ArticlePloS one2014
The Nijmegen decision tool for chronic low back pain. Development of a clinical decision tool for secondary or tertiary spine care specialists.
Article in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.
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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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it, 60 citations in OpenAlex.
- Evidence and practice in spine registries.Acta orthopaedica · 2015Pooled it
- Full endoscopic versus open discectomy for sciatica: randomised controlled non-inferiority trial.BMJ (Clinical research ed.) · 2022Trial
- Development and Feasibility Study of a Triage Tool for Early Referral to Spinal Cord Stimulation for Patients With Chronic Low Back and Leg Pain.European journal of pain (London, England) · 2025Article
- Body Image and Cosmesis after Percutaneous Transforaminal Endoscopic Discectomy versus Conventional Open Microdiscectomy for Sciatica.Global spine journal · 2024Article
- Development of an International AO Spine Guideline for the Use of Osteobiologics in Anterior Cervical Fusion and Decompression (AO-GO).Global spine journal · 2024Article
- Natural Language Processing of Referral Letters for Machine Learning-Based Triaging of Patients With Low Back Pain to the Most Appropriate Intervention: Retrospective Study.Journal of medical Internet research · 2024Article
- Assessing Serious Spinal Pathology Using Bayesian Network Decision Support: Development and Validation Study.JMIR formative research · 2023Article
- Current Applications of Machine Learning for Spinal Cord Tumors.Life (Basel, Switzerland) · 2023Review
- Machine learning clinical decision support for interdisciplinary multimodal chronic musculoskeletal pain treatment.Frontiers in pain research (Lausanne, Switzerland) · 2023Article
- Can EQ-5D-3L utility values of low back pain patients be validly predicted by the Oswestry Disability Index for use in cost-effectiveness analyses?Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2022Article
- An Evolution Gaining Momentum-The Growing Role of Artificial Intelligence in the Diagnosis and Treatment of Spinal Diseases.Diagnostics (Basel, Switzerland) · 2022Review
- Cost-effectiveness of full endoscopic versus open discectomy for sciatica.British journal of sports medicine · 2022Article
- International comparative study of low back pain care pathways and analysis of key interventions.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2021Article
- A Bayesian Network Decision Support Tool for Low Back Pain Using a RAND Appropriateness Procedure: Proposal and Internal Pilot Study.JMIR research protocols · 2021Article
- Extracellular vesicles from human mesenchymal stem cells expedite chondrogenesis in 3D human degenerative disc cell cultures.Stem cell research & therapy · 2020Article
- Serious Gaming During Multidisciplinary Rehabilitation for Patients With Chronic Pain or Fatigue Symptoms: Mixed Methods Design of a Realist Process Evaluation.Journal of medical Internet research · 2020Article
- Quadruple Decision Making for Parkinson's Disease Patients: Combining Expert Opinion, Patient Preferences, Scientific Evidence, and Big Data Approaches to Reach Precision Medicine.Journal of Parkinson's disease · 2020Article
- The longitudinal relationships between pain severity and disability versus health-related quality of life and costs among chronic low back pain patients.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2020Article
- Do socio-demographic characteristics and/or health status explain the magnitude of differences between patient and general public utility values? A chronic low back pain patients case study.Health and quality of life outcomes · 2019Article
- Development of a standard set of outcome measures for non-specific low back pain in Dutch primary care physiotherapy practices: a Delphi study.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2019Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn Western Europe, low back pain has the greatest burden of all diseases. When back pain persists, different medical specialists are involved and a lack of consensus exists among these specialists for medical decision-making in Chronic Low Back Pain (CLBP).
objectiveTo develop a decision tool for secondary or tertiary spine care specialists to decide which patients with CLBP should be seen by a spine surgeon or by other non-surgical medical specialists.
methodsA Delphi study was performed to identify indicators predicting the outcome of interventions. In the preparatory stage evidence from international guidelines and literature were summarized. Eligible studies were reviews and longitudinal studies. Inclusion criteria: surgical or non-surgical interventions and persistence of complaints, CLBP-patients aged 18-65 years, reported baseline measures of predictive indicators, and one or more reported outcomes had to assess functional status, quality of life, pain intensity, employment status or a composite score. Subsequently, a three-round Delphi procedure, to reach consensus on candidate indicators, was performed among a multidisciplinary panel of 29 CLBP-professionals (>five years CLBP-experience). The pre-set threshold for general agreement was ≥70%. The final indicator set was used to develop a clinical decision tool.
resultsA draft list with 53 candidate indicators (38 with conclusive evidence and 15 with inconclusive evidence) was included for the Delphi study. Consensus was reached to include 47 indicators. A first version of the decision tool was developed, consisting of a web-based screening questionnaire and a provisional decision algorithm.
conclusionsThis is the first clinical decision tool based on current scientific evidence and formal multidisciplinary consensus that helps referring the patient for consultation to a spine surgeon or a non-surgical spine care specialist. We expect that this tool considerably helps in clinical decision-making spine care, thereby improving efficient use of scarce sources and the outcomes of spinal interventions.
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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.