Is it time to abandon traditional MSK diagnostic labelling or MSK labels? We summarise research by Aasdahl et. al., (2021) to explore the potential answer.
Original research title: Recovery trajectories in common musculoskeletal complaints by
diagnosis contra prognostic phenotypes.
Authors: Line Aasdahl, Fredrik Granviken, Ingebright Meisingset, Astrid Woodhouse, Kari
Anne I. Evensen & Ottar Vasseljen
Musculoskeletal (MSK) disorders are traditionally classified and grouped based on the
location of pain or dysfunction. Despite a multitude of other factors that may be
contributing to an individual’s symptoms (or perception of symptoms), our tendency is to
group patients based on the region of pain. Currently, treatment guidelines do not
consider the commonly overlooked biopsychosocial components… Not only do biopsychosocial components have a large influence on patients’ response to therapies, they could play a significant role in the way a
This paper looks at traditional MSK diagnostic labelling by pain location and how it has
limited utility in informing clinical management. The authors highlight examples where
researchers targeted prognostic factors (age, type of work, pain duration, mood, and
widespread pain) rather than location of pain and were able to achieve more efficient care.
The authors used latent class analysis to identify phenotypes within a patient cohort and
subsequently track their respective trajectories of recovery.
By subclassifying patients according to prognostic factors, larger variations were observed
in clinical course and recovery that were not apparent in trajectories using traditional MSK
diagnostic groups. Regular prognostic data collection allows for the ability to stratify groups
in such a way as to obtain more reliable and meaningful longitudinal information. Ultimately,
a data set of this nature would assist clinicians in estimating prognosis for individual
patients as well as support decision-making in the clinical setting.
Expressing course and recovery trajectory by diagnosis group did not show significant
variation in prognosis. The phenotype classes (prognostic factors) showed a clear
decreasing rate of recovery, alerting to the diversity of recovery rates within a common MSK
disorder group, and thus the limitations of such classification method.
See the original research paper here.
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