17(9): 998-1011
1992
ISSN/ISBN: 0362-2436 PMID: 1384150 Document Number: 401302
It has been proposed that pain treatment evaluation is hindered by heterogeneous properties of patient samples. Therefore, to facilitate pain treatment evaluation in this psychological study, a heterogeneous group of chronic low back pain pateints was classified into more homogeneous subgroups. Two designs were used to compare the outcome by the "functioning activation" and the "spa resort" type of rehabilitation. In the first design, the outcome was compared in groups, clinically homogenized by sociodemographic variables and in respect to contraindications for heavy physical training. In the second design, the pain patient subgroups, homogenized by cluster analysis technique in accordance with the psychological profiles of functioning, were compared in their response to treatments. The results indicated that the outcome evaluation was facilitated by the latter design releasing more specific information about the effects of the program quality, the patient characteristics, and their interaction on the improvement by rehabilitation. It was concluded that in treatment outcome analysis, the subgroup's homogeneity must be considered.