Value of consensual ratings in differentiating organic and functional low back pain

Evaluated 40 low back pain patients by a multidisciplinary team (orthopedic surgeons, nursing staff and a medical psychologist) to identify the behavioral characteristics associated with functional and organic determinants of pain. Significant relationships were found between orthopedists' clinical judgments and higher scores on MMPI scales F, HS, and MA, between nurses' ratings and higher scores on MMPI scales D, PA, PT, and SI, and on the Zung Depression Scale and STAI Trait-Anxiety scale. Physicians and nurses consensually agreed on 27 cases. Behavioral observations of the orthopedists and the nursing staff revealed contrasting patterns of behavior for those patients classified as organic or functional. The power of the consensual rating method and its usefulness in clinical appraisals were discussed.