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Personalised Prognostic Models to Improve Well-being and Return to Work After Neck and Low Back Pain

Periodic Reporting for period 2 - Back-UP (Personalised Prognostic Models to Improve Well-being and Return to Work After Neck and Low Back Pain)

Reporting period: 2019-07-01 to 2021-04-30

Neck and low back pain (NLBP) are leading causes for years lived with disability in Europe and worldwide. About 70% of all adults experience NLBP at some point in their lives, and both conditions are among the top ten in terms of overall disease burden expressed as disability adjusted life years. Management of NLBP is a difficult challenge for healthcare professionals since their decisions have a decisive impact on the patient’s future health and welfare, as well as on the economic burden on the public and private healthcare systems. However, health professionals often lack appropriate information to tailor the management and follow-up of individual patients and to predict the outcome of a certain treatment.

The overall aim of the Back-UP project is to develop a tool with patient-specific prognostic models, to support more effective and efficient management of NLBP, based on the digital representation of multidimensional clinical information, including: personal, health, psychological, behavioural, and socioeconomic factors related to NLBP; biological patient characteristics, including musculoskeletal structures and function, and molecular data; and workplace and lifestyle risk factors. Back-UP will provide prognostics of pain, disability, function and time off work in the following weeks and months after clinic consultations, and support to rehabilitation, return to work and self-management, including tailored personalised plans.

Back-UP is targeted to a wide range of clinicians that deal with patients with NLBP like general practitioners, physiotherapists, chiropractors, occupational clinicians, etc., occupational managers, and patients. Different platforms, optimised for those user profiles, will be developed and integrated, based on state-of-the-art digital health technologies.
During the first half of the project, the system requirements of Back-UP have been completed, and the first prototype of the Professional and Researcher Platforms have been set up. Various systematic reviews and experimental activities have been carried out and their results have been used to develop the first models (risk stratification at the first contact; pain, disability, function and time off work prognostics at 2 and 6 months; integrity assessment and progression in WAD rehabilitation). Clinical guidelines and trials have been reviewed, and a clinical advisory group has been constituted to define matched treatments and advice for return to work. The constings of NLBP have been analysed for the national Spanish context.
The research that has been carried out in Back-UP approaches NLBP from a multi-dimensional perspective, which considers dozens of health related variables, including demographic traits, clinical history, reported outcomes, physical tests and biomarkers. More than twenty first-line treatments are evaluated and tailored by the models, which include expected pain, function and time-off-work outcomes over 6 month. During the second period of the project the platform and the models will be extended with the results of futher studies, including a large ongoing study about glycans and chronic low back pain. Tools and models will be validated with a usability and retrospective study.

Back-UP is expected to maximise treatment benefits in the patients who need it, and reduce overtreatment and harm in those at low risk. This will reduce healthcare costs related to NLBP and increase work productivity.
Back-UP workflow
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