title: Low-back pain definitions in occupational studies were categorized for a meta-analysis using Delphi consensus methods.
abstract: OBJECTIVE
  To determine which literature-based definitions of low back pain (LBP) could be combined to produce sufficiently similar sets for use in a meta-analysis.
  
  
  METHODS
  A group of six international experts participated in an e-mail-administered Delphi process. Literature-based LBP definitions were preliminarily classified into 14 sets within four outcome types: pathology, symptoms and care-seeking, functional limitations, and participation. Experts independently rated their level of agreement that each outcome definition belonged in its assigned set using a seven-point Likert scale. After each round, results were synthesized and revised classifications were fed back to the experts who were asked to consider them before rerating the outcome definitions.
  
  
  RESULTS
  The experts completed three Delphi rounds and reached consensus on the categorization of 115/119 (97%) of the outcome definitions. There were 20 final sets of outcomes identified: three sets of pathology outcomes, two sets each of functional limitation and participation outcomes, and 13 sets of symptom and care-seeking outcomes.
  
  
  CONCLUSIONS
  In a research area that currently lacks uniformly accepted definitions of outcomes, we successfully used a Delphi consensus process to reach substantial agreement on combinable LBP outcomes that would be combinable for a meta-analysis.
authors.affiliation: Program in Occupational Health and Environmental Medicine, McMaster University, HSC 3H57, Hamilton, Ontario, Canada L8N 3A5. griffith@mcaster.ca
authors.forename: Lauren E
authors.initials: LE
authors.lastname: Griffith
authors.forename: Sheilah
authors.initials: S
authors.lastname: Hogg-Johnson
authors.forename: Donald C
authors.initials: DC
authors.lastname: Cole
authors.forename: Niklas
authors.initials: N
authors.lastname: Krause
authors.forename: Jill
authors.initials: J
authors.lastname: Hayden
authors.forename: Alex
authors.initials: A
authors.lastname: Burdorf
authors.forename: Annette
authors.initials: A
authors.lastname: Leclerc
authors.forename: David
authors.initials: D
authors.lastname: Coggon
authors.forename: Paulien
authors.initials: P
authors.lastname: Bongers
authors.forename: Stephen D
authors.initials: SD
authors.lastname: Walter
authors.forename: Harry S
authors.initials: HS
authors.lastname: Shannon
mesh_terms: D000041:Absenteeism; D000203:Activities of Daily Living; D003697:Delphi Technique; D006801:Humans; D017116:Low Back Pain / Q000145:classification* / Q000209:etiology / Q000473:pathology; D015201:Meta-Analysis as Topic; D009784:Occupational Diseases / Q000145:classification* / Q000209:etiology; D010342:Patient Acceptance of Health Care / Q000523:psychology; D011379:Prognosis; D009626:Terminology as Topic; D014942:Workers' Compensation