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ABSTRACT: Objectives
To identify baseline patient characteristics that are (1) associated with a poor outcome on follow-up regardless of which treatment was provided (prognosis) or (2) associated with a successful outcome to a specific treatment (treatment effect modifiers).Design
Systematic literature review according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines.Data sources
Medline, Embase, Cinahl, Web of Science, Cochrane, SportDiscus, OT Seeker and PsychInfo were searched for prospective cohort studies up to February 2019 without limitation in publication date.Eligibility criteria
Prospective cohort studies reporting either prognostic factors or treatment effect modifiers on persistent musculoskeletal pain in 0-year-old to 19-year-old children and adolescents. Pain caused by tumours, fractures, infections, systemic and neurological conditions were excluded.Outcome measures
Our primary outcome was musculoskeletal pain at follow-up and identification of any baseline characteristics that were associated with this outcome (prognostic factors). No secondary outcomes were declared.Method
Two reviewers independently screened abstracts and titles. We included prospective cohort studies investigating the prognosis or treatment effect modifiers of 0-year-old to 19-year-old children and adolescents with self-reported musculoskeletal pain. Risk of bias assessment was conducted with the Quality in Prognostic Studies tool.Results
Twenty-six studies yielding a total of 111 unique prognostic factors were included. Female sex and psychological symptoms were the most frequent investigated prognostic factors. Increasing age, generalised pain, longer pain duration and smoking were other identified prognostic factors. No treatment effect modifiers were identified.Conclusion
Several prognostic factors are associated with a poor prognosis in children and adolescents with musculoskeletal pain. These prognostic factors may help guide clinical practice and shared decision-making. None of the included studies was conducted within a general practice setting which highlights an area in need of research.Prospero registration number
CRD42016041378.
SUBMITTER: Pourbordbari N
PROVIDER: S-EPMC6661566 | biostudies-literature | 2019 Jul
REPOSITORIES: biostudies-literature
Pourbordbari Negar N Riis Allan A Jensen Martin Bach MB Olesen Jens Lykkegaard JL Rathleff Michael Skovdal MS
BMJ open 20190718 7
<h4>Objectives</h4>To identify baseline patient characteristics that are (1) associated with a poor outcome on follow-up regardless of which treatment was provided (prognosis) or (2) associated with a successful outcome to a specific treatment (treatment effect modifiers).<h4>Design</h4>Systematic literature review according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines.<h4>Data sources</h4>Medline, Embase, Cinahl, Web of Science, Cochrane, SportDiscus, OT Seek ...[more]