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Multidomain assessment protocol feasible in secondary care for low back painCan a better pain check fit into routine care for 542 patients with low back pain?

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Key Takeaway
Consider that a multidomain assessment for low back pain is feasible in secondary care, but its clinical utility is not yet established.

This proof-of-concept cohort study evaluated the feasibility of embedding a multidomain disability evaluation protocol into routine secondary care for low back pain. The study included 542 patients referred for advanced assessment at the Spine Center of Southern Denmark. The protocol integrated patient-reported outcomes (PROs), performance-based measures, kinematic motion capture, quantitative sensory testing (QST), and electronic health record (EHR) data. No comparator was reported.

The main feasibility results showed the assessment battery had a mean completion time of 22 minutes, with data completeness over 95%. Patient-reported outcomes indicated significant disability, with an Oswestry Disability Index (ODI) score of 34 out of 100 and an EQ-5D visual analog scale (VAS) score of 55 out of 100. MRI data were available for 88% of patients. In a subgroup, SMS follow-up retention was 75% at 60 weeks.

Safety and tolerability were acceptable, with only two minor adverse events reported. The study did not report serious adverse events or discontinuation rates. Key limitations include that the study did not perform formal multidomain profiling or subgroup identification, and the publication type and funding/conflicts were not reported. The practice relevance is restrained to demonstrating that such an integrated assessment is feasible and safe within a specialized secondary care setting, but it does not establish clinical effectiveness or guide treatment decisions.

Imagine walking into a doctor's office for your back pain and leaving with a much clearer understanding of your condition. A team at the Spine Center of Southern Denmark asked if they could fit a detailed disability evaluation into regular appointments without making things harder for patients or staff. They worked with 542 patients referred for advanced assessment to see if this approach was possible.

The team integrated several tools, including patient-reported surveys, movement tests, and skin sensitivity checks, directly into their electronic health records. The results showed that the entire assessment battery took about 22 minutes on average. Over 95% of the data collected was complete, and 88% of MRI scans were available when needed. Patients found the process acceptable, and the team reported only two minor adverse events with no serious safety issues.

Even six months later, 75% of the patients who received text message follow-ups stayed engaged in their care. While this study proves the method is feasible and safe, it did not perform a full detailed profiling of every patient group. This means we know the system works, but we still need more research to see exactly how it changes long-term recovery for people with chronic pain.

What this means for you:
A detailed pain check fits into routine care for low back pain patients safely and is well accepted.

Study Details

Study typeCohort
EvidenceLevel 3
PublishedApr 2026
View Original Abstract ↓
Disability evaluation in low back pain (LBP) has traditionally relied on patient-reported outcomes (PROs), which alone incompletely capture functioning. This study tested the feasibility of embedding a multidomain disability evaluation protocol into routine secondary care, integrating PROs with performance-based measures, kinematic analysis, quantitative sensory testing (QST), and electronic health record (EHR) data, without performing formal multidomain profiling or subgroup identification. In this proof-of-concept study, 542 patients referred for advanced LBP assessment at the Spine Center of Southern Denmark underwent multidomain evaluation, including PROs (ODI, EQ-5D-5L, NPRS, STarT Back), functional capacity tests, markerless kinematic motion capture, QST, and EHR extraction; a subgroup provided 60-week SMS follow-up. Feasibility outcomes, including workflow integration, data completeness, acceptability, and adverse events, were evaluated overall and after the first 100 participants to guide protocol refinement. The assessment battery was completed in a mean of 22 min with over 95% data completeness, high acceptability, acceptable patient burden, and only two minor adverse events. PROs indicated moderate disability (ODI 34/100) and poor health (EQ-5D VAS 55/100), while functional and kinematic measures revealed substantial impairments, and QST showed widespread pain sensitivity with minimal conditioned pain modulation. EHR linkage was achieved for all participants, with MRI data available in 88%, and SMS follow-up retention was 75% at 60 weeks. These findings demonstrate that integrating PROs, performance-based tests, QST, kinematic assessment, and EHR data into routine secondary care is feasible, safe, and acceptable. The resulting multidomain dataset provides an infrastructure for future research on prognosis, subgrouping, and disability evaluation in LBP.
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