Multidimensional clinical phenotypes detected with latent class analysis in an osteopathic school: a cross sectional study of 402 patients
1|Arthur Agogué|IDHEO|LRO|France|
2|Antoine Cretal|IDHEO|LRO|France|
3|Mathieu Gonzalès-Bandrès|IDHEO|LRO|France|
4|Antoine Michaux|IDHEO|LRO|France|
5|Clément Orengo|IDHEO|LRO|France|
6|Alizée Gadel|IDHEO|LRO|France|
7|Gilles Toumaniantz|Nantes Université|Unité Inserm UMR 1087, CNRS UMR 6291 IRS-UN|France|
8|Mathis Brier|Nantes Université|UMR INSERM 1246, SPHERE,|France|
Pain is defined as an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage. One of the issues in musculoskeletal pain research and/or care is the lack of individualised treatment. Cognitive and functional therapy research showed that a person-centred care could have long-term effects on pain and disability. Implementing such tailored care seems to be difficult in osteopathic research. To our knowledge, no cluster analysis has been conducted in an osteopathic clinic.
A multidimensional clinical reasoning form has been fulfilled by students. This questionnaire was built with pre-existing forms, was qualitatively assessed. A latent class analysis was conducted to describe groups of patients consulting for musculoskeletal pain.
415 questionnaires were collected. 5 clusters emerged with between 63 and 104 patients. We described them as: 1/ dynamic patient with nociceptive pain; 2/ positive patients with contextual difficulties and nociceptive pain; 3/ a moderately difficult care for patients with complex pain; 4/ the patient with high risk of chronicity and; 5/ the average patient.
A An exploratory analysis of the structure of the questionnaire showed a composition of four domains: the ecologico-psycho-social factors, the reaction to pain, the “nociceptivity” and the clinical encounter. The area of pain, and chronicity weren’t predicted by latent traits. Further analyses could use this questionnaire, firstly, to describe the osteopaths’ or students’ approaches and, secondly, to evaluate the efficacy of osteopathic care for patients in each of these clusters.