Spinal Cord Stimulation–Naïve Patients vs Patients With Failed Previous Experiences With Standard Spinal Cord Stimulation: Two Distinct Entities or One Population?
Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
Introduction: Nowadays, the success of spinal cord stimulation (SCS) is evaluated separately in patients who have previous experiences with standard SCS and in SCS-naïve patients. Nevertheless, it is yet to be evaluated whether both patient groups are effectively distinct patient groups. Therefore, the aims of this study are twofold: 1) Are there clusters in the data to distinguish between both patient groups? 2) Can we discriminate both patient groups based on routinely collected clinical parameters? Materials and Methods: Baseline data from the Discover study were used, in which 263 patients with persistent spinal pain syndrome type 2 were included (185 neurostimulation-naïve patients and 78 patients with previous SCS experience). Pain intensity scores for low back and leg pain, functional disability, medication use, and health-related quality of life utility scores were used in the analysis. Model-based clustering was performed on standardized data. Discriminant analysis was performed with linear and quadratic discriminant analysis, with leave-one-out cross-validation to evaluate model performance. Results: Model-based clustering revealed two different clusters in the data. None of the clusters clearly separated SCS-naïve patients from patients with previous SCS experience. Linear discriminant analysis resulted in a leave-one-out cross-validation error rate of 30.0% to discriminate between both patient groups, based on routinely collected clinical parameters. Conclusions: Clustering analysis did not result in clusters that separate SCS-naïve patients from patients with previous SCS experience. This may suggest that both patient groups should not be considered as two different patient groups when comparing them on routine clinical parameters, with potentially profound implications for research and clinical settings. Clinical Trial Registration: The Clinicaltrials.gov registration number for the Discover study is NCT02787265.
Originalsprog | Engelsk |
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Tidsskrift | Neuromodulation |
Vol/bind | 26 |
Udgave nummer | 1 |
Sider (fra-til) | 157-163 |
ISSN | 1094-7159 |
DOI | |
Status | Udgivet - 2023 |
Bibliografisk note
Funding Information:
Source(s) of financial support: Discover was funded by Medtronic Europe Sárl, which provided an independent research grant. Medtronic was not involved in the collection and analysis of the data or in writing the article. Conflict of Interest: Maarten Moens has received speaker fees from Medtronic and Nevro. Lisa Goudman is a postdoctoral research fellow funded by the Research Foundation Flanders, Belgium (project number 12ZF622N). Philippe Rigoard reports grants and personal fees from Medtronic, Abbott, and Boston Scientific, outside the submitted work. STIMULUS received research grants from Medtronic. The remaining authors reported no conflict of interest.
Funding Information:
Source(s) of financial support: Discover was funded by Medtronic Europe Sárl , which provided an independent research grant. Medtronic was not involved in the collection and analysis of the data or in writing the article.
Funding Information:
Conflict of Interest: Maarten Moens has received speaker fees from Medtronic and Nevro. Lisa Goudman is a postdoctoral research fellow funded by the Research Foundation Flanders, Belgium (project number 12ZF622N). Philippe Rigoard reports grants and personal fees from Medtronic, Abbott, and Boston Scientific, outside the submitted work. STIMULUS received research grants from Medtronic. The remaining authors reported no conflict of interest.
Publisher Copyright:
© 2022 International Neuromodulation Society
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