• Jennifer L Brown, Penny S Edwards, James W Atchison, Ann Lafayette-Lucey, Virgil T Wittmer, and Michael E Robinson.
• Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida 32610, USA.
• Pain Med. 2008 Oct 1; 9 (7): 851-62.

ObjectiveThis study aimed to define patient-determined success criteria for treatment of chronic spine pain across four domains: pain, fatigue, emotional distress, and interference with daily activities.PatientsSeventy chronic spine pain patients were recruited from university-affiliated pain clinics.DesignThe study design was longitudinal, with pretreatment and post-treatment assessments. Post-treatment assessment occurred approximately 2 months after treatment initiation.Outcome MeasuresParticipants completed the Patient-Centered Outcomes Questionnaire and Follow-Up Patient-Centered Outcomes Questionnaire.ResultsAt pretreatment, patient requirements for success were a 58% reduction in pain, 61% reduction in fatigue, 64% reduction in distress, and 66% reduction in interference. These criteria, derived using a direct-scaling approach, are more stringent than criteria developed using other methods. However, patients adjusted their success criteria over time by becoming less stringent, and they used these less stringent criteria to make global judgments of treatment success. Using a scale comparison approach, success criteria for pain were a raw change of 17.5 points (0-100 numerical rating scale) and percent change of 25%. Other criteria were 7.5 (11%) for fatigue, 5.0 (13%) for distress, and 9.5 (12%) for interference.ConclusionsFuture research should validate these success criteria, particularly for the less studied domains of fatigue, distress, and interference, and investigate how these criteria evolve over the course of different treatments.

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