Factors predicting the transition from acute to persistent pain in people with ‘sciatica’: the FORECAST longitudinal prognostic factor cohort study protocol
Kathryn R Martin,
Annina B Schmid,
Brigitte Tampin,
Marco Barbero,
Christine Price,
Louise Hailey,
Claire Robinson,
Jeremy Fairbank,
Geert Crombez,
Georgios Baskozos,
Daniel Nanz,
Sarim Ather,
Lucy Ridgway,
Mohamed Tachrount,
Fay Probert,
Whitney Scott,
Soraya Koushesh,
Stuart Clare
Affiliations
Kathryn R Martin
Aberdeen Centre for Arhtritis and Musculoskeletal Health, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
Annina B Schmid
Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, Oxfordshire, UK
Brigitte Tampin
Department of Physiotherapy, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
Marco Barbero
Rehabilitation Research Laboratory 2rLab, Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Manno/Landquart, Switzerland
Christine Price
Patient partner FORECAST study, Oxford University, Oxford, UK
Louise Hailey
Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
Claire Robinson
Patient partner FORECAST study, Oxford University, Oxford, UK
Jeremy Fairbank
Nuffield Department of Orthopaedics Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, Oxfordshire, UK
Geert Crombez
Department of Experimental Clinical and Health Psychology, University of Ghent, Gent, Belgium
Georgios Baskozos
Neural Injury Group, Nuffield Department of Clinical Neuroscience, John Radcliffe Hospital, University of Oxford, Oxford, UK
Daniel Nanz
Swiss Center for Musculoskeletal Imaging, Balgrist Campus AG, Zurich, Zurich, Switzerland
Sarim Ather
Department of Radiology, John Radcliffe Hospital, Oxford, UK
Lucy Ridgway
Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, Oxfordshire, UK
Mohamed Tachrount
Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, Oxfordshire, UK
Fay Probert
Department of Chemistry, University of Oxford, Oxford, Oxfordshire, UK
Whitney Scott
lecturer
Soraya Koushesh
3Institute for Infection and Immunity, Musculoskeletal Research Group, St George’s, University of London, London, United Kingdom
Stuart Clare
Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, Oxfordshire, UK
Introduction Sciatica is a common condition and is associated with higher levels of pain, disability, poorer quality of life, and increased use of health resources compared with low back pain alone. Although many patients recover, a third develop persistent sciatica symptoms. It remains unclear, why some patients develop persistent sciatica as none of the traditionally considered clinical parameters (eg, symptom severity, routine MRI) are consistent prognostic factors.The FORECAST study (factors predicting the transition from acute to persistent pain in people with ‘sciatica’) will take a different approach by exploring mechanism-based subgroups in patients with sciatica and investigate whether a mechanism-based approach can identify factors that predict pain persistence in patients with sciatica.Methods and analysis We will perform a prospective longitudinal cohort study including 180 people with acute/subacute sciatica. N=168 healthy participants will provide normative data. A detailed set of variables will be assessed within 3 months after sciatica onset. This will include self-reported sensory and psychosocial profiles, quantitative sensory testing, blood inflammatory markers and advanced neuroimaging. We will determine outcome with the Sciatica Bothersomeness Index and a Numerical Pain Rating Scale for leg pain severity at 3 and 12 months.We will use principal component analysis followed by clustering methods to identify subgroups. Univariate associations and machine learning methods optimised for high dimensional small data sets will be used to identify the most powerful predictors and model selection/accuracy.The results will provide crucial information about the pathophysiological drivers of sciatica symptoms and may identify prognostic factors of pain persistence.Ethics and dissemination The FORECAST study has received ethical approval (South Central Oxford C, 18/SC/0263). The dissemination strategy will be guided by our patient and public engagement activities and will include peer-reviewed publications, conference presentations, social media and podcasts.Trial registration number ISRCTN18170726; Pre-results.
