Can large surveys conducted on highly selected populations provide valid information on the epidemiology of common health conditions? An analysis of UK Biobank data on musculoskeletal pain

Gary Macfarlane, Marcus Beasley, Blair H Smith, Gareth Jones, Tatiana MacFarlane

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Introduction: Biobank-type studies are typically large but have very low participation rates. It has been suggested that these studies may provide biased estimates of prevalence but are likely to provide valid estimates of association. We test these hypotheses using data collected on pain in a large Biobank study in the United Kingdom.

Methods: UK Biobank recruited 503,325 persons aged 40–69 years (participation rate 5.5%). Participants completed questionnaires, including pain, lifestyle and environment factors. As a comparison, we used both a large population study of pain (MUSICIAN: n = 8847, aged: 40–69 years) conducted 2008–2009 and the National Child Development study (NCDS) which recruited all persons in Great Britain born during one week of 1958 and followed them up at age 44 years (n = 9377).

Results: ‘Any pain’ (UK Biobank 61.0%; MUSICIAN 63.9%), chronic pain (42.9%, 52.2%) and site-specific musculoskeletal pain (back 26.2%, 29.7%; shoulder/neck 23.3%, 25.3%) were generally similar in UK Biobank and MUSICIAN. The prevalence of chronic pain and most regional musculoskeletal pains in UK Biobank were all within 2% of that in NCDS.

Conclusion: UK Biobank has provided estimates of the prevalence of pain which are similar to those from previous large-scale studies, although a formal comparison of the estimates cannot be made. It has also confirmed known associations with the reporting of pain. Despite its very low participation rate, such a study provides the opportunity to investigate novel exposure–pain relationships and investigate rarer exposures and characteristics to further our knowledge of the epidemiology of pain.
Original languageEnglish
Pages (from-to)203-212
Number of pages10
JournalBritish Journal of Pain
Issue number4
Early online date28 Jan 2015
Publication statusPublished - Nov 2015

Bibliographical note


This research has been conducted using the UK Biobank resource. We are grateful to other investigators in the MUSICIAN study: John McBeth, Karina Lovell, Phil Keeley, Phil Hannaford, Deborah Symmons, Gordon Prescott and Steve Woby. We are grateful to the following practices and their patients for participating in the MUSICIAN study in Aberdeen: Carden Medical Centre, Elmbank Medical Practice, Great Western Medical Practice, Garthdee Medical Group, and Macclesfield: Readesmoor Medical Group Practice, Lawton House Surgery, Bollington Medical Centre, Park Lane Surgery. The Scottish Primary Care Research Network facilitated access to patient information at the practices in Aberdeen city. Charlie Stockton was the MUSICIAN study manager during the setting up and for part of the conduct of the study and thereafter Chrysa Gkazinou. Dr John Norrie, Alison MacDonald and Gladys McPherson of the Health Services Research Unit (HSRU) at the University of Aberdeen provided input regarding the conduct of the study. Dev Acharya, Jennifer Banister, Flora Joyce and Michelle Rein from Aberdeen and Karen Kane and Rowan Jasper at the Arthritis Research UK Epidemiology Unit, University of Manchester, were the project assistants. Alison Littlewood, Arthritis Research UK Epidemiology Unit, University of Manchester, performed the MUSICIAN study management at the Manchester centre.

Funding The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This analysis was supported by internal funds at the University of Aberdeen. The MUSICIAN study was funded by Arthritis Research UK, Chesterfield (Grant No. 17292).


  • UK Biobank
  • pain
  • musculoskeletal
  • prevalence
  • associations


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