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Abstract
Objective: A systematic overview of evidence aimed at determining the clinical course of lateral
elbow pain and prognostic factors that affect elbow pain duration and outcomes.
Data Sources: Online bibliographic database searches from 1983 to 1994; information requests from
selected authors and bibliography screenings.
Study Selection: One author reviewed 424 articles; 40 met the following eligibility criteria: any
study with primary data on soft tissue injuries specific to the elbow which referred
to prognosis or reported use of any outcome measure.
Data Abstraction: Strength of evidence grade based on clinical epidemiological validity assessment.
Criteria included in the validity assessment included case definition, patient selection,
follow-up, outcome, prognostic factors, and analysis. All eligible studies were independently
assessed by two investigators.
Data Synthesis: Four studies (10%) were judged to provide moderate strength of evidence; no studies
were graded as providing strong evidence on prognosis. All four moderate-quality studies
were clinical trials of short duration. One study indicated that site of lesion and
prior occurrence may be predictive of poorer outcome in patients with lateral epicondylitis.
Conclusion: The majority of studies on lateral elbow pain were limited by methodological weaknesses
in selection and definition of the study population, length of follow-up, and analysis
of prognostic factors. Estimates of duration were only available from weaker studies
with longer follow-up times; significant subject heterogeneity in the weaker studies
prevented a determination of usual clinical course. More methodologically rigorous
research on prognosis could assist clinicians in patient care and evaluation of interventions.
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Article info
Publication history
Accepted:
November 9,
1995
Received:
July 6,
1995
Footnotes
☆Supported by the Institute for Work and Health, Toronto, Ontario, Canada.
☆No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors or upon any organization with which the authors are associated.
Identification
Copyright
© 1996 Published by Elsevier Inc.
