Journal
BEST PRACTICE & RESEARCH IN CLINICAL RHEUMATOLOGY
Volume 27, Issue 5, Pages 685-697Publisher
ELSEVIER SCI LTD
DOI: 10.1016/j.berh.2013.10.001
Keywords
Mediation; Treatment effectiveness; Back pain; Psychosocial factors; Mechanism
Categories
Funding
- National Institute for Health Research (NIHR) [RP-PG-0707-10131]
- National Health and Medical Research Council of Australia
- National Institutes of Health Research (NIHR) [RP-PG-0707-10131] Funding Source: National Institutes of Health Research (NIHR)
- National Institute for Health Research [RP-PG-0707-10131] Funding Source: researchfish
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Mediation analysis is a useful research method that potentially allows identification of the mechanisms through which treatments affect patient outcomes. This chapter reviews the theoretical framework, research designs and statistical approaches used in mediation analysis. It describes what can be learnt from previous mediation research, much of which has investigated mediating factors of psychosocial interventions in other health conditions. It also summarises the few treatment-mediation studies of psychosocial interventions conducted in back pain. This chapter shows that there is emerging evidence about the role of some psychological factors as potential treatment mediators, such as self-efficacy and catastrophising. Mediation analysis can equally be applied to non-psychological factors. Pre-planned and appropriately conducted mediation analysis in adequately powered clinical trials would be a step forward in understanding treatment effects in back pain and improving patient management. (C) 2013 Elsevier Ltd. All rights reserved.
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