EXPERT PERFORMANCE IN LOW-BACK DISORDER RECOGNITION USING PATIENT PAIN DRAWINGS

被引:34
作者
MANN, NH
BROWN, MD
ENGER, I
机构
[1] Department of Orthopaedics and Rehabilitation, University of Miami, School of Medicine, Miami, FL
来源
JOURNAL OF SPINAL DISORDERS | 1992年 / 5卷 / 03期
关键词
PATIENT PAIN DRAWING; BENIGN DISORDER; HERNIATED DISK; SPINAL STENOSIS; UNDERLYING DISORDER; PSYCHOGENIC DISTURBANCE;
D O I
10.1097/00002517-199209000-00002
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Eight low-back-pain experts who regularly include pain drawings in their clinical workup were asked to classify 25 drawings. The experts used only the drawings to place cases into one of five broadly defined diagnostic categories: benign disorder. herniated disc. spinal stenosis. underlying disorder. or psychogenic disturbance. The physicians demonstrated adequate accuracy-51% correct-when compared with change (20% correct). Classification accuracy was greatest for psychogenic disorders (85%), followed by spinal stenosis (58%). herniated discs (52%), and benign disorders (50%). Predictions were comparatively poor for the underlying disorder category (10%). The individual physician accuracies varied from 44 to 60%. "Classic" pain patterns for each disorder group were identified by determining which drawings were correctly classified by most physicians. Physicians may wish to impart greater significance to pain drawings close to one of our "classic" patterns than to others.
引用
收藏
页码:254 / 259
页数:6
相关论文
共 12 条
[1]  
Cummings G., Routan J., Accuracy of the unassisted pain drawings by patients with chronic pain, J Orthop Sports Phvs Ther, 8, pp. 391-396, (1987)
[2]  
Hieldebrant J., Franz C.E., Choroba-Mehnen B., Temme M., The use of pain drawings in screening for psychological involvement in complaints of low back pain, Spine, 13, pp. 681-685, (1988)
[3]  
Mann N.H., Brown M.D., Artificial intelligence in the diagnosis of low back pain, Orthop Clin North Am, 22, pp. 303-317, (1991)
[4]  
Margolis R., Chibnall J., Tait R., Test-retest of the pain drawing instrument, Pain, 33, pp. 49-51, (1986)
[5]  
Margolis R., Krause S., Tait R., Lateralization of chronic pain, Pain, 23, pp. 289-293, (1985)
[6]  
Margolis R., Tait R., Krause S., A rating system for use with patient pain drawings, Pain, 24, pp. 57-65, (1986)
[7]  
Ransford A., Cairns D., Mooney V., The pain drawings as an aid to the psychologic evaluation of patients with low back pain, Spine, 1, pp. 127-134, (1976)
[8]  
Schwartz D., Degood D., Global appropriateness of pain drawings: Blind ratings predict patterns of psychological distress and litigation status, Pain, 19, pp. 383-388, (1984)
[9]  
Spitzer W.O., Leblanc S.E., Depuis M., A report of the task force on spinal disorders. Scientific approach to treatment of activity related spinal disorders, Spine, 12, pp. S22-S30, (1987)
[10]  
Taylor W.P., Stern W.R., Kubiszyn T.W., Predicting patients’ perception of response to treatment of low back pain, Spine, 9, pp. 313-316, (1984)