ArticleThe spine journal : official journal of the North American Spine Society2019
Exploring the prevalence and construct validity of high-impact chronic pain across chronic low-back pain study samples.
Article in The spine journal : official journal of the North American Spine Society, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers.
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Who cites it
14 citing papers in PubMed.
- Physiotherapy with integrated virtual reality for patients with severe chronic low back pain: cluster-randomized controlled trial (VARIETY).BMC musculoskeletal disorders · 2026Trial
- Impact of chronic pain on the families of U.S. adults.Pain reports · 2026Article
- Ecological Momentary Assessments of daily pain experiences in bothersome and high-impact chronic pain.medRxiv : the preprint server for health sciences · 2026Article
- Home Physical Exercise Interventions in Chronic Non-Specific Low Back Pain: Systematic Review and Multivariate Meta-Analysis.Healthcare (Basel, Switzerland) · 2025Review
- Body Composition and Incident High-Intensity Back Pain and/or High Disability: A 10-Year Prospective Population-Based Male Cohort.Journal of cachexia, sarcopenia and muscle · 2025Article
- Are some ways of defining chronic low back pain more indicative of future back pain than others?Pain medicine (Malden, Mass.) · 2024Article
- Classifying patients with non-specific chronic low back pain using the impact stratification score in an online convenience sample.BMC musculoskeletal disorders · 2023Article
- High-impact chronic pain: evaluation of risk factors and predictors.The Korean journal of pain · 2023Article
- Unpacking the impact of chronic pain as measured by the impact stratification score.BMC musculoskeletal disorders · 2022Article
- A Scoping Review of Chronic Low Back Pain Classification Schemes Based on Patient-Reported Outcomes.Pain physician · 2022Article
- Epigenetic age predictors in community-dwelling adults with high impact knee pain.Molecular pain · 2022Article
- A protocol for chronic pain outcome measurement enhancement by linking PROMIS-29 scale to legacy measures and improving chronic pain stratification.BMC musculoskeletal disorders · 2020Observational
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Corrections and comments
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Authors and funding
5 authors.
Funding
Abstract
background contextThe US National Pain Strategy focused attention on high-impact chronic pain and its restrictions. Although many interventions have been studied for chronic low-back pain, results are typically reported for heterogeneous samples. To better understand chronic pain and target interventions to those who most need care, more granular classifications recognizing chronic pain's impact are needed. PURPOSE: To test whether chronic pain impact levels can be identified in chronic low-back pain clinical trial samples, examine the baseline patient mix across studies, and evaluate the construct validity of high-impact chronic pain. STUDY DESIGN/
settingDescriptive analyses using 12 large study datasets. PATIENT SAMPLES: Chronic low-back pain patients in nonsurgical, nonpharmacologic trials in the US, Canada, and UK. OUTCOME MEASURES: Preference-based health utilities from the SF-6D and EQ-5D, employment status and absenteeism.
methodsWe used two logistic regression models to predict whether patients had high-impact chronic pain and whether the remainder had low- or moderate-impact chronic pain. We developed these models using two datasets. Models with the best predictive power were used to impute impact levels for six other datasets. Stratified by these estimated chronic pain impact levels, we characterized the case mix of patients at baseline in each dataset, and summarized their health-utilities and work productivity. This study was funded by a National Center for Complementary and Integrative Medicine grant. The authors have no potential conflicts of interest.
resultsThe logistic models had excellent predictive power to identify those with high-impact chronic pain. Although studies were all of chronic low-back pain patients, the baseline mix of patients varied widely. Across all datasets, utilities, and productivity were similar for those with high-impact chronic pain and worsened as chronic pain impact increased.
conclusionsThere is a need to better categorize chronic pain patients to allow the targeting of optimal interventions for those with each level of chronic pain impact.
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