Pasientskader hos fastleger meldt til Norsk pasientskadeerstatning 2011–17

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A randomised comparison of a four- and a five-point scale version of the Norwegian Function Assessment Scale

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Musculoskeletal pain patterns and association between dizziness symptoms and pain in patients with long term dizziness – a cross-sectional study

Background The impact of long-term dizziness is considerable both on the personal level and in society and may lead to self-imposed restrictions in daily activities and social relations due to fear of triggering the symptoms. Musculoskeletal complaints seem to be common in persons with dizziness, but studies addressing these complaints as a widespread occurrence, are scarce. This study aimed to examine the occurrence of widespread pain in patients with long-term dizziness and investigate the associations between pain and dizziness symptoms. Further, to explore whether diagnostic belonging is related to the occurrence of pain. Methods This cross-sectional study was conducted in an otorhinolaryngology clinic and included 150 patients with persistent dizziness. The patients were categorized into three groups: episodic vestibular syndromes, chronic vestibular syndromes, and non-vestibular group. The patients completed questionnaires on dizziness symptoms, catastrophic thinking, and musculoskeletal pain when entering the study. Descriptive statistics were used to describe the population, and associations between pain and dizziness were investigated by linear regression. Results Pain was reported by 94.5% of the patients. A significantly higher prevalence of pain was reported in all the ten pain sites examined compared to the general population. Number of pain sites and pain intensity were associated with the dizziness severity. Number of pain sites was also associated with dizziness-related handicap, but not with catastrophic thinking. There was no association between pain intensity and dizziness-related handicap or catastrophic thinking. Pain was equally distributed in the diagnostic groups. Conclusion Patients with long-term dizziness have a considerably higher prevalence of pain and number of pain sites than the general population. Pain co-exists with dizziness and is associated with dizziness severity. These findings may indicate that pain should be systematically assessed and treated in patients with persisting dizziness.publishedVersio

Data splitting as a countermeasure against hypothesis fishing: with a case study of predictors for low back pain

There is growing concern in the scientific community that many published scientific findings may represent spurious patterns that are not reproducible in independent data sets. A reason for this is that significance levels or confidence intervals are often applied to secondary variables or sub-samples within the trial, in addition to the primary hypotheses (multiple hypotheses). This problem is likely to be extensive for population-based surveys, in which epidemiological hypotheses are derived after seeing the data set (hypothesis fishing). We recommend a data-splitting procedure to counteract this methodological problem, in which one part of the data set is used for identifying hypotheses, and the other is used for hypothesis testing. The procedure is similar to two-stage analysis of microarray data. We illustrate the process using a real data set related to predictors of low back pain at 14-year follow-up in a population initially free of low back pain. “Widespreadness” of pain (pain reported in several other places than the low back) was a statistically significant predictor, while smoking was not, despite its strong association with low back pain in the first half of the data set. We argue that the application of data splitting, in which an independent party handles the data set, will achieve for epidemiological surveys what pre-registration has done for clinical studies

Estimates of success in patients with sciatica due to lumbar disc herniation depend upon outcome measure

The objectives were to estimate the cut-off points for success on different sciatica outcome measures and to determine the success rate after an episode of sciatica by using these cut-offs. A 12-month multicenter observational study was conducted on 466 patients with sciatica and lumbar disc herniation. The cut-off values were estimated by ROC curve analyses using Completely recovered or Much better on a 7-point global change scale as external criterion for success. The cut-off values (references in brackets) at 12 months were leg pain VAS 17.5 (0–100), back pain VAS 22.5 (0–100), Sciatica Bothersomeness Index 6.5 (0–24), Maine-Seattle Back Questionnaire 4.5 (0–12), and the SF-36 subscales bodily pain 51.5, and physical functioning 81.7 (0–100, higher values indicate better health). In conclusion, the success rates at 12 months varied from 49 to 58% depending on the measure used. The proposed cut-offs may facilitate the comparison of success rates across studies

A strong association between non-musculoskeletal symptoms and musculoskeletal pain symptoms: results from a population study

<p>Abstract</p> <p>Background</p> <p>There is a lack of knowledge about the pattern of symptom reporting in the general population as most research focuses on specific diseases or symptoms. The number of musculoskeletal pain sites is a strong predictor for disability pensioning and, hence, is considered to be an important dimension in symptom reporting. The simple method of counting symptoms might also be applicable to non-musculoskeletal symptoms, rendering further dimensions in describing individual and public health. In a general population, we aimed to explore the association between self-reported non-musculoskeletal symptoms and the number of pain sites.</p> <p>Methods</p> <p>With a cross-sectional design, the Standardised Nordic Questionnaire and the Subjective Health Complaints Inventory were used to record pain at ten different body sites and 13 non-musculoskeletal symptoms, respectively, among seven age groups in Ullensaker, Norway (n = 3,227).</p> <p>Results</p> <p>Results showed a strong, almost linear relationship between the number of non-musculoskeletal symptoms and the number of pain sites (r = 0.55). The <it>number </it>and <it>type </it>of non-musculoskeletal symptoms had an almost equal explanatory power in the number of pain sites reported (27.1% vs. 28.2%).</p> <p>Conclusion</p> <p>The linear association between the number of non-musculoskeletal and musculoskeletal symptoms might indicate that the symptoms share common characteristics and even common underlying causal factors. The total burden of symptoms as determined by the number of symptoms reported might be an interesting generic indicator of health and well-being, as well as present and future functioning. Research on symptom reporting might also be an alternative pathway to describe and, possibly, understand the medically unexplained multisymptom conditions.</p