Presurgical behavioral medicine evaluation (PBME) for implantable devices for pain management: A 1-year prospective study

David R. Heckler, Robert J. Gatchel, Leland Lou, Tony Whitworth, Dana Bernstein, Anna W. Stowell

Research output: Contribution to journalArticlepeer-review

11 Scopus citations


To reduce poor surgical outcomes, presurgical psychological evaluations are used to better predict prognosis. The current study investigated the utility of a revised Presurgical Behavioral Medicine Evaluation (PBME) algorithm, developed specifically for patients who were candidates for implantable devices. Patients were categorized into a Green, Yellow I, Yellow II, or Red prognosis group, with Green having the best, and Red having the worst, prognosis for good surgical outcomes. Variables, including gender, disability payment status, and involvement in pending litigation, were found to be significantly different among the groups in a sample of 95 consecutive patients. Analysis of data at the initial evaluation indicated that patients within the Red group endorsed significantly more physical/functional limitations, depressive symptomatology, and psychosocial distress than the Green group. In a 12-month follow-up analysis, significant differences among the four groups on various psychosocial measures were found. In addition, post-hoc tests revealed specific significant differences among the groups. A repeated measures analysis of the initial evaluation, 6-month, and 12-month follow-up data revealed that these measures were also significantly affected by the prognostic group. Lastly, nonparametric analysis indicated that there were significant differences among the groups on total risk factor scores as determined by the PBME algorithm.

Original languageEnglish
Pages (from-to)110-122
Number of pages13
JournalPain Practice
Issue number2
StatePublished - Jun 2007


  • Implantable devices
  • Presurgical screening algorithm
  • Psychosocial risk factors
  • Surgical outcomes


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