TY - JOUR
T1 - A Definition of “Flare” in Low Back Pain
T2 - A Multiphase Process Involving Perspectives of Individuals With Low Back Pain and Expert Consensus
AU - Costa, Nathalia
AU - Ferreira, Manuela L.
AU - Setchell, Jenny
AU - Makovey, Joanna
AU - Dekroo, Tanya
AU - Downie, Aron
AU - Diwan, Ashish
AU - Koes, Bart
AU - Natvig, Bard
AU - Vicenzino, Bill
AU - Hunter, David
AU - Roseen, Eric J.
AU - Rasmussen-Barr, Eva
AU - Guillemin, Francis
AU - Hartvigsen, Jan
AU - Bennell, Kim
AU - Costa, Leonardo
AU - Macedo, Luciana
AU - Pinheiro, Marina
AU - Underwood, Martin
AU - Van Tulder, Mauritus
AU - Johansson, Melker
AU - Enthoven, Paul
AU - Kent, Peter
AU - O'Sullivan, Peter
AU - Suri, Pradeep
AU - Genevay, Stephane
AU - Hodges, Paul W.
PY - 2019/11/1
Y1 - 2019/11/1
N2 - Low back pain (LBP) varies over time. Consumers, clinicians, and researchers use various terms to describe LBP fluctuations, such as episodes, recurrences and flares. Although “flare” is use commonly, there is no consensus on how it is defined. This study aimed to obtain consensus for a LBP flare definition using a mixed-method approach. Step 1 involved the derivation of a preliminary candidate flare definition based on thematic analysis of views of 130 consumers in consultation with an expert consumer writer. In step 2, a workshop was conducted to incorporate perspectives of 19 LBP experts into the preliminary flare definition, which resulted in 2 alternative LBP flare definitions. Step 3 refined the definition using a 2-round Delphi consensus with 50 experts in musculoskeletal conditions. The definition favored by experts was further tested with 16 individuals with LBP in step 4, using the definition in three scenarios. This multiphase study produced a definition of LBP flare that distinguishes it from other LBP fluctuations, represents consumers’ views, involves expert consensus, and is understandable by consumers in clinical and research contexts: “A flare-up is a worsening of your condition that lasts from hours to weeks that is difficult to tolerate and generally impacts your usual activities and/or emotions.” Perspective: A multiphase process, incorporating consumers’ views and expert consensus, produced a definition of LBP flare that distinguishes it from other LBP fluctuations.
AB - Low back pain (LBP) varies over time. Consumers, clinicians, and researchers use various terms to describe LBP fluctuations, such as episodes, recurrences and flares. Although “flare” is use commonly, there is no consensus on how it is defined. This study aimed to obtain consensus for a LBP flare definition using a mixed-method approach. Step 1 involved the derivation of a preliminary candidate flare definition based on thematic analysis of views of 130 consumers in consultation with an expert consumer writer. In step 2, a workshop was conducted to incorporate perspectives of 19 LBP experts into the preliminary flare definition, which resulted in 2 alternative LBP flare definitions. Step 3 refined the definition using a 2-round Delphi consensus with 50 experts in musculoskeletal conditions. The definition favored by experts was further tested with 16 individuals with LBP in step 4, using the definition in three scenarios. This multiphase study produced a definition of LBP flare that distinguishes it from other LBP fluctuations, represents consumers’ views, involves expert consensus, and is understandable by consumers in clinical and research contexts: “A flare-up is a worsening of your condition that lasts from hours to weeks that is difficult to tolerate and generally impacts your usual activities and/or emotions.” Perspective: A multiphase process, incorporating consumers’ views and expert consensus, produced a definition of LBP flare that distinguishes it from other LBP fluctuations.
KW - consensus
KW - definition
KW - flare
KW - flare-up
KW - Low back pain
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U2 - 10.1016/j.jpain.2019.03.009
DO - 10.1016/j.jpain.2019.03.009
M3 - Article
C2 - 30904517
AN - SCOPUS:85064599877
SN - 1526-5900
VL - 20
SP - 1267
EP - 1275
JO - Journal of Pain
JF - Journal of Pain
IS - 11
ER -