STARS (Spine TARgeted Subgroups) Towards mechanism-based targeted treatment
Low back pain is the leading cause of disability and the leading condition requiring more effective treatment. A promising solution is to match treatments with subgroups of patients based on mechanisms of low back pain. This project will use information from a multidimensional assessment to identify mechanism-based subgroups of persistent low back pain, for targeting with best treatment.
Project status: In progress
Low back pain persists as the leading cause of disability from adolescence to old age, and the leading condition requiring more effective treatment. A promising solution is to match treatments with subgroups of patients based on mechanisms of low back pain. Existing mechanism-based subgroups are limited in their development (based on theory and unidimensional assessments) and do not consider all treatments in existing low back pain care pathways (for example, physiotherapy, surgery). This project will use data from a multidimensional assessment to identify mechanism-based subgroups of persistent low back pain, for targeting with best treatment.
We will invite 500 patients with persistent low back pain at Victoria Hospital to participate. We will collect multidimensional information including demographics (for example gender identity), questionnaires (for example disability), physical measures (for example muscle strength) and biomarkers (for example, measurable signs of pain experience). Collaborating with healthcare practitioners, we will collect information about treatments received within existing low back pain care pathways. Analysis of information will identify mechanism-based subgroups of patients and determine the relationship between subgroups and treatments.
We will use this information to develop decision tools that match patients with treatments best suited to their needs and likelihood of recovery, to improve patient outcomes and care.
CANSpine Researchers
Katie Kowalski
Alison Rushton
Collaborators
Chris Bailey
Jason Gilliland
Purpose
This project aims to develop data-driven multidimensional mechanism-based subgroups for persistent low back pain and determine the relationship between subgroups and treatments received in existing low back pain care pathways
Findings
This project is ongoing. We will provide our findings as soon as possible.
Impact
Results will enable development of decision tools for stratified care that targets treatment to subgroups based on mechanisms of low back pain. Mechanism-based subgroups will be integrated with research in our lab investigating predictors of low back pain outcome. The combined approach to stratified care based on mechanism and prognosis will inform development of novel precision interventions.
Funding
For this project, Katie Kowalski is supported in part by a Transdisciplinary Award from the Bone and Joint Institute at Western University
