ORCID Profile
0000-0002-5777-4117
Current Organisation
University of Nottingham
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Publisher: Springer Science and Business Media LLC
Date: 04-07-2019
Publisher: Elsevier BV
Date: 06-2021
Publisher: BMJ
Date: 10-2019
DOI: 10.1136/BMJOPEN-2018-025357
Abstract: We have previously developed and validated the Arthritis Research UK Musculoskeletal Health Questionnaire (MSK-HQ) for use across musculoskeletal care pathways, showing encouraging psychometric test results. The objective of this study was to determine the responsiveness of MSK-HQ following MSK treatments and to determine the minimally important change (MIC). We collected data in four cohorts from community physiotherapy and secondary-care orthopaedic hip, knee and shoulder clinics. 592 in iduals were recruited 210 patients treated with physiotherapy for a range of MSK conditions in primary care 150 patients undergoing hip replacement, 150 patients undergoing knee replacement and 82 undergoing shoulder surgery in secondary care. Preoperative data were collected including the MSK-HQ, European Quality of Life-5D (EQ-5D) and the OHS, OKS or OSS in each joint-specific group. The same scores, together with anchor questions, were collected postintervention at 3 months for the physiotherapy group and 6 months for all others. Following COnsensus-based Standards for the selection of health status Measurement INstruments (COSMIN) guidelines, responsiveness was assessed using correlation between scores and the MIC was calculated for the entire cohort using receiver operating characteristic curve analysis. The MSK-HQ demonstrated strong correlation (R=0.73) with EQ-5D across the entire cohort and with each of the joint-specific Oxford scores (hip R=0.87, knee R=0.92 and shoulder R=0.77). Moderate correlation was seen between MSK-HQ and EQ-5D across each in idual group (R value range 0.60–0.68), apart from the hip group where correlation was strong (R=0.77). The effect size with MSK-HQ was 0.93, in the entire cohort, double that measured with EQ-5D (0.43). In all subgroups, MSK-HQ measured a greater treatment effect compared with EQ-5D. The MIC is 5.5 (95% CI 2.7 to 8.3). Our study demonstrates that the MSK-HQ questionnaire is responsive to change across a range of musculoskeletal conditions, supporting its use as a generic MSK measurement instrument.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 24-08-2020
DOI: 10.1097/AJP.0000000000000879
Abstract: Little is known about the epidemiology of neuropathic pain in primary care patients consulting with low back-related leg pain. We aimed to describe prevalence, characteristics, and clinical course of low back-related leg pain patients with and without neuropathic pain, consulting with their family doctor in the United Kingdom. This was a prospective cohort study. Data were collected using a standardized baseline clinical examination and self-report questionnaires at baseline, 4, 12, and 36 months. We identified cases of neuropathic pain using 3 definitions: 2 based on clinical diagnosis (sciatica, with and without evidence of nerve root compression on magnetic resonance imaging), one on the self-report version of Leeds Assessment for Neurological Symptoms and Signs. Differences between patients with and without neuropathic pain were analyzed comparing each definition. Clinical course (mean pain intensity measured as the highest of leg or back pain intensity: mean of 3 Numerical Rating Scales, each 0 to 10) was investigated using linear mixed models over 36 months. Prevalence of neuropathic pain varied from 48% to 74% according to definition used. At baseline, patients with neuropathic pain had more severe leg pain intensity, lower pain self-efficacy, more patients had sensory loss than those without. Distinct profiles were apparent depending on neuropathic pain definition. Mean pain intensity reduced after 4 months (6.1 to 3.9 [sciatica]), most rapidly in cases defined by clinical diagnosis. This research provides new information on the clinical course of neuropathic pain and a better understanding of neuropathic pain in low back-related leg pain patients consulting in primary care.
Publisher: BMJ
Date: 03-2017
Publisher: Guttmacher Institute
Date: 12-2012
DOI: 10.1363/3818712
Abstract: In India, female sterilization accounts for 66% of contraceptive use, and age at sterilization is declining. It is likely that some women regret having been sterilized, but data on the prevalence of, and the social and economic correlates of, regret at the national level are insufficient. Data for analysis came from 30,999 sterilized women aged 15-49 interviewed in the 2005-2006 Indian National Family Health Survey. Logistic regression analyses and Wald tests were used to identify the social and demographic characteristics associated with sterilization regret. Nationally, 5% of sterilized women aged 15-49 reported sterilization regret. Women sterilized at age 30 or older were less likely than women sterilized before age 25 to express regret (odds ratio, 0.8). Compared with women having only sons, those who had only daughters were more likely to express regret (1.3), while those having both sons and daughters were less likely to express regret (0.8). Women who had experienced child loss had higher odds of reporting regret than women who had not (for one child lost, 1.6 for two or more children lost, 2.0). Given the large proportion of women undergoing sterilization, the potential numbers experiencing regret are considerable. If age at sterilization continues to decline, sterilization regret is likely to increase. Encouraging couples to delay sterilization and increasing the availability of highly effective reversible contraceptives are options that India may consider to avert sterilization regret.
Publisher: Elsevier BV
Date: 09-2023
Publisher: Oxford University Press (OUP)
Date: 07-01-2021
DOI: 10.1093/RHEUMATOLOGY/KEAA903
Abstract: To determine whether physiotherapist-led exercise intervention and US-guided subacromial CS injection is cost-effective when compared with standard advice and exercise leaflet and unguided injection in patients with subacromial pain (impingement) syndrome. An incremental cost–utility analysis using patient responses to the five-level EuroQoL-5D (EQ-5D-5L) questionnaire was undertaken from a healthcare perspective alongside a 2 × 2 factorial randomized trial with 256 participants over a 12-month follow-up period. Uncertainty was explored through the use of cost-effectiveness acceptability curves. The cost–utility analysis indicated that physiotherapist-led exercise was associated with an incremental cost of £155.99 (95% CI 69.02, 241.93) and 0.031 (95% CI −0.01, 0.07) additional quality-adjusted life-years (QALYs), an incremental cost-effectiveness ratio (ICER) of £5031 per QALY gained and an 85% chance of being cost-effective at a threshold of £20 000 per QALY gained compared with the advice and exercise leaflet. US-guided injection was associated with an incremental cost of £15.89 (95% CI −59.36, 109.86) and 0.024 (95% CI −0.02, 0.07) additional QALYs, an ICER of £662 per QALY gained and a 83% chance of being cost-effective at a threshold of £20 000 per QALY gained compared with unguided injection. Physiotherapist-led exercise was cost-effective compared with the advice and exercise leaflet, and US-guided injection was cost-effective when compared with unguided injection. ISRCTN, www.isrctn.com, ISRCTN42399123
Publisher: Elsevier BV
Date: 07-2020
Publisher: National Institute for Health and Care Research
Date: 10-2020
DOI: 10.3310/HTA24490
Abstract: Sciatica has a substantial impact on patients and society. Current care is ‘stepped’, comprising an initial period of simple measures of advice and analgesia, for most patients, commonly followed by physiotherapy, and then by more intensive interventions if symptoms fail to resolve. No study has yet tested a model of stratified care in which patients are subgrouped and matched to different care pathways based on their prognosis and clinical characteristics. The objectives were to investigate the clinical effectiveness and cost-effectiveness of a stratified care model compared with usual, non-stratified care. This was a two-parallel group, multicentre, pragmatic, 1 : 1 randomised controlled trial. Participants were recruited from primary care (42 general practices) in North Staffordshire, North Shropshire/Wales and Cheshire in the UK. Eligible patients were aged ≥ 18 years, had suspected sciatica, had access to a mobile phone/landline, were not pregnant, were not receiving treatment for the same problem and had not had previous spinal surgery. In stratified care, a combination of prognostic and clinical criteria associated with referral to spinal specialist services was used to allocate patients to one of three groups for matched care pathways. Group 1 received advice and up to two sessions of physiotherapy, group 2 received up to six sessions of physiotherapy, and group 3 was fast-tracked to magnetic resonance imaging and spinal specialist opinion. Usual care was based on the stepped-care approach without the use of any stratification tools/algorithms. Patients were randomised using a remote web-based randomisation service. The primary outcome was time to first resolution of sciatica symptoms (six point ordinal scale, collected via text messages). Secondary outcomes (at 4 and 12 months) included pain, function, psychological health, days lost from work, work productivity, satisfaction with care and health-care use. A cost–utility analysis was undertaken over 12 months. A qualitative study explored patients’ and clinicians’ views of the fast-track care pathway to a spinal specialist. A total of 476 patients were randomised (238 in each arm). For the primary outcome, the overall response rate was 89.3% (88.3% and 90.3% in the stratified and usual care arms, respectively). Relief from symptoms was slightly faster (2 weeks median difference) in the stratified care arm, but this difference was not statistically significant (hazard ratio 1.14, 95% confidence interval 0.89 to 1.46 p = 0.288). On average, participants in both arms reported good improvement from baseline, on most outcomes, over time. Following the assessment at the research clinic, most participants in the usual care arm were referred to physiotherapy. The stratified care model tested in this trial was not more clinically effective than usual care, and was not likely to be a cost-effective option. The fast-track pathway was felt to be acceptable to both patients and clinicians however, clinicians expressed reluctance to consider invasive procedures if symptoms were of short duration. Participants in the usual care arm, on average, reported good outcomes, making it challenging to demonstrate superiority of stratified care. The performance of the algorithm used to allocate patients to treatment pathways may have influenced results. Other approaches to stratified care may provide superior outcomes for sciatica. Current Controlled Trials ISRCTN75449581. This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment Vol. 24, No. 49. See the NIHR Journals Library website for further project information.
Publisher: Springer Science and Business Media LLC
Date: 26-04-2017
Publisher: Public Library of Science (PLoS)
Date: 17-09-2012
Publisher: BMJ
Date: 19-08-2020
DOI: 10.1136/BJSPORTS-2019-101268
Abstract: To compare the clinical effectiveness of (1) physiotherapist-led exercise versus an exercise leaflet, and (2) ultrasound-guided subacromial corticosteroid injection versus unguided injection for pain and function in subacromial pain (formerly impingement) syndrome (SAPS). This was a single-blind 2×2 factorial randomised trial. Adults with SAPS were randomised equally to one of four treatment groups: (1) ultrasound-guided corticosteroid injection and physiotherapist-led exercise, (2) ultrasound-guided corticosteroid injection and an exercise leaflet, (3) unguided corticosteroid injection and physiotherapist-led exercise and (4) unguided corticosteroid injection and an exercise leaflet. The primary outcome was the Shoulder Pain and Disability Index (SPADI), collected at 6 weeks, 6 and 12 months and compared at 6 weeks for the injection interventions and 6 months for the exercise interventions by intention to treat. We recruited 256 participants (64 treatment per group). Response rates for the primary outcome were 94% at 6 weeks, 88% at 6 months and 80% at 12 months. Greater improvement in total SPADI score was seen with physiotherapist-led exercise than with the exercise leaflet at 6 months (adjusted mean difference −8.23 95% CI −14.14 to -2.32). There were no significant differences between the injection groups at 6 weeks (−2.04 −7.29 to 3.22), 6 months (−2.36 −8.16 to 3.44) or 12 months (1.59 −5.54 to 8.72). In patients with SAPS, physiotherapist-led exercise leads to greater improvements in pain and function than an exercise leaflet. Ultrasound guidance confers no additional benefit over unguided corticosteroid injection. ISRCTN42399123 .
Publisher: Oxford University Press (OUP)
Date: 08-08-2019
DOI: 10.1093/PTJ/PZZ107
Abstract: Pregnancy-related low back pain and pelvic girdle pain (LBP/PGP) are common and negatively impact the lives of many pregnant women. Several patient-based outcome instruments measure treatment effect, but there is no consensus about which measure to use with women who have these pain presentations. The objective was to compare the responsiveness of 3 outcome measures in LBP/PGP: Oswestry Disability Index-version 2.0 (ODI), Pelvic Girdle Questionnaire (PGQ), and 0 to 10 numerical rating scale for pain severity (NRS) and to estimate a minimal important change (MIC) for these measures in pregnancy-related LBP/PGP. This was a methodology study using data from a pilot randomized controlled trial. Women (N = 124) with pregnancy-related LBP/PGP were recruited to a pilot randomized controlled trial evaluating the benefit of adding acupuncture to standard care, of whom 90 completed an 8-week follow-up. Responsiveness was evaluated by examining correlation between change score and the external anchor (6-point global perceived effect scale) and by using receiver operating characteristic curve analysis. MIC was estimated using anchor-based methods. All measures showed good responsiveness, with areas under the receiver operating characteristic curve ranging from 0.77 to 0.90. The estimated MICs were 3.1, 11.0, 9.4, 13.3, and 1.3 for the ODI, PGQ-total, PGQ-activity, PGQ-symptoms, and NRS, respectively. All the measures, apart from ODI, had MICs larger than the measurement error. The lack of an optimal “gold standard” or external criterion for assessing responsiveness and MIC was a limitation of this study. All 3 outcome measures demonstrated good responsiveness. MICs were derived for each instrument. The PGQ at 8 weeks postrandomization was identified as an appropriate outcome measure for pregnancy-related LBP/PGP because it is specific to these pain presentations and assesses both activity limitations and symptoms. The NRS is an efficient, shorter alternative.
Publisher: Elsevier BV
Date: 12-2018
DOI: 10.1016/J.MSKSP.2018.09.003
Abstract: Criticisms about overuse of MRI in low back pain are well documented. Yet, with the exception of suspicion of serious pathology, little is known about factors that influence clinicians' preference for magnetic resonance imaging (MRI) at first consultation. To explore factors associated with physiotherapists' preference for MRI for patients consulting with benign low back and leg pain (LBLP) including sciatica. Cross-sectional cohort study. Data were collected from 607 primary care LBLP patients participating in the ATLAS cohort study. Following clinical assessment, physiotherapists documented whether he/she wanted the patient to have an MRI. Factors potentially associated with physiotherapists' preference for imaging were selected a priori from patient characteristics and clinical assessment findings. A mixed-effects logistic regression model examined the associations between these factors and physiotherapists' preference for MRI. Physiotherapists expressed a preference for MRI in 32% (196/607) of patients, of whom 22 did not have a clinical diagnosis of sciatica (radiculopathy). Factors associated with preference for MRI included clinical diagnosis of sciatica (OR 4.23: 95% CI 2.29, 7.81), greater than 3 months pain duration (2.61: 1.58, 4.30), high pain intensity (1.24: 1.11, 1.37), patient's low expectation of improvement (2.40: 1.50, 3.83), physiotherapist's confidence in their diagnosis (1.19: 1.07, 1.33), with greater confidence associated with higher probability for MRI preference. A clinical diagnosis of sciatica and longer symptom duration were most strongly associated with physiotherapists' preference for MRI. Given current best practice guidelines, these appear to be justifiable reasons for MRI preference at first consultation.
Publisher: Wiley
Date: 22-03-2022
DOI: 10.1002/MSC.1634
Abstract: To investigate whether the accuracy of placement of ultrasound‐guided (US‐guided) corticosteroid injections for subacromial pain (impingement) syndrome (SAPS) influences pain and function outcomes. This was a secondary analysis of data collected in a previous randomised controlled trial (RCT). Video images of US‐guided subacromial corticosteroid injections delivered in the RCT were reviewed to categorise injection accuracy into three groups: definitely robably not in the subacromial bursa (Group 1) probably in the subacromial bursa (Group 2) and definitely in the subacromial bursa (Group 3). The primary outcome was the Shoulder Pain and Disability Index (SPADI) total score. Secondary outcomes included SPADI pain and function subscales and participants' self‐reported global impression of change. Outcomes were compared between the accuracy groups after adjusting for pre‐selected baseline characteristics. US‐guided injection accuracy data were available for 114 participants: 22 categorised into Group 1, 21 into Group 2 and 71 into Group 3. There were no significant differences in mean total SPADI scores between the three injection accuracy groups at 6 weeks (Group 2 vs. 1: 8.22 (95% CI −4.01, 20.50) Group 3 versus 1: −0.57 (95% CI −10.27, 9.13) or 6 months (Group 2 vs. 1: 12.38 (95% CI −5.34, 30.10) Group 3 versus 1: 3.10 (95% CI −11.04, 17.23). The accuracy of injection placement in SAPS did not influence pain and function, suggesting that improvements in patients' outcomes using subacromial corticosteroid injections can be achieved without US guidance.
Publisher: Public Library of Science (PLoS)
Date: 09-11-2012
Publisher: Springer Science and Business Media LLC
Date: 17-02-2018
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Reuben Ogollah.