Multidisciplinary biopsychosocial rehabilitation for chronic low back pain: the need to present minimal important differences units in meta-analyses

Health and Quality of Life Outcomes
Silvia GianolaMaria Grazia Valsecchi

Abstract

The results of meta-analyses are all too often elusive, making it difficult to interpret their relevance for clinical practice. Reporting them in minimal important difference (MID) units could improve the interpretation of evidence in meta-analyses. The aim of this study was to compare, via calculation of MID units, outcomes after multidisciplinary biopsychosocial rehabilitation (MBR) versus usual care for pain relief in chronic low back pain (LBP). We re-analyzed the data of a published Cochrane review on MBR. To attribute a MID to each pain instrument, we first searched the literature for MIDs. The MID was imputed for instruments without an established MID. We compared outcomes after MBR versus usual care for chronic LBP in the short (< 3 months), mid (> 3 and < 12 months), and long (≥12 months) term. The results of the meta-analyses are reported in MID units and interpreted as follows: if the overall effect size was greater than 1, many patients gained clinically important benefits, if it lay between 0.5 and 1.0, an appreciable number benefited, and if it fell below 0.5 few did. Improvement in back pain was observed in an appreciable number of patients in the short- and medium-term after MBR: the MID was lower but still clos...Continue Reading

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Citations

Nov 17, 2020·Complementary Therapies in Medicine·Fulvio Dal FarraAndrea Bergna

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