Diagnostic Test Accuracy Review

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Red flags to screen for malignancy in patients with low-back pain

  1. Nicholas Henschke1,*,
  2. Christopher G. Maher2,
  3. Raymond WJG Ostelo3,
  4. Henrica CW de Vet4,
  5. Petra Macaskill5,
  6. Les Irwig6

Editorial Group: Cochrane Back Group

Published Online: 28 FEB 2013

Assessed as up-to-date: 12 APR 2012

DOI: 10.1002/14651858.CD008686.pub2


How to Cite

Henschke N, Maher CG, Ostelo RWJG, de Vet HCW, Macaskill P, Irwig L. Red flags to screen for malignancy in patients with low-back pain. Cochrane Database of Systematic Reviews 2013, Issue 2. Art. No.: CD008686. DOI: 10.1002/14651858.CD008686.pub2.

Author Information

  1. 1

    University of Heidelberg, Institute of Public Health, Heidelberg, Germany

  2. 2

    University of Sydney, The George Institute for Global Health, Sydney, NSW, Australia

  3. 3

    VU University, Department of Health Sciences, EMGO Institute for Health and Care Research, Amsterdam, Netherlands

  4. 4

    VU University Medical Center, Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, Amsterdam, Netherlands

  5. 5

    School of Public Health, Screening and Test Evaluation Program (STEP), Sydney, NSW, Australia

  6. 6

    University of Sydney, School of Public Health, Sydney, NSW, Australia

*Nicholas Henschke, Institute of Public Health, University of Heidelberg, Im Neuenheimer Feld 324, Heidelberg, 69120, Germany. nhenschke@georgeinstitute.org.au.

Publication History

  1. Publication Status: New
  2. Published Online: 28 FEB 2013

SEARCH

[Figure 1]
Figure 1. Flow diagram of search strategy
[Figure 2]
Figure 2. Methodological quality summary: review authors' judgements about each methodological quality item for each included study.
[Figure 3]
Figure 3. Forest plot of sensitivity and specificities for: Age > 50 and Neurological symptoms.
[Test 1]
Test 1. Age > 50.
[Test 2]
Test 2. Age > 70.
[Test 3]
Test 3. Constant progressive pain.
[Test 4]
Test 4. Duration of this episode > 1 month.
[Test 5]
Test 5. Gradual onset before age 40.
[Test 6]
Test 6. Is the low-back pain familiar?.
[Test 7]
Test 7. Insidious onset.
[Test 8]
Test 8. Not improved after 1 month.
[Test 9]
Test 9. Previous history of cancer.
[Test 10]
Test 10. Recent back injury.
[Test 11]
Test 11. Severe pain.
[Test 12]
Test 12. Systemically unwell.
[Test 13]
Test 13. Thoracic pain.
[Test 14]
Test 14. Tried bedrest with no relief.
[Test 15]
Test 15. Unexplained weight loss.
[Test 16]
Test 16. Altered sensation from the trunk down.
[Test 17]
Test 17. Fever (temp > 100oF).
[Test 18]
Test 18. Muscle spasm.
[Test 19]
Test 19. Neurological symptoms.
[Test 20]
Test 20. Spine tenderness.