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Cited by 13Musculoskeletal pain and rehabilitationSpine and Intervertebral Disc PathologyPain Mechanisms and Treatments

Agreement of self-reported items and clinically assessed nerve root involvement (or sciatica) in a primary care setting

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Konstantinou, Kika, Lewis, Martyn, Dunn, Kate M.·2012·European Spine Journal
DOI 10.1007/s00586-012-2398-5PMC PMC3481089
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Abstract

INTRODUCTION: We analysed baseline measures from an RCT involving adults with low back pain (LBP) with or without referred leg pain, to identify self-report items that best identified clinically determined nerve root involvement (sciatica). METHODS: Potential indicators of nerve root involvement were gathered using a self-reported questionnaire. Participants underwent a standardised physical examination on the same day as questionnaire completion. Self-reported items were compared to a reference standard (clinical diagnosis) using sensitivity, specificity, predictive values, likelihood ratios (LRs), the area under the receiver operating characteristic curve and logistic regression. Two reference standards are presented: one based on a clinical diagnosis of nerve root problems and excluding possible/inconclusive cases (referred to as a confirmatory reference), and the other being inclusive of possible/inconclusive cases (referred to as an indicative reference). RESULTS: Pain below knee was the best single item for diagnostic accuracy with an area under curve (AUC) of 0.67-0.68, which however is slightly less than the 'acceptable discrimination'. A cluster of three items, including distribution of pain below the knee, leg pain that is worse than back pain, and feeling of numbness or pins and needles in the leg, did improve discrimination to an 'acceptable' level with an AUC of 0.72-0.74 in relation to confirmatory and indicative references, respectively. However, the likelihood ratios from the models were reflective of a 'small' amount of discrimination. CONCLUSION: In this primary care population seeking treatment for LBP with or without leg pain, we found no clear set of self-report items that accurately identified patients with nerve root pain. When accurate case definition is important, clinical assessment should be the method of choice for identifying LBP with possible nerve root involvement.

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  • The AUC values for SNORD115 (0.861), SNORD116 (0.886), and combined (0.947) exceeded the threshold of 0.8.

    “The values of AUC for SNORD115–0.861, as well as for SNORD116–0.886 exceeded the threshold, thus according to widely accepted classification within the range of “outstanding” (Konstantinou et al., 2012; Mandrekar, 2010).”

    From Small nucleolar RNAs in plasma extracellular vesicles and their discriminatory power as diagnostic biomarkers of Alzheimer's disease (2021) · cites this paper as Konstantinou et al., 2012

    The Methods (‘Performance of the diagnostic model’) classify AUC values from 0.8 to below 0.9 as ‘Excellent discrimination,’ not ‘Outstanding discrimination.’ The cited paper supports that 0.861 and 0.886 exceed 0.8, but contradicts the citing sentence’s classification of those values as outstanding. It does not report the SNORD results. (LLM, conf=0.90)

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  • SNORD115 and SNORD116 have high discriminatory power to differentiate AD samples from NC.

    “We applied ddPCR technique and identified SNORD115 and SNORD116 with a high discriminatory power to differentiate AD samples from NC.”

    From Small nucleolar RNAs in plasma extracellular vesicles and their discriminatory power as diagnostic biomarkers of Alzheimer's disease (2021) · cites this paper as Konstantinou et al., 2012

    The Methods (Data analysis) and Discussion concern self-reported symptoms used to identify nerve root involvement or sciatica, not RNA biomarkers. Searches for SNORD115, SNORD116, ddPCR, and Alzheimer’s disease found no passage addressing whether those markers distinguish AD samples from NC. (LLM, conf=0.78)

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Research works printed but not linked: 23

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Cited by

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Authors
Konstantinou, K., Lewis, M., & Dunn, K. M.
Affiliations
Arthritis Research UK (GB)
Corresponding author
Konstantinou, Kika
ORCID
Venue
European Spine Journal
Publisher
Springer Science and Business Media LLC
Published
2012-07-03
Volume
21
Issue
11
Pages
2306-2315
ISSN
  • 0940-6719 (ISSN-L)
  • 1432-0932
DOI
10.1007/s00586-012-2398-5
PMC
PMC3481089
OpenAlex
W2019100322
Cited by
13
References
1
Citations by year
2025: 2 · 2024: 1 · 2023: 1 · 2021: 2 · 2020: 2 · 2019: 2 · 2018: 1 · 2016: 1 · 2014: 1
FWCI
0.24
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • European Spine Journal (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Keele Research Repository (Keele University) (submittedVersion, cc-by)
Funders
  • Wellcome Trust
  • National Institute for Health and Care Research (RP-PG-0707-10131)
Topics
  • Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Spine and Intervertebral Disc Pathology
  • Health Sciences › Medicine › Physiology › Pain Mechanisms and Treatments
Keywords
nerve root involvement, sciatica, low back pain, self-reported symptoms, diagnostic accuracy, case definition, primary care, physical examination
MeSH terms
Adolescent, Adult, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Radiculopathy, Sciatica, Low Back Pain, Physical Therapy Modalities, Young Adult, Self Report

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