Identifying the Most Important Confounders When Assessing the Association Between Low-Grade Systemic Inflammation and Musculoskeletal Pain: A Modified Delphi Study

Abstract Objective The association between low-grade systemic inflammation and musculoskeletal pain may be influenced by multiple factors. However, little is known about the relative importance of these factors, and few studies account for them. This Delphi study aimed to reach consensus on the most...

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Veröffentlicht in:Pain medicine (Malden, Mass.) Mass.), 2021-11, Vol.22 (11), p.2661-2669
Hauptverfasser: Koop, Meghan A, Lutke Schipholt, Ivo J, Scholten-Peeters, Gwendolyne G M, Coppieters, Michel W
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container_issue 11
container_start_page 2661
container_title Pain medicine (Malden, Mass.)
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creator Koop, Meghan A
Lutke Schipholt, Ivo J
Scholten-Peeters, Gwendolyne G M
Coppieters, Michel W
description Abstract Objective The association between low-grade systemic inflammation and musculoskeletal pain may be influenced by multiple factors. However, little is known about the relative importance of these factors, and few studies account for them. This Delphi study aimed to reach consensus on the most important confounders which influence the association between low-grade systemic inflammation and musculoskeletal pain. Methods The panel consisted of 48 experts. In Round 1, the experts proposed what they believed were important confounders. In Round 2, the experts indicated for each confounder whether they believed it was important (yes/no). At least 50% of experts had to indicate the confounder was important to be considered in the final round. In Round 3, the experts rated the importance of each confounder on a 7-point Likert scale. Consensus was reached if ≥75% of the experts considered the factor either extremely or moderately important. Results In Round 1, 120 confounders were proposed, which were synthesized into 38 distinct factors. In Round 2, 33 confounders met the criterion to be considered important. In Round 3, consensus was reached for 14 confounders: acute illness/trauma, immune disease, medication use, endocrine, nutritional, or metabolic disease, other musculoskeletal conditions, age, handling of blood samples, sex, cancer, body composition, pregnancy, cardiovascular disease, physical activity, and pain characteristics. Conclusions These findings provide insight in the complexity of the association between low-grade systemic inflammation and musculoskeletal pain. Some factors currently listed as confounders may be re-classified as moderators or mediators as insights progress.
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However, little is known about the relative importance of these factors, and few studies account for them. This Delphi study aimed to reach consensus on the most important confounders which influence the association between low-grade systemic inflammation and musculoskeletal pain. Methods The panel consisted of 48 experts. In Round 1, the experts proposed what they believed were important confounders. In Round 2, the experts indicated for each confounder whether they believed it was important (yes/no). At least 50% of experts had to indicate the confounder was important to be considered in the final round. In Round 3, the experts rated the importance of each confounder on a 7-point Likert scale. Consensus was reached if ≥75% of the experts considered the factor either extremely or moderately important. Results In Round 1, 120 confounders were proposed, which were synthesized into 38 distinct factors. In Round 2, 33 confounders met the criterion to be considered important. In Round 3, consensus was reached for 14 confounders: acute illness/trauma, immune disease, medication use, endocrine, nutritional, or metabolic disease, other musculoskeletal conditions, age, handling of blood samples, sex, cancer, body composition, pregnancy, cardiovascular disease, physical activity, and pain characteristics. Conclusions These findings provide insight in the complexity of the association between low-grade systemic inflammation and musculoskeletal pain. Some factors currently listed as confounders may be re-classified as moderators or mediators as insights progress.</description><identifier>ISSN: 1526-2375</identifier><identifier>EISSN: 1526-4637</identifier><identifier>DOI: 10.1093/pm/pnab243</identifier><identifier>PMID: 34343332</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Body composition ; Cardiovascular diseases ; Consensus ; Delphi method ; Delphi Technique ; Development and progression ; Humans ; Immunological diseases ; Inflammation ; Metabolic disorders ; Musculoskeletal diseases ; Musculoskeletal Pain - diagnosis ; Musculoskeletal Pain - epidemiology ; Musculoskeletal, Rehabilitation &amp; Regenerative Medicine Section ; Pain ; Physical activity ; Risk factors</subject><ispartof>Pain medicine (Malden, Mass.), 2021-11, Vol.22 (11), p.2661-2669</ispartof><rights>The Author(s) 2021. Published by Oxford University Press on behalf of the American Academy of Pain Medicine. 2021</rights><rights>The Author(s) 2021. 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However, little is known about the relative importance of these factors, and few studies account for them. This Delphi study aimed to reach consensus on the most important confounders which influence the association between low-grade systemic inflammation and musculoskeletal pain. Methods The panel consisted of 48 experts. In Round 1, the experts proposed what they believed were important confounders. In Round 2, the experts indicated for each confounder whether they believed it was important (yes/no). At least 50% of experts had to indicate the confounder was important to be considered in the final round. In Round 3, the experts rated the importance of each confounder on a 7-point Likert scale. Consensus was reached if ≥75% of the experts considered the factor either extremely or moderately important. Results In Round 1, 120 confounders were proposed, which were synthesized into 38 distinct factors. In Round 2, 33 confounders met the criterion to be considered important. In Round 3, consensus was reached for 14 confounders: acute illness/trauma, immune disease, medication use, endocrine, nutritional, or metabolic disease, other musculoskeletal conditions, age, handling of blood samples, sex, cancer, body composition, pregnancy, cardiovascular disease, physical activity, and pain characteristics. Conclusions These findings provide insight in the complexity of the association between low-grade systemic inflammation and musculoskeletal pain. 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However, little is known about the relative importance of these factors, and few studies account for them. This Delphi study aimed to reach consensus on the most important confounders which influence the association between low-grade systemic inflammation and musculoskeletal pain. Methods The panel consisted of 48 experts. In Round 1, the experts proposed what they believed were important confounders. In Round 2, the experts indicated for each confounder whether they believed it was important (yes/no). At least 50% of experts had to indicate the confounder was important to be considered in the final round. In Round 3, the experts rated the importance of each confounder on a 7-point Likert scale. Consensus was reached if ≥75% of the experts considered the factor either extremely or moderately important. Results In Round 1, 120 confounders were proposed, which were synthesized into 38 distinct factors. In Round 2, 33 confounders met the criterion to be considered important. In Round 3, consensus was reached for 14 confounders: acute illness/trauma, immune disease, medication use, endocrine, nutritional, or metabolic disease, other musculoskeletal conditions, age, handling of blood samples, sex, cancer, body composition, pregnancy, cardiovascular disease, physical activity, and pain characteristics. Conclusions These findings provide insight in the complexity of the association between low-grade systemic inflammation and musculoskeletal pain. Some factors currently listed as confounders may be re-classified as moderators or mediators as insights progress.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>34343332</pmid><doi>10.1093/pm/pnab243</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-4409-9554</orcidid><orcidid>https://orcid.org/0000-0002-6524-7245</orcidid><orcidid>https://orcid.org/0000-0002-2293-0554</orcidid><orcidid>https://orcid.org/0000-0002-3958-4408</orcidid><oa>free_for_read</oa></addata></record>
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subjects Body composition
Cardiovascular diseases
Consensus
Delphi method
Delphi Technique
Development and progression
Humans
Immunological diseases
Inflammation
Metabolic disorders
Musculoskeletal diseases
Musculoskeletal Pain - diagnosis
Musculoskeletal Pain - epidemiology
Musculoskeletal, Rehabilitation & Regenerative Medicine Section
Pain
Physical activity
Risk factors
title Identifying the Most Important Confounders When Assessing the Association Between Low-Grade Systemic Inflammation and Musculoskeletal Pain: A Modified Delphi Study
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