Abstract
Background Several prognostic factors for chronic low back pain (CLBP) have been reported. However, there is no study regarding the prediction of CLBP development in general population, using a risk prediction model. Based on this background, the aims of this study were: (1) to develop and validate a risk prediction model for CLBP (chronic low back pain) development in the general population, and (2) to create a nomogram which can help a person at risk of developing CLBP to receive appropriate counseling on risk modification.Methods Data on CLBP development, demographics, socioeconomic history, and comorbid health condition of participants were obtained through a nationally representative health examination and survey from 2007 to 2009. Prediction models for CLBP development were derived for health survey on a random sample of 80% of the data and were validated in the remaining 20%. After developing the risk prediction model for CLBP development, this model was incorporated into a nomogram.Results Data for 17,038 participants were finally analyzed, including 2,693 with CLBP and 14,345 without. The finally selected risk factors included age, gender, occupation, education level, mid-intensity physical activity, depressive symptom, and comorbidities. This model had good predictive performance in the validation dataset (concordance statistic = 0.7569, Hosmer-Lemeshow chi-square statistic = 12.10, p =.278). The findings indicated no significant differences between the observed probability and predicted probability according to our model.Conclusions The risk prediction model, presented by a nomogram, which is a score-based prediction system, could be incorporated into the clinical setting. Thus, our prediction model with a nomogram can help a person at risk of developing CLBP to receive appropriate counseling on risk modification from primary physicians.