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Artificial intelligence to improve back pain outcomes and lessons learnt from clinical classification approaches: three systematic reviews

Version 3 2024-06-14, 18:18
Version 2 2024-06-05, 03:58
Version 1 2020-06-04, 13:18
journal contribution
posted on 2024-06-14, 18:18 authored by SD Tagliaferri, M Angelova, X Zhao, PJ Owen, Clint MillerClint Miller, Tim WilkinTim Wilkin, DL Belavy
AbstractArtificial intelligence and machine learning (AI/ML) could enhance the ability to detect patterns of clinical characteristics in low-back pain (LBP) and guide treatment. We conducted three systematic reviews to address the following aims: (a) review the status of AI/ML research in LBP, (b) compare its status to that of two established LBP classification systems (STarT Back, McKenzie). AI/ML in LBP is in its infancy: 45 of 48 studies assessed sample sizes <1000 people, 19 of 48 studies used ≤5 parameters in models, 13 of 48 studies applied multiple models and attained high accuracy, 25 of 48 studies assessed the binary classification of LBP versus no-LBP only. Beyond the 48 studies using AI/ML for LBP classification, no studies examined use of AI/ML in prognosis prediction of specific sub-groups, and AI/ML techniques are yet to be implemented in guiding LBP treatment. In contrast, the STarT Back tool has been assessed for internal consistency, test−retest reliability, validity, pain and disability prognosis, and influence on pain and disability treatment outcomes. McKenzie has been assessed for inter- and intra-tester reliability, prognosis, and impact on pain and disability outcomes relative to other treatments. For AI/ML methods to contribute to the refinement of LBP (sub-)classification and guide treatment allocation, large data sets containing known and exploratory clinical features should be examined. There is also a need to establish reliability, validity, and prognostic capacity of AI/ML techniques in LBP as well as its ability to inform treatment allocation for improved patient outcomes and/or reduced healthcare costs.

History

Journal

npj Digital Medicine

Volume

3

Article number

ARTN 93

Pagination

1 - 16

Location

England

Open access

  • Yes

ISSN

2398-6352

eISSN

2398-6352

Language

English

Publication classification

C1 Refereed article in a scholarly journal

Issue

1

Publisher

NATURE RESEARCH