Clinical Prediction Rule of Cook

Following items from patient history indicate a positive finding:

  1. Bilateral symptoms
  2. Leg pain worse than back pain
  3. Pain during walking/standing
  4. Pain relief upon sitting
  5. Age >48 years

 

Positive Outcome: 1 or less positive items to lower the post-test probability of lumbar spinal stenosis (LSS) and 4 or more positive items to moderately increase the chance of having LSS

Study Reliability Sn Sp LR+ LR-
Cook et al. (2011):1 out of 5 NA 96 20 1.2 0.19
Cook et al. (2011):4 out of 5 NA 6 98 4.6 0.95