{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,20]],"date-time":"2026-01-20T16:01:17Z","timestamp":1768924877974,"version":"3.49.0"},"reference-count":22,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2017,3,17]],"date-time":"2017-03-17T00:00:00Z","timestamp":1489708800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pain Practice"],"published-print":{"date-parts":[[2017,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine the best regional pain score cutoff value that corresponds with patient\u2010reported improvement in lumbosacral radiculopathy (<jats:styled-content style=\"fixed-case\">LSR<\/jats:styled-content>).<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Retrospective pooled data analysis from 3 randomized, controlled, multicenter trials using similar outcome assessments. All participants were exposed to interventions (epidural injections).<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Military medical centers (6 U.S.A., 1 Germany) and large tertiary care hospitals (4 urban, 1 Veterans Affairs) between 2008 and 2014.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects<\/jats:title><jats:p>A total of 352 active duty military personnel and civilians \u2265 18 years of age with <jats:styled-content style=\"fixed-case\">LSR<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Receiver operating characteristics (<jats:styled-content style=\"fixed-case\">ROC<\/jats:styled-content>) with area under the curve (<jats:styled-content style=\"fixed-case\">AUC<\/jats:styled-content>) were calculated for 1\u2010month outcomes for pain (numeric rating scale) using absolute and relative change in regional pain scores (back, leg) to predict clinical improvement (global perceived effect).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Leg pain demonstrated greater predictive ability to identify clinical improvement compared to back pain for both absolute (<jats:styled-content style=\"fixed-case\">ROC AUC<\/jats:styled-content> [95% confidence interval (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>)] 0.855 [0.813, 0.896] vs. 0.753 [0.702, 0.805]; <jats:italic>P<\/jats:italic> &lt; 0.001) and relative (<jats:styled-content style=\"fixed-case\">AUC<\/jats:styled-content> [95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>]; 0.867 [0.826, 0.909] vs. 0.780 [0.729, 0.831]; <jats:italic>P<\/jats:italic> = 0.002) reduction in reported pain. Clinical improvement was best identified using a leg pain reduction threshold of \u2265 1.75 points (absolute) and \u2265 23.5% (relative).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Region\u2010specific pain cutoff ratings predicted clinical improvement for patients with <jats:styled-content style=\"fixed-case\">LSR<\/jats:styled-content>. Cutoff points using newly identified, smaller reductions of 1.75 points and 23.5% more accurately predicted clinical improvement for <jats:styled-content style=\"fixed-case\">LSR<\/jats:styled-content> than conventionally used cutoffs (2 points and 30%). <jats:styled-content style=\"fixed-case\">LSR<\/jats:styled-content> patients report meaningful clinical improvement with smaller reductions in pain compared to other chronic pain diagnoses, suggesting <jats:styled-content style=\"fixed-case\">LSR<\/jats:styled-content> patients may have different expectations.<\/jats:p><\/jats:sec>","DOI":"10.1111\/papr.12569","type":"journal-article","created":{"date-parts":[[2017,2,22]],"date-time":"2017-02-22T22:42:39Z","timestamp":1487803359000},"page":"1058-1065","source":"Crossref","is-referenced-by-count":5,"title":["Which Regional Pain Rating Best Predicts Patient\u2010Reported Improvement in Lumbar Radiculopathy?"],"prefix":"10.1111","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9406-5953","authenticated-orcid":false,"given":"Mark C.","family":"Bicket","sequence":"first","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine Johns Hopkins University School of Medicine Baltimore Maryland U.S.A"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul F.","family":"Pasquina","sequence":"additional","affiliation":[{"name":"Departments of Physical Medicine and Rehabilitation Uniformed Services University of the Health Sciences Bethesda Maryland U.S.A"},{"name":"Walter Reed National Military Medical Center Bethesda Maryland U.S.A"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven P.","family":"Cohen","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Critical Care Medicine Johns Hopkins University School of Medicine Baltimore Maryland U.S.A"},{"name":"Departments of Physical Medicine and Rehabilitation Uniformed Services University of the Health Sciences Bethesda Maryland U.S.A"},{"name":"Walter Reed National Military Medical Center Bethesda Maryland U.S.A"},{"name":"Departments of Neurology and Physical Medicine &amp; Rehabilitation Johns Hopkins School of Medicine Baltimore Maryland U.S.A"},{"name":"Department of Anesthesiology Walter Reed National Military Medical Center Bethesda Maryland U.S.A"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2017,3,17]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2012.07.033"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.berh.2015.04.023"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3959(00)00339-0"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2007.09.005"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3959(01)00349-9"},{"key":"e_1_2_6_7_1","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1007\/s00586-002-0464-0","article-title":"The clinical importance of changes in outcome scores after treatment for chronic low back pain","volume":"12","author":"H\u00e4gg O","year":"2003","journal-title":"Eur Spine J"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2003.015792"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mayocp.2015.10.009"},{"key":"e_1_2_6_10_1","first-page":"369","article-title":"Pain extent and diagnosis: development and validation of the regional pain scale in 12,799 patients with rheumatic disease","volume":"30","author":"Wolfe F","year":"2003","journal-title":"J Rheumatol"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-156-8-201204170-00397"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinternmed.2011.593"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.h1748"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11552-008-9123-1"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.berh.2005.03.002"},{"key":"e_1_2_6_16_1","first-page":"749","article-title":"Listening to injured workers: how recovery expectations predict outcomes\u2014a prospective study","volume":"166","author":"Cole DC","year":"2002","journal-title":"CMAJ"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1955.02960340022006"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pupt.2013.01.006"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.38726.603310.55"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1097\/j.pain.0000000000000333"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0b013e31828ea086"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1313265"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.h6234"}],"container-title":["Pain Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fpapr.12569","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/papr.12569","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,24]],"date-time":"2023-09-24T10:47:41Z","timestamp":1695552461000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/papr.12569"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,3,17]]},"references-count":22,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2017,11]]}},"alternative-id":["10.1111\/papr.12569"],"URL":"https:\/\/doi.org\/10.1111\/papr.12569","archive":["Portico"],"relation":{},"ISSN":["1530-7085","1533-2500"],"issn-type":[{"value":"1530-7085","type":"print"},{"value":"1533-2500","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,3,17]]}}}