Prognostic factors associated with changes in knee pain outcomes, identified from initial primary care consultation data. A systematic literature review

• Published in: Annals of medicine (Helsinki) 2023-12, Vol.55 (1), p.401-418
• Main Authors: Collier, Thomas S., Hughes, Tom, Chester, Rachel, Callaghan, Michael J., Selfe, James
• Format: Article
• Language: English
• Subjects: Adult; Humans; knee pain; musculoskeletal; Pain - diagnosis; Pain - etiology; Primary Care; Primary Health Care; Prognosis; prognostic factors; Prospective Studies; Reproducibility of Results; systematic literature review; Systematic Review
• ISSN: 0785-3890; 1365-2060
• DOI: 10.1080/07853890.2023.2165706

Data collected during initial primary care consultations could be a source of baseline prognostic factors associated with changes in outcome measures for patients with knee pain. To identify, appraise and synthesize studies investigating prognostic factors associated with changes in outcome for people presenting with knee pain in primary care. EMBASE, CINAHL, AMED, MEDLINE and MedRxiv electronic databases were searched from inception to March 2021 and repeated in August 2022. Prospective cohort studies of adult participants with musculoskeletal knee pain assessing the association between putative prognostic factors and outcomes in primary care were included. The Quality in Prognostic Studies (QUIPS) tool and The Modified Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework, specific to prognostic reviews were used to appraise and synthesize the evidence respectively. Eight studies were included. Eight knee pain outcomes were identified. Methodological and statistical heterogeneity resulted in qualitative analysis. All evidence was judged to be of low to very low quality. Bilateral knee pain (multivariable odds ratio (OR) range 2.60-2.74; 95%CI range 0.90-8.10, p value = 0.09) and a lower educational level (multivariable (OR) range 1.74-5.6; 95%CI range 1.16-16.20, p value =