nonspecific low back pain.27,28 Our primary outcomes were pain A better understanding of the clinical course of low back pain and disability, while global measure of recovery was a second- across various pain durations and populations is important in the ary outcome. [...] early detection of slow recovery and escalation of care at the We excluded studies reporting participants with low back patient level, and in verifying that recommendations in clinical pain for greater than 12 months as we were interested in captur- guidelines to reassure patients about a favourable prognosis are ing the trajectory of low back pain within the first year of pain appropriate.14–24 W. [...] back pain to be consistent with the definition of acute in the pre- vious review (< 6 wk), and to align with most clinical guidelines.14 Risk of bias and certainty of evidence The inclusion of a subacute group was a deviation from our regis- We are unaware of any risk of bias tools designed specifically for tered protocol. [...] shape of the fitted line to vary by including functions of time To assess the level of confidence in pooled estimates of (commonly 2) as predictors of the outcome (Appendix 5, avail- means and 95% confidence intervals (CIs) of pain and disability able at www.cmaj.ca/lookup/doi/10.1503/cmaj.230542/tab scores, we used the Grading of Recommendations, Assessment, -related-content). [...] Because of the high Clinical course of pain and disability risk of selection bias, we planned sensitivity analyses (for each group of participants with acute, subacute or persistent low back Pain pain) to include only studies that had a high follow-up rate Pain outcomes were reported for 43 cohorts, included in the (> 80% of participants).34,35 As it is unclear whether the clinical meta-analysis.
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