UI - 000086

AU - Deyo RA

AU - Bass JE

AU - Walsh NE

AU - Schoenfeld LS

AU - Ramamurthy S

TI - Prognostic variability among chronic pain patients: implications for study design,

interpretation, and reporting

AB - Chronic pain patients share many characteristics, but there is important prognostic variability among

them. By selecting for certain characteristics, different recruitment methods and entry criteria for clinical or

research programs may influence the likelihood of success regardless of treatment efficacy. This was

demonstrated when subjects (n = 55) were recruited through lay publicity for a clinical trial of therapy for

chronic back pain. In comparison to routine pain clinic patients (n=61), subjects in the clinical trial were

better educated, were more often employed, had more favorable personality profiles, and were less likely to

have had surgery or narcotic use (all p less than 0.004). Pain relief was significantly better for clinical trial

subjects, apparently due to baseline prognostic differences rather than uniquely efficacious therapy. We

conclude that chronic pain patients vary in prognostically important ways; that recruitment methods and

criteria strongly influence these characteristics; and that greater attention to these details is needed when

interpreting and reporting clinical research

SO - Archives of Physical Medicine & Rehabilitation 1988;69:174-178