ArticlePloS one2018
Clinical diagnostic model for sciatica developed in primary care patients with low back-related leg pain.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers.
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Who cites it
19 citing papers in PubMed, 39 citations in OpenAlex.
- Effectiveness of Epidural Steroid Injection Depending on Discoradicular Contact: A Prospective Randomized Trial.International journal of environmental research and public health · 2023Trial
- Pragmatic neural tissue management improves short-term pain and disability in patients with sciatica: a single-arm clinical trial.The Journal of manual & manipulative therapy · 2019Trial
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- Revolutionizing nerve regeneration: A novel approach using polylactic acid/chitosan conduit with nerve-like cells andRegenerative therapy · 2025Article
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- Prevalence of weakness and factors mediating discrepancy between reported and observed leg weakness in people with sciatica.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2024Article
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- Differentiating Lumbar Spinal Etiology from Peripheral Plexopathies.Biomedicines · 2023Review
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- Extending the straight leg raise test for improved clinical evaluation of sciatica: validity and diagnostic performance with reference to the magnetic resonance imaging.BMC musculoskeletal disorders · 2021Article
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- Axially Loaded Magnetic Resonance Imaging Identification of the Factors Associated with Low Back-Related Leg Pain.Journal of clinical medicine · 2021Article
- Pulmonary infection after cardiopulmonary bypass surgery in children: a risk estimation model in China.Journal of cardiothoracic surgery · 2021Article
- Extending the straight leg raise test for improved clinical evaluation of sciatica: reliability of hip internal rotation or ankle dorsiflexion.BMC musculoskeletal disorders · 2021Article
- Identification of Immune-Related Biomarkers for Sciatica in Peripheral Blood.Frontiers in genetics · 2021Article
- Research on Roles of Mongolian Medical Warm Acupuncture in Inhibiting p38 MAPK Activation and Apoptosis of Nucleus Pulposus Cells.Evidence-based complementary and alternative medicine : eCAM · 2018Article
- Article
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
Abstract
backgroundIdentification of sciatica may assist timely management but can be challenging in clinical practice. Diagnostic models to identify sciatica have mainly been developed in secondary care settings with conflicting reference standard selection. This study explores the challenges of reference standard selection and aims to ascertain which combination of clinical assessment items best identify sciatica in people seeking primary healthcare.
methodsData on 394 low back-related leg pain consulters were analysed. Potential sciatica indicators were seven clinical assessment items. Two reference standards were used: (i) high confidence sciatica clinical diagnosis; (ii) high confidence sciatica clinical diagnosis with confirmatory magnetic resonance imaging findings. Multivariable logistic regression models were produced for both reference standards. A tool predicting sciatica diagnosis in low back-related leg pain was derived. Latent class modelling explored the validity of the reference standard.
resultsModel (i) retained five items; model (ii) retained six items. Four items remained in both models: below knee pain, leg pain worse than back pain, positive neural tension tests and neurological deficit. Model (i) was well calibrated (p = 0.18), discrimination was area under the receiver operating characteristic curve (AUC) 0.95 (95% CI 0.93, 0.98). Model (ii) showed good discrimination (AUC 0.82; 0.78, 0.86) but poor calibration (p = 0.004). Bootstrapping revealed minimal overfitting in both models. Agreement between the two latent classes and clinical diagnosis groups defined by model (i) was substantial, and fair for model (ii).
conclusionFour clinical assessment items were common in both reference standard definitions of sciatica. A simple scoring tool for identifying sciatica was developed. These criteria could be used clinically and in research to improve accuracy of identification of this subgroup of back pain patients.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.