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Article: Chronic low back pain: A heterogeneous condition with challenges for an evidence-based approach

TitleChronic low back pain: A heterogeneous condition with challenges for an evidence-based approach
Authors
Issue Date2011
PublisherLippincott, Williams & Wilkins. The Journal's web site is located at http://www.spinejournal.com
Citation
Spine, 2011, v. 36 n. 21 SUPPL., p. S1-S9 How to Cite?
Abstract"Chronic" low back pain (LBP), defined as present for 3 or more months, has become a major socioeconomic problem insufficiently addressed by five major entities largely working in isolation from one another - procedural based specialties, strength based rehabilitation, cognitive behavioral therapy, pain management and manipulative care. As direct and indirect costs continue to rise, many authors have systematically evaluated the body of evidence in an effort to demonstrate the effectiveness (or lack thereof) for various diagnostic and therapeutic interventions. The objective of this Spine Focus issue is not to replicate previous work in this area. Rather, our expert panel has chosen a set of potentially controversial topics for more in-depth study and discussion. A recurring theme is that chronic LBP is a heterogeneous condition, and this affects the way it is diagnosed, classified, treated, and studied. The efficacy of some treatments may be appreciated only through a better understanding of heterogeneity of treatment effects (i.e., identification of clinically relevant subgroups with differing responses to the same treatment). Current clinical guidelines and payer policies for LBP are systematically compared for consistency and quality. Novel approaches for data gathering, such as national spine registries, may offer a preferable approach to gain meaningful data and direct us towards a "results-based medicine." This approach would require more high-quality studies, more consistent recording for various phenotypes and exploration of studies on genetic epidemiologic undertones to guide us in the emerging era of "results based medicine." © 2011, Lippincott Williams & Wilkins.
Persistent Identifierhttp://hdl.handle.net/10722/137444
ISSN
2015 Impact Factor: 2.439
2015 SCImago Journal Rankings: 1.459
ISI Accession Number ID
Funding AgencyGrant Number
AOSpine North America
Funding Information:

AOSpine North America and foundation funds were received to support this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

References

 

DC FieldValueLanguage
dc.contributor.authorFourney, DRen_HK
dc.contributor.authorAndersson, Gen_HK
dc.contributor.authorArnold, PMen_HK
dc.contributor.authorDettori, Jen_HK
dc.contributor.authorCahana, Aen_HK
dc.contributor.authorFehlings, MGen_HK
dc.contributor.authorNorvell, Den_HK
dc.contributor.authorSamartzis, Den_HK
dc.contributor.authorChapman, JRen_HK
dc.date.accessioned2011-08-26T14:25:14Z-
dc.date.available2011-08-26T14:25:14Z-
dc.date.issued2011en_HK
dc.identifier.citationSpine, 2011, v. 36 n. 21 SUPPL., p. S1-S9en_HK
dc.identifier.issn0362-2436en_HK
dc.identifier.urihttp://hdl.handle.net/10722/137444-
dc.description.abstract"Chronic" low back pain (LBP), defined as present for 3 or more months, has become a major socioeconomic problem insufficiently addressed by five major entities largely working in isolation from one another - procedural based specialties, strength based rehabilitation, cognitive behavioral therapy, pain management and manipulative care. As direct and indirect costs continue to rise, many authors have systematically evaluated the body of evidence in an effort to demonstrate the effectiveness (or lack thereof) for various diagnostic and therapeutic interventions. The objective of this Spine Focus issue is not to replicate previous work in this area. Rather, our expert panel has chosen a set of potentially controversial topics for more in-depth study and discussion. A recurring theme is that chronic LBP is a heterogeneous condition, and this affects the way it is diagnosed, classified, treated, and studied. The efficacy of some treatments may be appreciated only through a better understanding of heterogeneity of treatment effects (i.e., identification of clinically relevant subgroups with differing responses to the same treatment). Current clinical guidelines and payer policies for LBP are systematically compared for consistency and quality. Novel approaches for data gathering, such as national spine registries, may offer a preferable approach to gain meaningful data and direct us towards a "results-based medicine." This approach would require more high-quality studies, more consistent recording for various phenotypes and exploration of studies on genetic epidemiologic undertones to guide us in the emerging era of "results based medicine." © 2011, Lippincott Williams & Wilkins.en_HK
dc.languageengen_US
dc.publisherLippincott, Williams & Wilkins. The Journal's web site is located at http://www.spinejournal.comen_HK
dc.relation.ispartofSpineen_HK
dc.titleChronic low back pain: A heterogeneous condition with challenges for an evidence-based approachen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0362-2436&volume=36, Suppl. 21S&spage=S1&epage=S9&date=2011&atitle=Chronic+low+back+pain:+a+heterogeneous+condition+with+challenges+for+an+evidence-based+approach-
dc.identifier.emailSamartzis, D:dspine@hku.hken_HK
dc.identifier.authoritySamartzis, D=rp01430en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1097/BRS.0b013e31822f0a0den_HK
dc.identifier.pmid21952181-
dc.identifier.scopuseid_2-s2.0-80053392210en_HK
dc.identifier.hkuros189127en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-80053392210&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume36en_HK
dc.identifier.issue21 SUPPL.en_HK
dc.identifier.spageS1en_HK
dc.identifier.epageS9en_HK
dc.identifier.isiWOS:000296067700001-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridFourney, DR=6602628882en_HK
dc.identifier.scopusauthoridAndersson, G=25653803700en_HK
dc.identifier.scopusauthoridArnold, PM=7202944018en_HK
dc.identifier.scopusauthoridDettori, J=6602589206en_HK
dc.identifier.scopusauthoridCahana, A=6701834433en_HK
dc.identifier.scopusauthoridFehlings, MG=7005942578en_HK
dc.identifier.scopusauthoridNorvell, D=7801385099en_HK
dc.identifier.scopusauthoridSamartzis, D=34572771100en_HK
dc.identifier.scopusauthoridChapman, JR=7402660853en_HK

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