Preferences for risks and benefits of treatment outcomes for chronic low back pain: Choice-based conjoint measure development and discrete choice experiment.
Leslie Wilson, Alina Denham, Yelena Ionova and 11 others
PMID 38040670WHAT IT FOUND
Patients with chronic low back pain valued walking at least 1 mile, walking outside for short distances, and accomplishing basic household routines most strongly.
Avoiding much difficulty with thinking was also a strong preference.
Key findings
01The strongest positive preferences were for the three highest physical activity levels: walking at least 1 mile, walking outside the house for short distances, and walking inside and accomplishing basic household routines.
02Avoiding much difficulty with thinking was a stronger negative preference than avoiding severe pain, almost always feeling anxious or depressed, or always feeling fatigued.
03Latent class analysis identified two preference groups: 56% were more risk accepting and willing to accept lower outcome levels, and 44% were more risk averse and preferred maximum outcomes.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The sample was mostly female (66.5%) and white (85.4%), and many participants came from online registries, so it may not represent all clinic patients. Choices were hypothetical outcome profiles, not actual treatments or observed patient outcomes. The seven attributes did not cover every possible chronic low back pain outcome. Preferences varied by pain, disability, income, and latent class, so one preference pattern may not fit all patients. The study did not test whether using these preferences improves shared decision-making or treatment results.
Declared interests
No author conflicts of interest are stated in the supplied text. The publication types list NIH extramural research support.
The easy way to misread this
Do not conclude that a treatment improving walking will be effective or that patients should prioritise walking over pain. This study measured stated preferences for hypothetical outcome profiles, not actual treatment outcomes.