title: The accuracy of pain drawing in identifying psychological distress in low back pain-systematic review and meta-analysis of diagnostic studies.
abstract: The aim of this systematic review and meta-analysis was to estimate the accuracy of qualitative pain drawings (PDs) in identifying psychological distress in subacute and chronic low back pain (LBP) patients. [Subjects and Methods] Data were obtained from searches of PubMed, EBSCO, Scopus, PsycINFO and ISI Web of Science from their inception to July 2014. Quality assessments of bias and applicability were conducted using the Quality of Diagnostic Accuracy Studies-2 (QUADAS-2). [Results] The summary estimates were: sensitivity=0.45 (95% CI 0.34, 0.61), specificity=0.66 (95% CI 0.53, 0.82), positive likelihood ratio=1.23 (95% CI 0.93, 1.62), negative likelihood ratio=0.84 (95% CI 0.70, 1.01), and diagnostic odds ratio=1.46 (95% CI 0.79, 2.68). The area under the curve was 78% (CI, 57 to 99%). [Conclusion] The results of this systematic review do not show broad and unqualified support for the accuracy of PDs in detecting psychological distress in subacute and chronic LBP.
authors.affiliation: School of Physical Therapy, Alma Mater Studiorum University of Bologna, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Bertozzi
authors.affiliation: University of Bologna, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Rosso
authors.affiliation: University of Bologna, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Romeo
authors.affiliation: IRCCS Don Gnocchi Foundation, Italy.
authors.forename: Jorge Hugo
authors.initials: JH
authors.lastname: Villafañe
authors.affiliation: Department of Rehabilitation Science, College of Health and Human Services, George Mason University, USA.
authors.forename: Andrew A
authors.initials: AA
authors.lastname: Guccione
authors.affiliation: Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum, University of Bologna, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Pillastrini
authors.affiliation: Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum, University of Bologna, Italy.
authors.forename: Carla
authors.initials: C
authors.lastname: Vanti
keywords: Low back pain; Pain drawing; Stress psychological