Dialogue Support for Spine Surgery — Based on Swespine, the Swedish Spine Registry
All Interested Users Should Be Aware of the Following
The Dialogue Support is predicting outcome 1 year after surgery for spinal disorders. The underlying prediction models used have been trained on a sizable body of data throughout Sweden during a 10-year period and is updated every year. The data quantity thus always includes outcomes no more than 1 year old.
The prediction is demonstrated as a proportion of a specific group achieving a certain outcome, here Global assessment (“Totally pain free-Much better-Somewhat better-Unchanged-Worse”) *, and gives a measure of the probability of a certain outcome for an individual with a selected baseline patient profile. Each prediction algorithm (one per specific group) was based on 2-12000 individuals answering the PROM.
The number of observations refers to the total number of Index surgeries that serve as the basis for the prediction models and is not specific for selected patient types. The models have no information about patients with characteristics outside the range of previously treated patients. Extending the model to exceptionally unusual combinations of characteristics can produce erroneous results. Thus, tool usage needs to be combined with clinical judgement. Age is however a built-in limitation: 1. Spinal stenosis and DDD ≥ 20 years; 2. Disc herniation and isthmic spondylolysis/-listhesis ≥ 10 years. Cases below these limits are extremely rare.
Any user outside Sweden should also be aware of the fact that the predictions are based on a Swedish population with its perhaps specific characteristics. Populations in other countries may have other characteristics resulting in different predictions. Therefore predictions produced in this Dialogue Support have to be interpreted with some caution, until the model has been tested on a population in the country you wish to apply it on.
Olle Hägg and Peter Fritzell for the Steering group/Swespine
* Fritzell P, Mesterton J, Hagg O. Prediction of outcome after spinal surgery-using The Dialogue Support based on the Swedish national quality register. Eur Spine J. 2022 Apr;31(4):889-900.
* Hägg O, Fritzell P, Odén A, Nordwall A; Swedish Lumbar Spine Study Group. Simplifying outcome measurement: evaluation of instruments for measuring outcome after fusion surgery for chronic low back pain. Spine 2002 Jun 1;27(11):1213-22.