ALTERATION: The shift from pain intensity towards health-related quality of life as novel framework to quantify the individual status of patients with chronic low back pain with a composite measure. 19

Chronic pain treatments are typically quantified as successful in case 50% pain relief is obtained.
Despite the widespread acceptance of the threshold, this unidimensional view is nowadays under
intense debate. This project will overcome the oversimplification of chronic low back pain
management and will develop a holistic evaluation in which data is continuously collected within the
daily patient situation and based on complementary evaluations of self-reported and more objective
outcomes. By replacing pain intensity with health-related quality of life, this novel framework
responds to the long-standing scientific challenge of 50% pain relief. The project’s central aim is to
create a holistic framework relying on health-related quality of life, and to determine which outcome
measurements determine health-related quality of life in chronic low back pain patients. To reach this
goal, prospectively gathered data will be combined with multiple existing data sources in an empirical
Bayesian framework, after which feature selection will reveal relevant self-reported and more
objective outcomes of health-related quality of life. This work will lead to a fundamental revision of
how we evaluate, understand, and guide chronic pain management by revealing the full extent of the
complexity of chronic pain. The methodological development in Bayesian data analysis that
ALTERATION will achieve, will be applicable in diverse (non-)medical settings, and thus be impactful
beyond my field.