Summary
The PANDA-S study is a longitudinal UK-based clinical cohort of at least 400 primary care and physiotherapy patients with musculoskeletal shoulder pain, combining quantitative prognostic modelling with qualitative investigation of diagnostic and management experiences. The research aims to develop a validated short-term prognostic model for pain and disability outcomes at 6 months, explore the added predictive value of physical examination and ultrasound findings, and characterise long-term pain trajectories and associated healthcare costs over 36 months. This mixed-methods approach addresses diagnostic uncertainty in primary care shoulder pain management by generating evidence to optimise patient stratification and inform clinical decision-making.
UK applicability
The study was conducted entirely within UK primary care and physiotherapy services, making its findings directly applicable to NHS practice pathways, GP and physiotherapist decision-making, and resource allocation for shoulder pain management in the United Kingdom. The prognostic model and cost estimates will inform evidence-based commissioning and guideline development for musculoskeletal conditions in the UK health system.
Key measures
Shoulder Pain and Disability Index (SPADI); weekly SMS/app-based short-term data collection (0–12 weeks); clinical physiotherapist assessment; ultrasound findings; healthcare utilisation and cost data; qualitative interviews with patient–healthcare professional dyads
Outcomes reported
The study will describe short-term and long-term trajectories of shoulder pain and disability using the Shoulder Pain and Disability Index (SPADI), develop a multivariable prognostic model to predict pain and disability levels at 6 months, and estimate direct and indirect costs of care including work absence and productivity losses.
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