Acute XXXX and primary care: how to define recovery and chronification?

@entity1 @entity1643 @entity158
STUDY DESIGN: A prospective cohort study. OBJECTIVE: To establish outcome measures for recovery and chronic @entity158 for studies with @entity1 who present with recent-onset @entity1643 ( @entity1643 ) in primary care. SUMMARY OF BACKGROUND DATA: Among back @entity158 researchers, no consensus exists about outcome definitions or how to identify primary-care @entity1 as not-recovered from an episode of @entity1643 . Cut points for outcome scales have mostly been arbitrarily chosen. Theoretical models for establishing minimal important change values in studies of @entity1 with @entity1643 have been proposed and need to be applied to real data. METHODS: A sample of 521 @entity1 who presented with acute @entity1643 (<4 weeks) in primary care clinics were observed for 6 months and scores for @entity158 and disability were compared with ratings on a Global Perceived Effect Scale. Using multiple potential "gold standards" as anchors (reference standards), the receiver operating characteristic method was used to determine optimal cut points for different ways of defining nonrecovery from acute @entity1643 . RESULTS: Minimal important change values and upper limits for @entity158 and disability scores as well as minimal important percentage changes are presented for five different definitions of recovery. A previously suggested 30% change from baseline scores does not accurately discriminate between recovered @entity1 and nonrecovered @entity1 in @entity1 presenting with acute @entity1643 in primary care. CONCLUSION: Outcome definitions that combine ratings from perceived recovery scales with @entity158 and disability measures provide the highest accuracy in discriminating recovered @entity1 from nonrecovered @entity1 .
