Lower back pain (LBP) is a common problem that will affect many people at some point in their lifetime, but there is limited information available on the number of annual incidences in the UK, which makes it difficult to determine the health benefits gained from research-led LBP treatments, or whether these treatments are cost effective. We must first understand the number of incidences of diagnosis for lower back pain in the UK annually over a period of 20 years. The CPRD provides the most robust long-term data on trends which indicates the total UK population diagnosed with LBP annually, broken down by age and gender. The data collected on the incidence of lower back pain will be used to inform a wider study which estimates returns to UK publicly funded musculoskeletal-related research to better understand the impacts of investment into biomedical research, including the economic benefits.
Data on the incidence of lower back pain (LBP) in the UK is not publicly available. This protocol proposes a simple descriptive study using primary care data from the CPRD database to determine the incidence of lower back pain on an annual basis to determine the proportion of the population receiving research led interventions in the UK. This study will obtain age specific incidence rates on an annual basis (from 1994 to 2013) from the CPRD database. Incidence rates for back pain will be estimated using aggregated counts for new incidences as numerator and person years as denominator. Confidence intervals will be estimated using the binomial distribution (unless working with small values, in which case a partial distribution will be used to estimate the confidence intervals). As indicated above incidence rates will be estimated by gender and five year age group for each year between 1994 and 2013. This study will feed into a wider research study to inform a model of the returns to UK publicly funded musculoskeletal-related research in terms of the net value of improved health outcomes.
The only measure of interest is the occurrence of new diagnoses of back pain. These will be identified from the appended code list. We will use the CPRD GOLD Define tool to identify new incidences of back pain that were more than 12 months after the start of patients' records. The 'results' file from the Define tool will give use index-dates for each patient. We can merge this data with the Denominator file, and then aggregate the person years and new incidences of back pain by calendar year, gender and five-year age group.
Jonathan Grant - Chief Investigator - King's College London (KCL)
Martin Gulliford - Corresponding Applicant - King's College London (KCL)
Alexandra (Alex) Pollitt - Collaborator - King's College London (KCL)
Erin Montague - Collaborator - King's College London (KCL)
Matthew Glover - Collaborator - Brunel University London
Stephen Hanney - Collaborator - Brunel University London
Susan Guthrie - Collaborator - Rand Europe