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. 2019 Sep 12;19(1):1262.
doi: 10.1186/s12889-019-7564-9.

Development and validation of a pre-scoring system for nonspecific low back pain among general population in Guangzhou: a cross-sectional study

Kai Wang  1   2 , Jing-Wen Zhang  1 , Shao-Xiong Min  3 , Xin-Yi Xu  3 , Sheng-Li An  4
Affiliations

Development and validation of a pre-scoring system for nonspecific low back pain among general population in Guangzhou: a cross-sectional study

Kai Wang et al. BMC Public Health. .

Abstract

Background: Nonspecific Low Back Pain (NLBP) is a common disease with a low cure rate and significant impact on the population. This study aimed to develop and validate a pre-scoring system for identifying the risk of suffering from NLBP among the general population in Guangzhou.

Methods: A total of 1439 eligible subjects were surveyed in Guangzhou by stratified random sampling and was divided randomly into the development dataset (69.6%) and validation dataset (30.4%) subsequently. Based on the development dataset, potential associated factors (average exercise times weekly, the intensity of daily work, etc.) with NLBP were tested by the sequential logistic regression, and a pre-scoring system was formulated with Sullivan's method and graded afterward. The internal validity of the system was assessed by AUC and calibration plot, and the external validation was performed in the validation dataset.

Results: The prevalence rates of NLBP in the development dataset and the validation dataset were 12.97 and 13.27%, respectively. Age, BMI, average exercise times weekly, gender, educational level, the intensity of daily work, place of residence, monthly income, overall evaluation of health condition and physiology health were identified as significant factors. The total risk score ranged from 0 to 38, which was split into three risk grades: low risk (0 to 18), intermediate risk (19 to 22) and high risk (23 to 38). The pre-scoring system had an adequate calibration and a good discriminating ability with bootstrap-corrected AUC equaling 0.861 in the development dataset and 0.821 in the validation dataset.

Conclusions: A pre-scoring system that could help clinicians to assess the risk of NLBP in the general population was validated. Further validation of the system in a new population or prospective cohort study is suggested.

Keywords: Associated factors; General population; Non-specific low back pain; Pre-scoring system.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram of enrolling the participants at each stage of study
Fig. 2
Fig. 2
Receiver operator characteristic curve showing area under the curve for NLBP in general population (Notes: The basic model includes demographical and work-related factors. Risk model means basic model+SF2+ SF_PHYS. Scoring system means the sum of each factor score)
Fig. 3
Fig. 3
Calibration plot about observed versus estimated risk for NLBP in the development dataset and validation dataset respectively. a Calibration plot (Histogram) about observed risk versus estimated risk for NLBP in the development dataset with risk divided into ten groups by default. b Calibration plot (Histogram) about observed risk versus estimated risk for NLBP in the validation dataset with risk divided into ten groups by default. c Calibration plot (Line graph) about observed risk versus estimated risk for NLBP in the development dataset and validation dataset. The points with different colors indicate the observed risk against estimated risk
See this image and copyright information in PMC

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