Consensus on the Clinical Diagnosis of Lumbar Spinal Stenosis: Results of an International Delphi Study
MetadataShow full item record
Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved. STUDY DESIGN.: Delphi. OBJECTIVE.: Obtain an expert consensus on which history factors are most important in the clinical diagnosis of LSS. SUMMARY OF BACKGROUND DATA.: Lumbar spinal stenosis (LSS) is a poorly defined clinical syndrome. Criteria for defining LSS are needed and should be informed by the experience of expert clinicians. METHODS.: Phase 1 (Delphi Items): 20 members of the International Taskforce on the Diagnosis and Management of LSS confirmed a list of 14 history items. An on-line survey was developed that permits specialists to express the logical order in which they consider the items, and the level of certainty ascertained from the questions. Phase 2 (Delphi Study) Round 1: Survey distributed to members of the International Society for the Study of the Lumbar Spine. Round 2: Meeting of 9 members of Taskforce where consensus was reached on a final list of 10 items. Round 3: Final survey was distributed internationally. Phase 3: Final Taskforce consensus meeting. RESULTS.: 279 clinicians from 29 different countries, with a mean of 19 (±SD: 12) years in practice participated. The six top items were “leg or buttock pain while walking”, “flex forward to relieve symptoms”, “feel relief when using a shopping cart or bicycle”, “motor or sensory disturbance while walking”, “normal and symmetric foot pulses”, “lower extremity weakness” and “low back pain”. Significant change in certainty ceased after 6 questions at 80% (p?<?.05). CONCLUSIONS.: This is the first study to reach an international consensus on the clinical diagnosis of LSS, and suggests that within six questions clinicians are 80% certain of diagnosis. We propose a consensus-based set of “7 history items” that can act as a pragmatic criterion for defining LSS in both clinical and research settings, which in the long-term may lead to more cost-effective treatment, improved health-care utilization and enhanced patient outcomes.Level of Evidence: 2
Showing items related by title, author, creator and subject.
Slade, D.; Dionne, C.; Underwood, M.; Buchbinder, R.; Beck, B.; Bennell, K.; Brosseau, L.; Costa, L.; Cramp, F.; Cup, E.; Feehan, L.; Ferreir, M.; Forbes, S.; Glasziou, P.; Habets, B.; Harris, S.; Hay-Smith, J.; Hillier, S.; Hinman, R.; Holland, A.; Hondras, M.; Kelly, G.; Kent, Peter; Lauret, G.; Long, A.; Maher, C.; Morso, L.; Osteras, N.; Peterson, T.; Quinlivan, R.; Rees, K.; Regnaux, J.; Reitberg, M.; Saunders, D.; Skoetz, N.; Sogard, K.; Takken, T.; van Tulder, M.; Voet, N.; Ward, L.; White, C. (2016)Background: Exercise interventions are often incompletely described in reports of clinical trials, hampering evaluation of results and replication and implementation into practice. Objective: The aim of this study was to ...
Expert consensus for respiratory physiotherapy management of mechanically ventilated adults with community-acquired pneumonia: A Delphi studyvan der Lee, L.; Hill, Anne-Marie; Patman, S. (2018)Rationale and aims: Patients with community-acquired pneumonia (CAP) are frequently admitted to an intensive care unit. Physiotherapy may be provided to optimize respiratory function; however, there is significant variability ...
Discordant identification of pediatric severe sepsis by research and clinical definitions in the SPROUT international point prevalence studyWeiss, S.; Fitzgerald, J.; Maffei, F.; Kane, J.; Rodriguez-Nunez, A.; Hsing, D.; Franzon, D.; Kee, S.; Bush, J.; Roy, J.; Thomas, N.; Nadkarni, V.; Fontela, P.; Tucci, M.; Dumistrascu, M.; Skippen, P.; Krahn, G.; Bezares, E.; Puig, G.; Puig-Ramos, A.; Garcia, R.; Villar, M.; Bigham, M.; Polanski, T.; Latifi, S.; Giebner, D.; Anthony, H.; Hume, J.; Galster, A.; Linnerud, L.; Sanders, R.; Hefley, G.; Madden, K.; Thompson, A.; Shein, S.; Gertz, S.; Han, Y.; Williams, Teresa; Hughes-Schalk, A.; Chandler, H.; Orioles, A.; Zielinski, E.; Doucette, A.; Orioles, A.; Zielinski, E.; Doucette, A.; Zebuhr, C.; Wilson, T.; Dimitriades, C.; Ascani, J.; Layburn, S.; Valley, S.; Markowitz, B.; Terry, J.; Morzov, R.; McInnes, A.; McArthur, J.; Woods, K.; Murkowski, K.; Spaeder, M.; Sharron, M.; Wheeler, D.; Beckman, E.; Frank, E.; Howard, K.; Carroll, C.; Nett, S.; Jarvis, D.; Patel, V.; Higgerson, R.; Christie, L.; Typpo, K.; Deschenes, J.; Kirby, A.; Uhl, T.; Rehder, K.; Cheifetz, I.; Wrenn, S.; Kypuros, K.; Ackerman, K.; Maffei, F.; Bloomquist, G.; Rizkalla, N.; Kimura, D.; Shah, S.; Tigges, C.; Su, F.; Barlow, C.; Michelson, K.; Wolfe, K.; Goodman, D.; Campbel, L.; Sorce, L.; Bysani, K.; Monjure, T.; Evans, M.; Totapally, B.; Chegondi, M.; Rodriguez, C.; Frazier, J. (2015)Introduction: Consensus criteria for pediatric severe sepsis have standardized enrollment for research studies. However, the extent to which critically ill children identified by consensus criteria reflect physician ...