Responsiveness of objective, disease-specific, and generic outcome measures in patients with chronic low back pain: an assessment for improving, stable, and deteriorating patients.

Study Design: Analysis of outcome data collected prospectively from 250 patients recruited to the UK Spine Stabilization Trial.

Objectives: To compare the responsiveness of the Shuttle Walking Test (SWT), which is an objective outcome measure, with that of a disease-specific (the Oswestry Disability Index) and 2 generic (the EQ-5D and SF-36) instruments in patients with chronic low back pain (LBP).

Summary Of Background Data: Studies assessing the performance of subjective disease-specific and generic measures have increased in recent years, although there is a paucity of research reporting the responsiveness of objective measures in patients with LBP.

Reporting the cost-effectiveness of interventions with nonsignificant effect differences: example from a trial of secondary prevention of coronary heart disease.

Objectives: This study reports the cost-effectiveness of interventions with nonsignificant differences in effect, and considers reporting of cost-effectiveness in situations where nonsignificant differences arise in some but not all end points.

Methods: Data on costs and effects associated with three end points (adequate assessment, risk factors, and life-years) were derived from a trial of methods to promote secondary prevention of coronary heart disease. Incremental cost per life-year gained figures were calculated, and the uncertainty around these was displayed on cost-effectiveness planes in the form of ellipses.