Table 3 Data extraction for classification systems: Systems classifying by Clinical Features

Barker (1990) [79]

Devise classification meaningful to General Practitioner (GP).

Judgemental approach.

GP authorship.

Low Back Pain (LBP).

486 patients attending authors’ GP practice.

Febrile illness, backache accompanied by many other complaints.

1: Acute lumbago

2: Acute mechanical derangement

3: Acute sciatica

4: Sacro-iliac joint (SIJ)

5: Mild sciatica

Patient history, pain location drawings, clinical examination.

None.

Ben Debba et al. (2000) [36]

Assign LBP patients into one of four modified Quebec Task Force Classification categories.

Judgemental and statistical approach.

Neurosurgeon authorship.

Persistent LBP.

1,997 patients from tertiary care.

Age under 25, ≥1 prior surgical or interdiscal procedure, no pain in the small of the back.

1: Back pain only

2: Back and above knee pain

3: Back and below knee pain

4: Back and below knee pain with positive straight leg raise (SLR)

Spatial distribution of patient’s pain (from questionnaire).

Results of SLR test.

Standardization of SLR performed by clinician or technician.

Glassman et al. (2011) [37]

Develop simple diagnostic classification for use in clinical practice.

Judgement approach.

Orthopaedic spine surgeon authorship.

LBP.

Case histories compiled.

None.

Clinical Symptoms

(relevant to primary care):

1-6: Dominant location of pain

7: Neurogenic claudication

8: Cauda equine

Additional axis: Yes

Acute/chronic

Patient history and clinical examination.

Not known. Case histories were compiled and reviewed by orthopaedic spine surgeons.

Nachemson and Andersson (1982) [80]

Introduce a simple classification system suitable for use in epidemiological screening.

Judgement approach.

Orthopaedic spine surgeon authorship.

LBP.

None.

1: Insufficienta dorsi

2: Lumbago

3: Sciatica

4: Rhizopathy

5: Lumbago sciatica

Additional axis: Yes-

Duration and recurrence

Patient history and clinical examination.

Radiographic results can be used.

Authors report it is simple to use.

Spitzer et al. (1987) [25]

Compile a diagnostic classification system for: clinical decision making; establishing prognosis; evaluating quality of care; Conducting scientific research.

Judgement approach.

Multidisciplinary task force representing wide range of disciplines.

LBP.

None.

1: Pain without radiation

2: Pain + radiation proximal extremity

3: Pain + radiation distal extremity

4: Pain + radiation to upper limb/lower limb with neurological signs

5: Presumptive root compression, +ve image

6: Root compression, +ve image

7: Spinal stenosis

8: Post surgical < 6 months

9: Post surgical > 6 months

10: Chronic pain syndrome

11: Other diagnoses

Additional Axis: Yes

Work and duration

Patient history.

Clinical examination and paraclinical test results (laboratory tests, radiography, imaging methods, Electromyography (EMG) nerve blocks).

Able to interpret investigative tests.

Sweetman et al. (1992) [26]

Describe common patterns of LBP and identify clinical tests to help recognize the patterns.

Statistical approach.

Rheumatologists authorship.

LBP.

301 patients referred from GP to rheumatology clinic.

Less than 15 or over 75 years old.

1: Persistent unilateral back pain and sciatica

2: Back pain or sciatic switching sides(sacroiliitis)

3: Central/bilateral back pain

4: Lateral flexion or rotation cause pain on the opposite side(facet joint)

5: Back pain at rest on one side but pain on opposite side with several tests (unstable L4/5 syndrome)

6: Dorso lumbar junction conditions

7. Persistent unilateral back pain and sciatica with loss of lower limb reflex (Disc with nerve root compression)

Questionnaire and clinical examination and x-ray.

Uses a computer algorithm for pattern recognition.