Persistent pain after wrist or hand fracture: Development and validation of a prognostic model
Background: Worldwide, the incidence of wrist fracture is increasing. There are currently no externally validated prognostic models to inform early decision making for these patients. Objectives: To develop and validate a prognostic model from a comprehensive range of candidate prognostic factors th...
| Main Authors: | , , , , , , |
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| Format: | Journal Article |
| Language: | English |
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J O S P T
2019
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| Online Access: | http://hdl.handle.net/20.500.11937/75517 |
| _version_ | 1848763498293624832 |
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| author | Harrington, Flavia Cashin, A. Traeger, A. Hübscher, M. Lorimer Moseley, G. Parkitny, L. Mcauley, J. |
| author_facet | Harrington, Flavia Cashin, A. Traeger, A. Hübscher, M. Lorimer Moseley, G. Parkitny, L. Mcauley, J. |
| author_sort | Harrington, Flavia |
| building | Curtin Institutional Repository |
| collection | Online Access |
| description | Background: Worldwide, the incidence of wrist fracture is increasing. There are currently no externally validated prognostic models to inform early decision making for these patients. Objectives: To develop and validate a prognostic model from a comprehensive range of candidate prognostic factors that can identify patients who are at risk of developing persistent pain following wrist or hand fracture. Methods: We developed and validated a prognostic model using secondary data derived from a prospective cohort study (n = 715), with recruitment sites in 3 metropolitan hospitals in Sydney, Australia. The primary outcome was persistent pain 4 months following the injury. The current study used a backward stepwise regression analysis to develop the model in 2 hospitals (n = 408) and externally validate it in a third hospital (n = 307). To determine the accuracy of the model, we assessed calibration and discrimination in accordance with the PROGnosis RESearch Strategy framework. Results: Complete data were available for 95% of the cohort. Of 14 candidate variables, the final model contained 2 prognostic factors: patient age and pain intensity reported at initial presentation. The area under the receiver operating characteristic curve was 0.63 (95% confidence interval: 0.56, 0.69) in the development sample and 0.61 (95% confidence interval: 0.51, 0.70) in the validation sample. The model systematically overestimated risk (intercept, −1.13; slope, 0.73). Conclusion: We developed and externally validated a prognostic model to predict persistent pain 4 months after a wrist or hand fracture. Future studies are needed to assess whether the accuracy of this model can be improved by updating and validating it in local settings. Level of Evidence: Prognosis, level 1b. |
| first_indexed | 2025-11-14T11:04:25Z |
| format | Journal Article |
| id | curtin-20.500.11937-75517 |
| institution | Curtin University Malaysia |
| institution_category | Local University |
| language | English |
| last_indexed | 2025-11-14T11:04:25Z |
| publishDate | 2019 |
| publisher | J O S P T |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | curtin-20.500.11937-755172019-05-24T00:04:23Z Persistent pain after wrist or hand fracture: Development and validation of a prognostic model Harrington, Flavia Cashin, A. Traeger, A. Hübscher, M. Lorimer Moseley, G. Parkitny, L. Mcauley, J. Science & Technology Life Sciences & Biomedicine Orthopedics Rehabilitation Sport Sciences hand fracture persistent pain prognostic model rehabilitation wrist fracture BACK-PAIN DISTAL DISABILITY RECOVERY PATIENT PREDICTORS OUTCOMES SURGERY Background: Worldwide, the incidence of wrist fracture is increasing. There are currently no externally validated prognostic models to inform early decision making for these patients. Objectives: To develop and validate a prognostic model from a comprehensive range of candidate prognostic factors that can identify patients who are at risk of developing persistent pain following wrist or hand fracture. Methods: We developed and validated a prognostic model using secondary data derived from a prospective cohort study (n = 715), with recruitment sites in 3 metropolitan hospitals in Sydney, Australia. The primary outcome was persistent pain 4 months following the injury. The current study used a backward stepwise regression analysis to develop the model in 2 hospitals (n = 408) and externally validate it in a third hospital (n = 307). To determine the accuracy of the model, we assessed calibration and discrimination in accordance with the PROGnosis RESearch Strategy framework. Results: Complete data were available for 95% of the cohort. Of 14 candidate variables, the final model contained 2 prognostic factors: patient age and pain intensity reported at initial presentation. The area under the receiver operating characteristic curve was 0.63 (95% confidence interval: 0.56, 0.69) in the development sample and 0.61 (95% confidence interval: 0.51, 0.70) in the validation sample. The model systematically overestimated risk (intercept, −1.13; slope, 0.73). Conclusion: We developed and externally validated a prognostic model to predict persistent pain 4 months after a wrist or hand fracture. Future studies are needed to assess whether the accuracy of this model can be improved by updating and validating it in local settings. Level of Evidence: Prognosis, level 1b. 2019 Journal Article http://hdl.handle.net/20.500.11937/75517 10.2519/jospt.2019.8342 English J O S P T restricted |
| spellingShingle | Science & Technology Life Sciences & Biomedicine Orthopedics Rehabilitation Sport Sciences hand fracture persistent pain prognostic model rehabilitation wrist fracture BACK-PAIN DISTAL DISABILITY RECOVERY PATIENT PREDICTORS OUTCOMES SURGERY Harrington, Flavia Cashin, A. Traeger, A. Hübscher, M. Lorimer Moseley, G. Parkitny, L. Mcauley, J. Persistent pain after wrist or hand fracture: Development and validation of a prognostic model |
| title | Persistent pain after wrist or hand fracture: Development and validation of a prognostic model |
| title_full | Persistent pain after wrist or hand fracture: Development and validation of a prognostic model |
| title_fullStr | Persistent pain after wrist or hand fracture: Development and validation of a prognostic model |
| title_full_unstemmed | Persistent pain after wrist or hand fracture: Development and validation of a prognostic model |
| title_short | Persistent pain after wrist or hand fracture: Development and validation of a prognostic model |
| title_sort | persistent pain after wrist or hand fracture: development and validation of a prognostic model |
| topic | Science & Technology Life Sciences & Biomedicine Orthopedics Rehabilitation Sport Sciences hand fracture persistent pain prognostic model rehabilitation wrist fracture BACK-PAIN DISTAL DISABILITY RECOVERY PATIENT PREDICTORS OUTCOMES SURGERY |
| url | http://hdl.handle.net/20.500.11937/75517 |