Prognostic value of quantitative sensory testing in low back pain: a systematic review of the literature

Anna Marcuzzi,1,2 Catherine M Dean,1,2 Paul J Wrigley,3,4 Rosemary J Chakiath,3,4 Julia M Hush1,2 1Discipline of Physiotherapy, Department of Health Professions, Faculty of Medicine and Health Sciences, 2The Centre for Physical Health, Macquarie University, Sydney, 3Pain Management Research Institute, Kolling Institute of Medical Research, Royal North Shore Hospital, St Leonards, 4Sydney Medical School – Northern, University of Sydney, Sydney, NSW, Australia Abstract: Quantitative sensory testing (QST) measures have recently been shown to predict outcomes in various musculoskeletal and pain conditions. The aim of this systematic review was to summarize the emerging body of evidence investigating the prognostic value of QST measures in people with low back pain (LBP). The protocol for this review was prospectively registered on the International Prospective Register of Systematic Reviews. An electronic search of six databases was conducted from inception to October 2015. Experts in the field were contacted to retrieve additional unpublished data. Studies were included if they were prospective longitudinal in design, assessed at least one QST measure in people with LBP, assessed LBP status at follow-up, and reported the association of QST data with LBP status at follow-up. Statistical pooling of results was not possible due to heterogeneity between studies. Of 6,408 references screened after duplicates removed, three studies were finally included. None of them reported a significant association between the QST measures assessed and the LBP outcome. Three areas at high risk of bias were identified which potentially compromise the validity of these results. Due to the paucity of available studies and the methodological shortcomings identified, it remains unknown whether QST measures are predictive of outcome in LBP. Keywords: prognosis, quantitative sensory testing, low back pain, cohort studies, pain, sensory testin