{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T04:42:49Z","timestamp":1792644169835,"version":"4.5.0"},"reference-count":42,"publisher":"Oxford University Press (OUP)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016,3,1]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>In a small proportion of patients experiencing unspecified back pain, a specified underlying pathology is present.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>The purposes of this study were: (1) to identify the prevalence of physician-specified causes of back pain and (2) to assess associations between \u201cred flags\u201d and vertebral fractures, as diagnosed by the patients' general practitioner (GP), in older adults with back pain.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>The Back Complaints in the Elders (BACE) study is a prospective cohort study. Patients (aged &amp;gt;55 years) with back pain were included when consulting their GP. A questionnaire was administered and a physical examination and heel bone densitometry were performed, and the results determined back pain and patient characteristics, including red flags. Participants received a radiograph, and reports were sent to their GP. The final diagnoses established at 1 year were collected from the GP's patient registry.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of the 669 participants included, 6% were diagnosed with a serious underlying pathology during the 1-year follow-up. Most of these participants (n=33, 5%) were diagnosed with a vertebral fracture. Multivariable regression analysis showed that age of \u226575 years, trauma, osteoporosis, a back pain intensity score of \u22657, and thoracic pain were associated with a higher chance of getting the diagnosis of a vertebral fracture. Of these variables, trauma showed the highest positive predictive value for vertebral fracture of 0.25 (95% confidence interval=0.09, 0.41) and a positive likelihood ratio of 6.2 (95% confidence interval=2.8, 13.5). A diagnostic prediction model including the 5 red flags did not increase these values.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Limitations<\/jats:title>\n                  <jats:p>Low prevalence of vertebral fractures could have led to findings by chance.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>In these older adults with back pain presenting in general practice, 6% were diagnosed with serious pathology, mainly a vertebral fracture (5%). Four red flags were associated with the presence of vertebral fracture.<\/jats:p>\n               <\/jats:sec>","DOI":"10.2522\/ptj.20140525","type":"journal-article","created":{"date-parts":[[2015,7,17]],"date-time":"2015-07-17T01:30:09Z","timestamp":1437096609000},"page":"305-312","source":"Crossref","is-referenced-by-count":54,"title":["Prevalence and \u201cRed Flags\u201d Regarding Specified Causes of Back Pain in Older Adults Presenting in General Practice"],"prefix":"10.1093","volume":"96","author":[{"given":"Wendy T.M.","family":"Enthoven","sequence":"first","affiliation":[{"name":"W.T.M. Enthoven, MD, Department of General Practice, Erasmus MC, University Medical Center, Post Box 2040, 3000 CA Rotterdam, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judith","family":"Geuze","sequence":"additional","affiliation":[{"name":"J. Geuze, MD, Department of General Practice, Erasmus MC, University Medical Center."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jantine","family":"Scheele","sequence":"additional","affiliation":[{"name":"J. Scheele, PhD, Department of General Practice, Erasmus MC, University Medical Center."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sita M.A.","family":"Bierma-Zeinstra","sequence":"additional","affiliation":[{"name":"S.M.A. Bierma-Zeinstra, PhD, Department of General Practice and Department of Orthopaedics, Erasmus MC, University Medical Center."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Herman J.","family":"Bueving","sequence":"additional","affiliation":[{"name":"H.J. Bueving, MD, PhD, Department of General Practice, Erasmus MC, University Medical Center."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arthur M.","family":"Bohnen","sequence":"additional","affiliation":[{"name":"A.M. Bohnen, MD, PhD, Department of General Practice, Erasmus MC, University Medical Center."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilco C.","family":"Peul","sequence":"additional","affiliation":[{"name":"W.C. Peul, MD, PhD, Department of Neurosurgery, Leiden University Medical Center, Leiden, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurits W.","family":"van Tulder","sequence":"additional","affiliation":[{"name":"M.W. van Tulder, PhD, Department of Health Sciences and EMGO Institute for Health and Care Research, Faculty of Earth and Life Sciences, VU University Amsterdam, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marjolein Y.","family":"Berger","sequence":"additional","affiliation":[{"name":"M.Y. Berger, MD, PhD, Department of General Practice, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bart W.","family":"Koes","sequence":"additional","affiliation":[{"name":"B.W. Koes, PhD, Department of General Practice, Erasmus MC, University Medical Center."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pim A.J.","family":"Luijsterburg","sequence":"additional","affiliation":[{"name":"P.A.J. 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