title: Identifying neck and back pain in administrative data: defining the right cohort.
abstract: METHODS
  We reviewed existing methods for identifying patients with neck and back pain in administrative data. We compared these methods using data from the Department of Veterans Affairs.
  
  
  OBJECTIVE
  To answer the following questions: (1) what diagnosis codes should be used to identify patients with neck pain and back pain in administrative data; (2) because the majority of complaints are characterized as nonspecific or mechanical, what diagnosis codes should be used to identify patients with nonspecific or mechanical problems in administrative data; and (3) what procedure and surgical codes should be used to identify patients who have undergone a surgical procedure on the neck or back.
  
  
  BACKGROUND
  Musculoskeletal neck and back pain are pervasive problems, associated with chronic pain, disability, and high rates of health care utilization. Administrative data have been widely used in formative research, which has largely relied on the original work of Volinn, Cherkin, Deyo, and Einstadter and the Back Pain Patient Outcomes Assessment Team first published in 1992. Significant variation in reports of incidence, prevalence, and morbidity associated with these problems may be due to nonstandard or conflicting methods to define study cohorts.
  
  
  METHODS
  A literature review produced 7 methods for identifying neck and back pain in administrative data. These code lists were used to search Veterans Health Administration data for patients with back and neck problems, and to further categorize each case by spinal segment involved, as nonspecific/mechanical and as surgical or not.
  
  
  RESULTS
  There is considerable overlap in most algorithms. However, gaps persist.
  
  
  CONCLUSIONS
  Gaps are evident in existing methods and a new framework to identify patients with neck pain and back pain in administrative data is proposed.
authors: VA Health Economics Resource Center, Menlo Park, CA 94025, USA. patricia.sinnott@va.gov
authors: Patricia L
authors: PL
authors: Sinnott
authors: Andrew M
authors: AM
authors: Siroka
authors: Andrea C
authors: AC
authors: Shane
authors: Jodie A
authors: JA
authors: Trafton
authors: Todd H
authors: TH
authors: Wagner
mesh_terms: D001416:Back Pain / Q000175:diagnosis* / Q000453:epidemiology; D059019:Clinical Coding / Q000379:methods* / Q000592:standards; D015331:Cohort Studies; D016208:Databases, Factual / Q000592:standards; D006801:Humans; D019547:Neck Pain / Q000175:diagnosis* / Q000453:epidemiology; D010147:Pain Measurement / Q000379:methods / Q000592:standards; D013223:Statistics as Topic / Q000379:methods* / Q000592:standards; D014481:United States / Q000453:epidemiology; D014493:United States Department of Veterans Affairs / Q000592:standards