Hanne B Albert

University of Southern Denmark | SDU

Objective: To quantify variability in the results of statistical analyses based on contingency tables and discuss the implications for the choice of sample size for studies that derive clinical prediction rules. Study design and setting: An analysis of three pre-existing sets of large cohort data (n= 4,062 to 8,674) was performed. In each datase...

Background: Magnetic resonance imaging (MRI) is used to identify spinal pathoanatomy in people with persistent low back pain. However, the clinical relevance of spinal degenerative MRI findings remains uncertain. Although multiple MRI findings are almost always present at the same time, research into the association with clinical outcomes (such as...

Large-scale clinical registries are increasingly recognized as important resources for quality assurance and research to inform clinical decision-making and health policy. We established a clinical registry (SpineData) in a conservative care setting where more than 10,000 new cases of spinal pain are assessed each year. This paper describes the Spi...

Objective: To determine the psychometric properties of the 23-item version of the Roland Morris Disability Questionnaire (RMDQ-23) and to quantify their stability across 2 cultures/languages and 2 types of care-settings. Methods: Rasch analysis of data from 1,000 patients with low back pain from primary care (UK and Denmark) and secondary care (...

Purpose Low back pain (LBP) is common and social isolation is both a risk factor for poor recovery from LBP and a consequence of LBP. The Friendship Scale is a brief measure of social isolation that has been validated for use in the general population and in people with LBP. The aim of this study was to translate, culturally adapt and validate the...

Background Perceived social isolation is prevalent among patients with low back pain (LBP) and could be a potential prognostic factor for clinical outcomes following an episode of LBP.MethodsA secondary analysis of an original prospective cohort study, which investigated the validity of the Danish version of the STarT Back Screening Tool (STarT), i...

Background Modic type 1 changes (bone edema) in the vertebrae are present in 6% of the general population and in 35 to 40% of the low back pain population. It is strongly associated with low back pain (LBP). The aim was to test the efficacy of antibiotic treatment in patients with chronic LBP (> 6 months) and Modic type 1 changes (bone edema). Met...

(i) to test the concurrent validity of brief screening questions for five psychosocial constructs (anxiety, depression, social isolation, catastrophization and fear of movement), and (ii) to translate into Danish and validate those screening questions. Data were collected from five cross-sectional samples (total n=1105) of people seeking care for l...

The author of this Letter to the Editor claims that he felt that he needed to review this paper carefully because Professor Claus Manniche, in addition to his full-time job, recently started a clinic where he treats patients with Modic changes and chronic lower back pain. It is not true that Claus Manniche after the publishing of the paper has esta...

The anaerobic skin commensal Propionibacterium acnes is an underestimated cause of human infections and clinical conditions. Previous studies have suggested a role for the bacterium in lumbar disc herniation and infection. To further investigate this, five biopsy samples were surgically excised from each of 64 patients with lumbar disc herniation....

To describe and interpret Danish Chiropractors' perspectives regarding the purpose and rationale for using MC (maintenance care), its content, course and patient characteristics. Semi-structured interviews were conducted with 10 chiropractors identified using a stratified, theoretical sampling framework. Interviews covered four domains relating to...

The writer of the Letter to the Editor wonders why since several of the authors of the papers are members of the MAST Academy that “no competing interest” was declared. This was not declared because there are/were no competing interests.

Thank you for your kind comments regarding our study. We fully agree that patients who receive this antibiotic treatment should be carefully chosen. In your letter, you urge caution due to the worry that the infection in the disc is due to previous surgery, local injections or epidurals. You propose that patients who have not had previous surgica...

The predictive ability of the STarT Back Tool (SBT) in secondary care settings has not been investigated. The aim of this study was to determine the SBT's predictive ability in a Danish secondary care setting and compare this to a Danish primary care setting. Poor clinical outcome at 6 months (>30 points on a 0-100 Roland Morris Disability Scale) w...

Background Low back pain (LBP) patients with related leg pain have a more severe profile than those with local LBP and a worse prognosis. Pain location above or below the knee and the presence of neurological signs differentiate patients with different profiles, but knowledge about the prognostic value of these subgroups is sparse. The objectives o...

Purpose: Modic type 1 changes/bone edema in the vertebrae are present in 6 % of the general population and 35-40 % of the low back pain population. It is strongly associated with low back pain. The aim was to test the efficacy of antibiotic treatment in patients with chronic low back pain (>6 months) and Modic type 1 changes (bone edema). Methods...

PURPOSE: To investigate the prevalence of infected herniated nucleus material in lumbar disc herniations and to determine if patients with an anaerobic infected disc are more likely to develop Modic change (MC) (bone oedema) in the adjacent vertebrae after the disc herniation. MCs (bone oedema) in vertebrae are observed in 6 % of the general popula...

Purpose: The STarT Back Tool (SBT) was recently translated into Danish and its concurrent validity described. This study tested the predictive validity of the Danish SBT. Methods: Danish primary care patients (n = 344) were compared to a UK cohort. SBT subgroup validity for predicting high activity limitation at 3 months' follow-up was assessed...

Background Leg pain associated with low back pain (LBP) is recognized as a risk factor for a poor prognosis, and is included as a component in most LBP classification systems. The location of leg pain relative to the knee and the presence of a positive straight leg raise test have been suggested to have clinical implications. To understand differen...

Differences between the psychosocial risk factors of low back pain (LBP) patients in primary and secondary care are under-investigated. Similarly, differences in the psychosocial profile of people classified into STarT Back Screening Tool (SBT) subgroups in primary and secondary care settings have not been investigated. The aim of the study was to...

We thank you for your Letter to the Editor and would like to reply to the comments: 1. The patients were examined once at baseline by the blinded examiner and classified at that time point. We agree with the comments in the Letter to the Editor that it is most likely that the peripheralizers later became centralizers. The theory that the classific...

To determine the frequency of different patterns of centralization and their association with outcomes and MRI findings in patients experiencing sciatica. A prospective longitudinal cohort study of 176 patients with radicular pain below the knee, who all had an MDT clinical assessment. Based on their pain response, patients were divided into five g...

Although reproducibility in reading MRI images amongst radiologists and clinicians has been studied previously, no studies have examined the reproducibility of inexperienced clinicians in extracting pathoanatomic information from magnetic resonance imaging (MRI) narrative reports and transforming that information into quantitative data. However, th...

The STarT Back Screening Tool (STarT) is a nine-item patient self-report questionnaire that classifies low back pain patients into low, medium or high risk of poor prognosis. When assessed by GPs, these subgroups can be used to triage patients into different evidence-based treatment pathways. The objective of this study was to translate the English...

Modic changes are of increasing interest, however their age and gender prevalence are not well described. To date, the associations between Modic changes and other common vertebral pathologies have only been described in small samples (n < 100). Our aim was, in a large dataset of people with low back pain, to (1) describe the prevalence of a range...

This study was designed to investigate whether the PainDETECT Questionnaire (PDQ) classification was predictive of outcomes at 3 and 12 months follow-up in low back pain (LBP) patients with associated leg pain. Identification of clinically important subgroups and targeted treatment is believed to be important in LBP care. The PD-Q is designed to cl...

Prospective single-blind, randomized, clinical, controlled trial. To evaluate the efficacy of active conservative treatment and to compare 2 active conservative treatment programs for patients with severe sciatica. Reviews have demonstrated little or no efficacy for passive conservative treatment modalities in patients suffering from sciatica. The...

The aim of this study was via PET imaging to reveal if any highly metabolic processes were occurring in Modic changes type 1 and/or in the adjacent discs. Modic changes (MC) are signal changes in the vertebral endplate and body visualised by magnetic resonance imaging (MRI). MC are strongly associated with low back pain (LBP). MC type 1 appear to b...

The aim of this study was to assess the clinical effect of antibiotic treatment in a cohort of patients with low-back pain (LBP) and Modic changes Type 1 (bone oedema) following a lumbar herniated disc. This was a prospective uncontrolled trial of 32 LBP patients who had Modic changes and were treated with Amoxicillin-clavulanate (500 mg/125 mg) 3...

A guideline on pelvic girdle pain (PGP) was developed by "Working Group 4" within the framework of the COST ACTION B13 "Low back pain: guidelines for its management", issued by the European Commission, Research Directorate-General, Department of Policy, Coordination and Strategy. To ensure an evidence-based approach, three subgroups were formed to...

The shape and orientation of the thoracic and lumbar zygapophyseal facets at the T1-L5 level in children were measured and analyzed. To detect the pattern of zygapophyseal facet asymmetry in the thoracic and lumbar spines in children. Whereas many studies have defined the pattern of zygapophyseal facet asymmetry in adults, there is insufficient dat...

Unlabelled: In patients with low back pain (LBP) it is only possible to diagnose a small proportion, (approximately 20%), on a patho-anatomical basis. Therefore, the identification of relevant LBP subgroups, preferably on a patho-anatomical basis, is strongly needed. Signal changes on MRI in the vertebral body marrow adjacent to the end plates als...

Only a small proportion (20%) of patients with LBP can be diagnosed based on a patho-anatomical entity. Therefore, the identification of relevant subgroups, preferably on a patoanatomical basis, is strongly needed. Modic changes have been described by several authors as being closely linked with LBP. The aims of this study were to describe the prev...

The aims of this study were to investigate the possible prognostic value of disk-related magnetic resonance imaging (MRI) findings in relation to recovery at 14 months in patients with severe sciatica, and whether improvement of disk herniation and/or nerve root compromise is concurrent with recovery. All patients included in this prospective obser...

This study investigates whether it is possible to reproduce the lumbar lordosis in the upright position during magnetic resonance imaging (MRI) by positioning the patient supine with straightened lower extremities and investigates intra- and interexaminer reliability of measurements of the lumbar lordosis on radiographs and MRI. This was an observa...

Hintergrund: Beckengürtelschmerz (BGS) ist eine häufig auftretende spezifische Form von Rückenschmerz. Schmerz verursachende Strukturen bei Beckengürtelschmerz sind das Iliosakralgelenk (ISG) und in geringerem Maß die Symphysis pubica. Ein Zusammenhang zu nicht optimaler Stabilität des Beckengürtels scheint erwiesen. Ziel: Dieser Artikel ist eine k...

A prospective observational study of patients with sciatica. To describe the 14-month development of disc-related MRI findings in patients with sciatica receiving active conservative treatment. Previous studies of disc changes over time have reported reduction of herniations in 35% to 100% of cases. This wide range may be explained by differences i...

In this prospective epidemiologic cohort study the aim was to identify possible risk factors for developing four different syndromes of pelvic girdle pain during pregnancy. Over a one-year period a total of 2,269 consecutive pregnant women -- at week 33 of gestation -- responded to a structured questionnaire and underwent a thorough physical examin...

In a group of 188 consecutive patients with sciatica, three intradural tumors, one case of bone metastasis and one case of pre-erosive bone marrow changes indicating early spondylarthropathy were diagnosed by lumbar MRI. Most of these cases could have been missed with CT. When imaging is needed in cases of sciatica, MRI should be the first choice.

Introduction: The main concern of patients with low back pain is the functional limitation which the symptoms cause. Therefore it is important to find a valid tool by means of which their functional level can be assessed. The aim of this study was to validate the first Danish translation of the Roland Morris Questionnaire (RMQ), which evaluates the...

The main concern of patients with low back pain is the functional limitation which the symptoms cause. Therefore it is important to find a valid tool by means of which their functional level can be assessed. The aim of this study was to validate the first Danish translation of the Roland Morris Questionnaire (RMQ), which evaluates the functional le...

A prospective epidemiologic cohort study. To determine the incidence of clearly defined pelvic joint pain in pregnancy based on both history and objective confirmation and to classify pelvic joint pain into four groups and determine their incidence. Pelvic and low back pain in pregnancy is a substantial problem, and the correct treatment is hampere...

The aim of the present study was to describe, on the basis of specific classification criteria and for a period of two years after delivery, the prognosis for women suffering from pregnancy-related pelvic joint pain, and to describe the characteristics influencing the prognosis. One thousand seven hundred and eighty-nine pregnant women who were boo...

Pain in the pelvic joints and lower back, a major problem for pregnant women, has proved resistant to precise measurement and quantification. To develop a classification system, the clinical tests used must be able to separate pelvic from low back pain; they must also have a high inter-examiner reliability, sensitivity and specificity, and preferab...

This study evaluates group treatment for women suffering from chronic pelvic pain. The concept of group treatment was based on psychosomatic and physio-therapeutical principles and on cognitive and operant behavioral therapy. Each group was composed of up to six women suffering from chronic pelvic pain, and two physiotherapists. Each group treatmen...

The hormone relaxin induces loosening of the pelvic ligaments and joints in several species. Previous studies have suggested a similar role for relaxin during human pregnancy. Furthermore, a correlation has been noted between high circulating levels of this hormone and severe pelvic pain in pregnant women. The present study was designed to evaluate...