ArticleArthritis care & research2014
Variations among primary care physicians in exercise advice, imaging, and analgesics for musculoskeletal pain: results from a factorial experiment.
Article in Arthritis care & research, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
21 citing papers in PubMed, 1 synthesis or guideline pooled it, 40 citations in OpenAlex.
- Evidence-based treatment recommendations for neck and low back pain across Europe: A systematic review of guidelines.European journal of pain (London, England) · 2021Pooled it
- The Contribution of Patient, Primary Care Physician, and Primary Care Clinic Factors to Good Bone Health Care.The Permanente journal · 2021Trial
- Stratified primary care versus non-stratified care for musculoskeletal pain: findings from the STarT MSK feasibility and pilot cluster randomized controlled trial.BMC family practice · 2020Trial
- Dose-Response Effects of Tai Chi and Physical Therapy Exercise Interventions in Symptomatic Knee Osteoarthritis.PM & R : the journal of injury, function, and rehabilitation · 2018Trial
- Trial
- Clinic variation in recruitment metrics, patient characteristics and treatment use in a randomized clinical trial of osteoarthritis management.BMC musculoskeletal disorders · 2014Trial
- Designing a web-based factorial survey experiment on diagnostic evaluation of cardiovascular symptoms in emergency care.Research and practice in thrombosis and haemostasis · 2026Article
- Variation in mental health-related sickness absence duration: The role of occupational health professionals.PloS one · 2026Article
- Association of physical activity with loss of knee joint space width over two years: a compositional data analysis in the Osteoarthritis Initiative.Osteoarthritis and cartilage · 2023Article
- Walking, running, and recreational sports for knee osteoarthritis: An overview of the evidence.European journal of rheumatology · 2022Article
- Racial/Ethnic and Socioeconomic Disparities in Osteoarthritis Management.Rheumatic diseases clinics of North America · 2021Review
- Physician Prescribing Patterns and Risk of Future Long-Term Opioid Use Among Patients With Rheumatoid Arthritis: A Prospective Observational Cohort Study.Arthritis & rheumatology (Hoboken, N.J.) · 2020Observational
- Racial/Ethnic Disparities in Physical Function Before and After Total Knee Arthroplasty Among Women in the United States.JAMA network open · 2020Article
- Matching treatment options for risk sub-groups in musculoskeletal pain: a consensus groups study.BMC musculoskeletal disorders · 2019Article
- Why Aren't There More Female Pain Medicine Physicians?Regional anesthesia and pain medicine · 2018Review
- Health Care Provider Counseling for Physical Activity or Exercise Among Adults with Arthritis - United States, 2002 and 2014.MMWR. Morbidity and mortality weekly report · 2018Article
- Effects of Treadmill Exercise on Advanced Osteoarthritis Pain in Rats.Arthritis & rheumatology (Hoboken, N.J.) · 2017Article
- GPs' attitudes, beliefs and behaviours regarding exercise for chronic knee pain: a questionnaire survey.BMJ open · 2017Article
- Article
- Variation in the utilization and positivity rates of CT pulmonary angiography among emergency physicians at a tertiary academic emergency department.Emergency radiology · 2015Article
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveTo examine whether medical decisions regarding evaluation and management of musculoskeletal pain conditions varied systematically by characteristics of the patient or provider.
methodsWe conducted a balanced factorial experiment among primary care physicians in the US. Physicians (n = 192) viewed 2 videos of different patients (actors) presenting with pain: undiagnosed sciatica symptoms or diagnosed knee osteoarthritis. Systematic variations in patient gender, socioeconomic status, and race and physician gender and experience (<20 versus ≥20 years in practice) permitted estimation of unconfounded effects. Analysis of variance was used to evaluate associations between patient or provider attributes and clinical decisions. Quality of decisions was defined based on the current recommendations of the American College of Rheumatology, American Pain Society, and clinical expert consensus.
resultsDespite current recommendations, less than one-third of physicians would provide exercise advice (30.2% for osteoarthritis and 32.8% for sciatica). Physicians with fewer years in practice were more likely to provide advice on lifestyle changes, particularly exercise (P ≤ 0.01), and to prescribe nonsteroidal antiinflammatory drugs for pain relief, both of which were appropriate and consistent with current recommendations for care. Newer physicians ordered fewer tests, particularly basic laboratory investigations or urinalysis. Test ordering decreased as organizational emphasis on business or profits increased. Patient factors and physician gender had no consistent effects on pain evaluation or treatment.
conclusionPhysician education on disease management recommendations regarding exercise and analgesics and implementation of quality measures may be useful, particularly for physicians with more years in practice.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.