Logo of nihpaAbout Author manuscriptsSubmit a manuscriptHHS Public Access; Author Manuscript; Accepted for publication in peer reviewed journal;
PMC full text:
J Manipulative Physiol Ther. Author manuscript; available in PMC 2011 Oct 8.
Published in final edited form as:
J Manipulative Physiol Ther. 2010 Oct; 33(8): 562–575.
Published online 2010 Oct 8. doi:  10.1016/j.jmpt.2010.08.017

Table 6

Do Episodes-of-Pain Without Utilization Occur Before or After Episodes-of-Pain with Utilization?

Episode-of-Care Category (N=8,244)% Change RndXRndn = those who do change patternPattern 1 (n), %Pattern 2 (n),%Pattern 3 (n),%Pattern 4 (n),%Pattern 5 (n),%
A) Single limited episode (n=4,350)23% (984/2824)984(555),56%(316),32%(113),12%
B) Single prolonged episode (n=1,189)25%296(177),60%(88),30%(31),10%
C) Longterm Continuous (n=1,495)18%266(144),54%(111),42%(11),4%
D Multiple Recurrent episodes (n=1,210)43%525(88),17%(74),14%(4),1%(322),61%(37),7%
Direction of Change of Round-by-Round Pattern (P1 is Pattern 1, P2 is Pattern 2, etc)

P1) Back Pain Utilization Round-by-Round Pattern plus Back Pain Experience Round-by-Round Pattern adds Non-Utilization Experience Rounds subsequent to Utilization Rounds (e.g. Utilization(U) Pattern XOOOO + Pain(P) Pattern XXOOO => Both(U+P) Pattern XXOOO)

P2) Utilization plus Experience adds Non-Utilization Rounds prior to Utilization Rounds (e.g. Utilization (U) Pattern OOOOX + Pain (P) Pattern OOOXX => Both (U+P) Pattern OOOXX)

P3) Utilization plus Experience adds Non-Utilization Rounds BOTH subsequent and prior to Utilization Rounds (e.g. OOXOO + XOXOX => XOXOX)

P4) Utilization plus Experience adds Non-Utilization Rounds that “Fill-In” between Utilization Rounds (e.g. XOXOX + XXXOX => XXXOX)

P5) Utilization plus Experience does NOT add Non-Utilization rounds, but just OVERLAYS existing rounds (e.g. XXXOO + XXOOO => XXXOO)

Note: Reading Row one as example, 4,350 adult MEPS respondents were initially categorized as having a single limited back pain episode based only on their Utilization Events Round-by-Round pattern, and 645 of these (23%) changed their Round-by-Round pattern when their Utilization back pain rounds were supplemented with their Non-Utilization back pain rounds. Of the 984 with a changed pattern, 56% experienced additional Non-Utilization rounds following their Utilization rounds (Change Pattern 1), 32% experienced additional Non-Utilization rounds preceding their Utilization rounds (Change Pattern 2), and 12% experienced additional Non-Utilization both before and after their Utilization rounds (Change Pattern 3). This table demonstrates how adding Back Pain Experience Rounds (from the Medical Condition file) to the Utilization Back Pain Rounds (from the Utilization Events files) changes the final overall Round-by-Round pattern for adult Back Pain (Utilization plus Non-Utilization).