A consensus approach toward the standardization of back pain definitions for use in prevalence studies.
METHODS
A modified Delphi study conducted with 28 experts in back pain research from 12 countries.


OBJECTIVE
To identify standardized definitions of low back pain that could be consistently used by investigators in prevalence studies to provide comparable data.


BACKGROUND
Differences in the definition of back pain prevalence in population studies lead to heterogeneity in study findings, and limitations or impossibilities in comparing or summarizing prevalence figures from different studies.


METHODS
Back pain definitions were identified from 51 articles reporting population-based prevalence studies, and dissected into 77 items documenting 7 elements. These items were submitted to a panel of experts for rating and reduction, in 3 rounds (participation: 76%). Preliminary results were presented and discussed during the Amsterdam Forum VIII for Primary Care Research on Low Back Pain, compared with scientific evidence and confirmed and fine-tuned by the panel in a fourth round and the preparation of the current article.


RESULTS
Two definitions were agreed on a minimal definition (with 1 question covering site of low back pain, symptoms observed, and time frame of the measure, and a second question on severity of low back pain) and an optimal definition that is made from the minimal definition and add-ons (covering frequency and duration of symptoms, an additional measure of severity, sciatica, and exclusions) that can be adapted to different needs.


CONCLUSIONS
These definitions provide standards that may improve future comparisons of low back pain prevalence figures by person, place and time characteristics, and offer opportunities for statistical summaries.
Dionne
Clermont E
CE
Population Health Research Unit, (URESP) Research Centre of the Laval University Affiliated Hospital, Québec, QC, Canada. clermont.dionne@uresp.ulaval.ca
Dunn
Kate M
KM
Croft
Peter R
PR
Nachemson
Alf L
AL
Buchbinder
Rachelle
R
Walker
Bruce F
BF
Wyatt
Mary
M
Cassidy
J David
JD
Rossignol
Michel
M
Leboeuf-Yde
Charlotte
C
Hartvigsen
Jan
J
Leino-Arjas
Päivi
P
Latza
Ute
U
Reis
Shmuel
S
Gil Del Real
Maria Teresa
MT
Kovacs
Francisco M
FM
Oberg
Birgitta
B
Cedraschi
Christine
C
Bouter
Lex M
LM
Koes
Bart W
BW
Picavet
H Susan J
HS
van Tulder
Maurits W
MW
Burton
Kim
K
Foster
Nadine E
NE
Macfarlane
Gary J
GJ
Thomas
Elaine
E
Underwood
Martin
M
Waddell
Gordon
G
Shekelle
Paul
P
Volinn
Ernest
E
Von Korff
Michael
M
D000203:Activities of Daily Living; D003697:Delphi Technique; D004185:Disability Evaluation; D005104:Expert Testimony; D006801:Humans; D007391:International Cooperation; D017116:Low Back Pain / Q000145:classification* / Q000175:diagnosis / Q000503:physiopathology; D012720:Severity of Illness Index; D009626:Terminology as Topic