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Gómez-Gómez E, Martínez-Salamanca JI, Bianco F, Miles BJ, Burgos J, Quintas JJ, Cano-Castiñeira R, Gómez-Ferrer Á, Rodríguez-Antolín A, Chéchile G, Fernández L, Martín A, Hidalgo P, Parramón M. ProsTAV, a clinically useful test in prostate cancer: an extension study. World J Urol 2024; 42:395. [PMID: 38985190 PMCID: PMC11236897 DOI: 10.1007/s00345-024-05098-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Accepted: 05/30/2024] [Indexed: 07/11/2024] Open
Abstract
PURPOSE To assess the clinical performance of ProsTAV®, a blood-based test based on telomere associate variables (TAV) measurement, to support biopsy decision-making when diagnosing suspicious prostate cancer (PCa). METHODS Preliminary data of a prospective observational pragmatic study of patients with prostate-specific antigen (PSA) levels 3-10 ng/ml and suspicious PCa. Results were combined with other clinical data, and all patients underwent prostate biopsies according to each center's routine clinical practice, while magnetic resonance imaging (MRI) before the prostate biopsy was optional. Sensitivity, specificity, positive and negative predicted values, and subjects where biopsies could have been avoided using ProsTAV were determined. RESULTS The mean age of the participants (n = 251) was 67.4 years, with a mean PSA of 5.90 ng/ml, a mean free PSA of 18.9%, and a PSA density of 0.14 ng/ml. Digital rectal examination was abnormal in 21.1% of the subjects, and according to biopsy, the prevalence of significant PCa was 47.8%. The area under the ROC curve of ProsTAV was 0.7, with a sensitivity of 0.90 (95% CI, 0.85-0.95) and specificity of 0.27 (95% CI, 0.19-0.34). The positive and negative predictive values were 0.53 (95% CI, 0.46-0.60) and 0.74 (95% CI, 0.62-0.87), respectively. ProsTAV could have reduced the biopsies performed by 27% and showed some initial evidence of a putative benefit in the diagnosis pathway combined with MRI. CONCLUSIONS ProsTAV increases the prediction capacity of significant PCa in patients with PSA between 3 and 10 ng/ml and could be considered a complementary tool to improve the patient diagnosis pathway.
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Affiliation(s)
- Enrique Gómez-Gómez
- Department of Urology, Hospital Universitario Reina Sofía, Universidad de Córdoba, IMIBIC, Córdoba, Spain
| | | | | | - Brian J Miles
- Urologic Oncology, Houston Methodist Hospital, Houston, TX, USA
| | - Javier Burgos
- Department of Urology, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Instituto Ramón y Cajal de Investigación Sanitaria, Madrid, Spain
| | | | - Roque Cano-Castiñeira
- Department of Urology, Hospital Universitario Reina Sofía, Universidad de Córdoba, IMIBIC, Córdoba, Spain
- Department of Urology, Hospital Infanta Margarita, Córdoba, Spain
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Beales D, Larsson ME, O'Sullivan P, Straker L, Linton SJ, Smith A. The Predictive Ability of the Full and Short Versions of the Orebro Questionnaire for Absenteeism and Presenteeism Over the Subsequent 12 Months, in a Cohort of Young Community-Based Adult Workers. J Occup Environ Med 2021; 63:1058-1064. [PMID: 34238909 DOI: 10.1097/jom.0000000000002314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The primary purpose of this study was to investigate the predictive ability of the Örebro Musculoskeletal Pain Screening Questionnaire (ÖMPSQ) in regard to work productivity (absenteeism and presenteeism) in early adulthood. METHODS A prospective study was performed using data from the Raine Study Generation 2 (Gen2) 22-year follow-up. The ÖMPSQ was completed at baseline, and absenteeism and presenteeism assessed at four intervals over the following 12 months. RESULTS In early adulthood, the full and short versions of the ÖMPSQ showed some predictive ability for work absenteeism but the Receiver Operator Characteristic demonstrated poor discrimination. There was no evidence of predictive ability for presenteeism. CONCLUSION Further work is required to increase the fidelity of screening for risk of reduced work productivity at the population level.
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Affiliation(s)
- Darren Beales
- Curtin enAble Institute and Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, GPO Box U1987, Perth, WA 6845, Australia (Dr Beales, Dr O'Sullivan, Dr Straker, and Dr Smith); Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden (Dr Larsson); Education, Research, and Development Primary Health Care, Region Västra Götaland, Sweden (Dr Larsson); Center for Health and Medical Psychology, School of Law, Psychology and Social Work, Örebro University, Örebro, Sweden (Dr Linton)
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3
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Macedo LG, Hodges PW, Bostick G, Hancock M, Laberge M, Hanna S, Spadoni G, Gross A, Schneider J. Which Exercise for Low Back Pain? (WELBack) trial predicting response to exercise treatments for patients with low back pain: a validation randomised controlled trial protocol. BMJ Open 2021; 11:e042792. [PMID: 33472786 PMCID: PMC7818834 DOI: 10.1136/bmjopen-2020-042792] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION Exercise therapy is the most recommended treatment for chronic low back pain (LBP). Effect sizes for exercises are usually small to moderate and could be due to the heterogeneity of people presenting with LBP. Thus, if patients could be better matched to exercise based on individual factors, then the effects of treatment could be greater. A recently published study provided evidence of better outcomes when patients are matched to the appropriate exercise type. The study demonstrated that a 15-item questionnaire, the Lumbar Spine Instability Questionnaire (LSIQ), could identify patients who responded best to one of the two exercise approaches for LBP (motor control and graded activity). The primary aim of the current study isill be to evaluate whether preidentified baseline characteristics, including the LSIQ, can modify the response to two of the most common exercise therapies for non-specific LBP. Secondary aims include an economic evaluations with a cost-effectiveness analysis. METHODS AND ANALYSIS Participants (n=414) will be recruited by primary care professionals and randomised (1:1) to receive motor control exercises or graded activity. Participants will undergo 12 sessions of exercise therapy over an 8-week period. The primary outcome will be physical function at 2 months using the Oswestry Disability Index. Secondary outcomes will be pain intensity, function and quality of life measured at 2, 6 and 12 months. Potential effect modifiers will be the LSIQ, self-efficacy, coping strategies, kinesiophobia and measures of nociceptive pain and central sensitisation. We will construct linear mixed models with terms for participants (fixed), treatment group, predictor (potential effect modifier), treatment group×predictor (potential effect modifier), physiotherapists, treatment group×physiotherapists and baseline score for the dependent variable. ETHICS AND DISSEMINATION This study received ethics approval from the Hamilton Integrate Research Ethics Board. Results will be submitted for publication in peer-reviewed journals. TRIAL REGISTRATION NUMBER NCT04283409.
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Affiliation(s)
- Luciana G Macedo
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Paul W Hodges
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, QLD, Australia
| | - Geoff Bostick
- Department of Physical Therapy, University of Alberta, Edmonton, Alberta, Canada
| | - Mark Hancock
- Department of Health Professions, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Maude Laberge
- Faculty of Administration, Universite Laval, Quebec, Quebec, Canada
| | - Steven Hanna
- Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
| | - Greg Spadoni
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Anita Gross
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Julia Schneider
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
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4
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Serrano-García A, Fernández-González M, Betegón-Nicolás J, Villar-Pérez J, Lozano-Muñoz A, Hernández-Encinas J, Fernández-Bances I, Esteban-Blanco M, Seco-Calvo JÁ. Evaluation of Dram Score as a Predictor of Poor Postoperative Outcome in Spine Surgery. J Clin Med 2020; 9:jcm9123825. [PMID: 33255911 PMCID: PMC7760254 DOI: 10.3390/jcm9123825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 11/20/2020] [Accepted: 11/22/2020] [Indexed: 11/16/2022] Open
Abstract
The Distress Risk Assessment Method (DRAM) was presented by Main, Wood and Hillis in 1992 as a simple means of assessing the risk of failure due to psychosocial factors in spine surgery. To our knowledge, it has not been used in our setting. The aim of this study was to analyse the usefulness of the Spanish translation of this instrument to predict poor outcomes. Methods: A prospective blind study was conducted including 65 patients undergoing spine surgery. We created two groups of patients based on DRAM score: not distressed (NDRAM) or distressed (DDRAM). A visual analogue scale for pain and the 12-Item Short Form Health Survey (SF-12) were used at baseline, 6 weeks and 6 months. Results: 24 patients were classified as DDRAM and 38 as NDRAM, with 3 patients not completing the questionnaires. The analysis found no significant differences in the demographic or clinical variables at baseline. At 6 weeks and 6 months, the NDRAM group showed improvements in low back pain (p < 0.001; p = 0.005), leg pain (p < 0.001; p = 0.017), physical health (p = 0.031; p = 0.003) and mental health (p = 0.137; p = 0.049). In contrast, in the DDRAM group, though leg pain score improved (p < 0.001; p = 0.002), there was no improvement at 6 weeks or 6 months in low back pain (p = 0.108; p = 0.287), physical health (p = 0.620; p = 0.263) or mental health (p = 0.185; p = 0.329). Conclusions: In our setting, the DRAM is a useful screening tool, and it has allowed the creation of a program between psychiatry and spine surgery.
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Affiliation(s)
- Antonio Serrano-García
- Psychiatry Service, Department of Psychosomatic, Complejo Asistencial Universitario de León, 24008 León, Spain
- Correspondence:
| | - Manuel Fernández-González
- Spine Unit, Department of Orthopedic Surgery and Traumatology, Complejo Asistencial Universitario de León, 24008 León, Spain; (M.F.-G.); (J.B.-N.); (J.V.-P.); (A.L.-M.); (J.H.-E.); (I.F.-B.); (M.E.-B.)
| | - Jesús Betegón-Nicolás
- Spine Unit, Department of Orthopedic Surgery and Traumatology, Complejo Asistencial Universitario de León, 24008 León, Spain; (M.F.-G.); (J.B.-N.); (J.V.-P.); (A.L.-M.); (J.H.-E.); (I.F.-B.); (M.E.-B.)
| | - Julio Villar-Pérez
- Spine Unit, Department of Orthopedic Surgery and Traumatology, Complejo Asistencial Universitario de León, 24008 León, Spain; (M.F.-G.); (J.B.-N.); (J.V.-P.); (A.L.-M.); (J.H.-E.); (I.F.-B.); (M.E.-B.)
| | - Ana Lozano-Muñoz
- Spine Unit, Department of Orthopedic Surgery and Traumatology, Complejo Asistencial Universitario de León, 24008 León, Spain; (M.F.-G.); (J.B.-N.); (J.V.-P.); (A.L.-M.); (J.H.-E.); (I.F.-B.); (M.E.-B.)
| | - José Hernández-Encinas
- Spine Unit, Department of Orthopedic Surgery and Traumatology, Complejo Asistencial Universitario de León, 24008 León, Spain; (M.F.-G.); (J.B.-N.); (J.V.-P.); (A.L.-M.); (J.H.-E.); (I.F.-B.); (M.E.-B.)
| | - Ignacio Fernández-Bances
- Spine Unit, Department of Orthopedic Surgery and Traumatology, Complejo Asistencial Universitario de León, 24008 León, Spain; (M.F.-G.); (J.B.-N.); (J.V.-P.); (A.L.-M.); (J.H.-E.); (I.F.-B.); (M.E.-B.)
| | - Marta Esteban-Blanco
- Spine Unit, Department of Orthopedic Surgery and Traumatology, Complejo Asistencial Universitario de León, 24008 León, Spain; (M.F.-G.); (J.B.-N.); (J.V.-P.); (A.L.-M.); (J.H.-E.); (I.F.-B.); (M.E.-B.)
| | - Jesús Ángel Seco-Calvo
- Institute of Biomedicine (IBIOMED), University of León, Campus de Vegazana, 24071 Leon, Spain;
- Department of Physiology, Visiting Researcher of Basque Country University, 48940 Leioa, Spain
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Multidimensional screening for predicting pain problems in adults: a systematic review of screening tools and validation studies. Pain Rep 2019; 4:e775. [PMID: 31875182 PMCID: PMC6882575 DOI: 10.1097/pr9.0000000000000775] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 06/11/2019] [Accepted: 06/26/2019] [Indexed: 12/14/2022] Open
Abstract
Screening tools allowing to predict poor pain outcomes are widely used. Often these screening tools contain psychosocial risk factors. This review (1) identifies multidimensional screening tools that include psychosocial risk factors for the development or maintenance of pain, pain-related distress, and pain-related disability across pain problems in adults, (2) evaluates the quality of the validation studies using Prediction model Risk Of Bias ASsessment Tool (PROBAST), and (3) synthesizes methodological concerns. We identified 32 articles, across 42 study samples, validating 7 screening tools. All tools were developed in the context of musculoskeletal pain, most often back pain, and aimed to predict the maintenance of pain or pain-related disability, not pain-related distress. Although more recent studies design, conduct, analyze, and report according to best practices in prognosis research, risk of bias was most often moderate. Common methodological concerns were identified, related to participant selection (eg, mixed populations), predictors (eg, predictors were administered differently to predictors in the development study), outcomes (eg, overlap between predictors and outcomes), sample size and participant flow (eg, unknown or inappropriate handling of missing data), and analysis (eg, wide variety of performance measures). Recommendations for future research are provided.
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[Effectiveness of a risk-tailored short intervention to prevent chronic low back pain : A cluster-randomized study in general practice]. Schmerz 2019; 33:226-235. [PMID: 30796580 DOI: 10.1007/s00482-019-0362-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND A subgroup of patients with acute low back pain (LBP) will develop chronic LBP. Risk factors summarized as yellow flags are fear-avoidance beliefs, depression, catastrophizing, and work-related problems. OBJECTIVE The aim was to evaluate the effectiveness of screening for yellow flags in general practice followed by a risk-tailored group intervention compared to care as usual. METHODS This is a cluster-randomized controlled trial in 35 general practices with 354 patients with acute LBP. Information or a standardized group intervention was offered to patients in the intervention group according to the screening algorithm with a short questionnaire for physical and psychosocial risk factors for chronic LBP. Standardized group information contained education concerning back pain and strategies for physical activities and planning of actions. Primary outcome was functional capacity assessed after 6 and 12 months with a questionnaire. Secondary outcomes were pain severity, fear avoidance beliefs, depression score, self-rated health and health service utilization. RESULTS The intervention had no clinically relevant effect on the primary outcome functional capacity and secondary outcomes, although the course was consistently slightly better. Adherence to the offered intervention was low. Health service utilization was not altered to a relevant extent. A subgroup analysis comparing adherent and non-adherent patients showed a consistently better course of adherent patients. CONCLUSIONS A risk-tailored short intervention to prevent chronic LBP in general practice had no significant impact on the clinical course compared to care as usual. A subgroup analysis comparing adherent and non-adherent patients suggests that it is possible to have a positive impact on patient-relevant outcomes.
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De Luca A, Mariani M, Riccardi MT, Damiani G. The role of the Cincinnati Prehospital Stroke Scale in the emergency department: evidence from a systematic review and meta-analysis. Open Access Emerg Med 2019; 11:147-159. [PMID: 31410071 PMCID: PMC6646799 DOI: 10.2147/oaem.s178544] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 06/21/2019] [Indexed: 01/01/2023] Open
Abstract
INTRODUCTION Stroke is one of the leading causes of morbidity, disability, and mortality in high-income countries. Early prehospital stroke recognition plays a fundamental role, because most clinical decisions should be made within the first hours after onset of symptoms. The Cincinnati Prehospital Stroke Scale (CPSS) is a validated screening tool whose utilization is suggested during triage. The aim of this study is to review the role of the CPSS by assessing its sensitivity and specificity in prehospital and hospital settings. METHODS A systematic review and a meta-analysis of the literature reporting the CPSS sensitivity and specificity among patients suspected of stroke were undertaken. Electronic databases were searched up to December 2018, and the quality assessment was carried out by using the Revised Quality Assessment of Diagnostic Accuracy Studies -2 (QUADAS-2). RESULTS Eleven studies were included in the meta-analysis. Results showed an overall sensitivity of 82.46% (95% confidence interval [CI] 74.83-88.09%) and specificity of 56.95% (95% CI 41.78-70.92). No significant differences were found in terms of sensitivity when CPSS was performed by physicians (80.11%, 95% CI 66.14-89.25%) or non-physicians (81.11%, 95% CI 69.78-88.87%). However, administration by physicians resulted in higher specificity (73.57%, 95% CI 65.78-80.12%) when compared to administration by non-physicians (50.07%, 95% CI 31.54-68.58%). Prospective studies showed higher specificity 71.61% (95% CI 61.12-80.18%) and sensitivity 86.82% (95% CI 74.72-93.63) when compared to retrospective studies which showed specificity of 33.37% (95% CI 22.79-45.94%) and sensitivity of 78.52% (95% CI 75.08-81.60). CONCLUSIONS The CPSS is a standardized and easy-to-use stroke screening tool whose implementation in emergency systems protocols, along with proper and consistent coordination with local, regional, and state agencies, medical authorities and local experts are suggested.
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Affiliation(s)
- A De Luca
- Istituti Fisioterapici Ospitalieri, Rome, Italy
| | - M Mariani
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - MT Riccardi
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - G Damiani
- Università Cattolica del Sacro Cuore, Rome, Italy
- Fondazione Policlinico Universitario A. Gemelli Istituto di Ricerca e Cura a Carattere Scientifico (IRCCS), Rome, Italy
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Lheureux A, Berquin A. Comparison between the STarT Back Screening Tool and the Örebro Musculoskeletal Pain Screening Questionnaire: Which tool for what purpose? A semi-systematic review. Ann Phys Rehabil Med 2019; 62:178-188. [PMID: 30342997 DOI: 10.1016/j.rehab.2018.09.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 08/31/2018] [Accepted: 09/15/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND Prevention of chronicization of low back pain requires accurate detection of at-risk patients. Questionnaires have been validated, including the STarT Back Screening Tool (SBST) and the Örebro Musculoskeletal Pain Screening Questionnaire (OMPSQ). This review aims to compare these questionnaires in terms of predictive value and in terms of aims, to guide the choice in clinical practice. METHODS This study is a semi-systematic literature review. Studies evaluating at least one of the questionnaires and written between 1997 and October 10th 2017 were selected from Pubmed database. Inclusion criteria were pain duration<3months, outcomes including pain, function and/or global recovery. For work outcomes, inclusion criteria were extended to chronic patients. Studies had to provide information on sensitivity, specificity and area under the ROC Curve (AUC). RESULTS Twenty-eight studies met our inclusion criteria (7 SBST, 21 original OMPSQ, 3 short OMPSQ). The OMPSQ best predicted a Pain NRS≥3 at 3 months (AUC=0.64 (0.50-0.78)) and at 6 months (AUC between 0.70 (no confidence interval provided) and 0.84 (0.71-0.97)). The SBST and the OMPSQ are comparable to predict an Oswestry Disability Index≥30% at 6 months. A single study showed no difference between the SBST and the OMPSQ to predict absenteeism≥30 days at 6 months. The two questionnaires cannot be compared for "global recovery" outcomes. CONCLUSION The OMPSQ seems better than the SBST for predicting "pain" and "work" outcomes, the SBST may be better for "function" outcomes. These results should be taken with caution because of the high heterogeneity between studies. It should be noted that the OMPSQ was elaborated with the aim of creating a prognostic tool while the SBST was devised as a treatment-allocating tool and is easier to use in clinical practice. This should guide the choice of using one questionnaire rather than the other.
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Affiliation(s)
- Alexis Lheureux
- Université catholique de Louvain, Institut de Recherche Expérimentale et Clinique, Neuro Musculo Skeletal lab, Avenue Mounier 53/B1.53.07, 1200 Brussels, Belgium.
| | - Anne Berquin
- Department of Physical and Rehabilitation Medicine, Cliniques universitaires Saint-Luc, Avenue Hippocrate 10/1650, 1200 Brussels, Belgium.
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Böger A, Braun C, Butz M. [Help for self-help for patients with chronic pain]. MMW Fortschr Med 2017; 159:64-68. [PMID: 29468510 DOI: 10.1007/s15006-017-0069-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Andreas Böger
- DRK-Klinken Nordhessen gGmbH, Klinik für Schmerzmedizin, Hansteinstraße 29, D-34121, Kassel, Deutschland.
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