Evidence map›Paper›PMID 25828191›Full record

ArticleActa orthopaedica2015

A proposed set of metrics for standardized outcome reporting in the management of low back pain.

R Carter Clement, Adina Welander, Caleb Stowell, Thomas D Cha, John L Chen, Michelle Davies, Jeremy C Fairbank, Kevin T Foley, Martin Gehrchen, Olle Hagg and 16 more

Open access · goldAbstract read
In one paragraph

Article in Acta orthopaedica, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 86 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
86citing papers in PubMed, 6 pooled it
15.5field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

86 citing papers in PubMed, 6 syntheses or guidelines pooled it, 163 citations in OpenAlex.

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  12. Sex difference in outcomes and risk factors for lumbar decompressive surgery.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 · 2026
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  14. Factors associated with preoperative health-related quality of life in patients undergoing lumbar spine surgery: a multi-ethnic Asian cohort.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2026
    Article
  15. Length of stay after lumbar decompressive surgery: prediction model, clinical reasons for prolonged stay, and association of prolonged stay with outcomes.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 · 2026
    Article
  16. Loss to follow-up after lumbar decompressive surgery: effect of collection method and perioperative factors on patient-reported outcome measures.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 · 2026
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26 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

26 authors at 20 institutions in 8 countries.

R Carter Clementa 1 Department of Orthopaedic Surgery, University of North Carolina Hospitals , Chapel Hill, NC, USA.
Adina Welanderb 2 Boston Consulting Group , Stockholm, Sweden.
Caleb Stowellc 3 International Consortium for Health Outcomes Measurement , Boston, MA, USA.
Thomas D Chad 4 Department of Orthopaedics, Massachusetts General Hospital , Boston, MA, USA.
John L Chene 5 Department of Orthopaedic Surgery , Singapore General Hospital, Singapore.
Michelle Daviesf 6 Patient representative , Brisbane, Australia.
Jeremy C Fairbankg 7 Nuffield Orthopaedic Centre, University of Oxford , Oxford, UK.
Kevin T Foleyh 8 Department of Neurosurgery, University of Tennessee Health Science Center , Memphis, TN, USA.
Martin Gehrcheni 9 Department of Orthopaedic Surgery, Spine Section, Rigshospitalet, University Hospital of Copenhagen , Copenhagen, Denmark.
Olle Haggj 10 Spine Center Göteborg , Gothenburg, Sweden.
Wilco C Jacobsk 11 Department of Neurosurgery, Leiden University Medical Center , Leiden, the Netherlands.
Richard Kahlerl 12 BrizBrain and Spine , Brisbane, Australia.
Safdar N Khanm 13 Department of Orthopaedics, Division of Spine, Ohio State University , Wexner Medical Center, Columbus, OH, USA.
Isador H Liebermann 14 Texas Back Institute , Plano, TX, USA.
Beth Morissono 15 Newro Foundation , Brisbane, Australia.
Donna D Ohnmeissn 14 Texas Back Institute , Plano, TX, USA.
Wilco C Peulp 16 Department of Neurosurgery, Leiden University Medical Center and Medical Center Haaglanden , Leiden and The Hague, the Netherlands.
Neal H Shonnardq 17 Director, Spine SCOAP Collaborative, Rainier Orthopedic Institute , Puyallup, WA, US.
Matthew W Smuckr 18 Department of Orthopaedic Surgery, PM&R Section, Stanford University , Palo Alto, CA, USA.
Tore K Solbergs 19 Department of Ophthalmology and Neurosurgery, University Hospital of Northern Norway , Tromsø, Norway.
Bjorn H Stromqvistu 21 Department of Orthopedics, Clinical Sciences Lund, Lund University Hospital , Lund, Sweden.
Miranda L Van Hooffv 22 Sint Maartenskliniek, Research , Nijmegen, the Netherlands.
Ajay D Wasanw 23 Department of Anesthesiology , University of Pittsburgh Medical Center Pittsburgh, PA, USA.
Paul C Willemsx 24 Maastricht University Medical Center , Maastricht, the Netherlands.
William Yeoy 25 Orthopaedic Diagnostic Centre , Singapore General Hospital, Singapore.
Peter Fritzellz 26 Department of Orthopaedic Surgery, Ryhov Hospital , Jönköping, Sweden.
Leiden University Medical Center · NLSingapore General Hospital · SGTexas Back Institute · USCollaborative Group (United States) · USCopenhagen University Hospital · DKHouse of Representatives · NLInnovation Management Consulting Group (Sweden) · SELund University · SEMaastricht University Medical Centre · NLMassachusetts General Hospital · USNetherlands Heart Registration · NLNuffield Orthopaedic Centre · GBOutcomes Research Consortium · USPalo Alto University · USQueensland Emergency Medicine Research Foundation · AUSint Maartenskliniek · NLSpeech Pathology Australia · AUSpine Center Göteborg · SEThe Ohio State University Wexner Medical Center · USUniversity Hospital of North Norway · NO

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

background and purposeOutcome measurement has been shown to improve performance in several fields of healthcare. This understanding has driven a growing interest in value-based healthcare, where value is defined as outcomes achieved per money spent. While low back pain (LBP) constitutes an enormous burden of disease, no universal set of metrics has yet been accepted to measure and compare outcomes. Here, we aim to define such a set. PATIENTS AND

methodsAn international group of 22 specialists in several disciplines of spine care was assembled to review literature and select LBP outcome metrics through a 6-round modified Delphi process. The scope of the outcome set was degenerative lumbar conditions.

resultsPatient-reported metrics include numerical pain scales, lumbar-related function using the Oswestry disability index, health-related quality of life using the EQ-5D-3L questionnaire, and questions assessing work status and analgesic use. Specific common and serious complications are included. Recommended follow-up intervals include 6, 12, and 24 months after initiating treatment, with optional follow-up at 3 months and 5 years. Metrics for risk stratification are selected based on pre-existing tools.

interpretationThe outcome measures recommended here are structured around specific etiologies of LBP, span a patient's entire cycle of care, and allow for risk adjustment. Thus, when implemented, this set can be expected to facilitate meaningful comparisons and ultimately provide a continuous feedback loop, enabling ongoing improvements in quality of care. Much work lies ahead in implementation, revision, and validation of this set, but it is an essential first step toward establishing a community of LBP providers focused on maximizing the value of the care we deliver.

Indexed as

Delphi TechniqueHumansLow Back PainOutcome Assessment, Health CarePain ManagementPain MeasurementPatient SatisfactionRisk FactorsTreatment Outcome

Identifiers

PMID25828191
PMCPMC4564773
OpenAlexW1984174044

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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.