Evidence map›Paper›PMID 32252643›Full record

ArticleBMC family practice2020

A classification-based approach to low back pain in primary care - protocol for a benchmarking controlled trial.

A S Simula, A Malmivaara, N Booth, J Karppinen

Open access · goldAbstract readClinical Trial Protocol
In one paragraph

Article in BMC family practice, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.2field-weighted citation impact, top 48% 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

5 citing papers in PubMed, 7 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 3 institutions in 1 country.

A S SimulaMedical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland. anna.simula@oulu.fi.ORCID 0000-0003-0796-4892
A MalmivaaraCentre for Health and Social Economics, Finnish Institute for Health and Welfare, Helsinki, Finland.
N BoothFaculty of Social Sciences (Health Sciences), Tampere University, Tampere, Finland.
J KarppinenMedical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.
Oulu University Hospital · FIFinnish Institute for Health and Welfare · FITampere University · FI

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundGuidelines recommend a biopsychosocial framework for low back pain (LBP) management and the avoidance of inappropriate imaging. In clinical practice, care strategies are often inconsistent with evidence and guidelines, even though LBP is the most common disabling health condition worldwide. Unhelpful beliefs, attitudes and inappropriate imaging are common. LBP is understood to be a complex biopsychosocial phenomenon with many known multidimensional risk factors (symptom- and lifestyle-related, psychological and social) for persistent or prolonged disability, which should be identified and addressed by treatment. The STarT Back Tool (SBT) was developed for early identification of individual risk factors of LBP to enable targeted care. Stratified care according SBT has been shown to improve the effectiveness of care in a primary care setting. A biopsychosocially-oriented patient education booklet, which includes imaging guidelines and information, is one possible way to increase patients' understanding of LBP and to reduce inappropriate imaging. Premeditated pathways, education of professionals, written material, and electronic patient registry support in health care organizations could help implement evidence-based care.

methodsWe will use a Benchmarking Controlled Trial (BCT) design in our study. We will prospectively collect data from three health care regions before and after the implementation of a classification-based approach to LBP in primary care. The primary outcome will be change in PROMIS (Patient-Reported Outcomes Measurement Information System) (short form 20a) over 12-month follow-up. DISCUSSION: The implementation of a classification-based biopsychosocial approach can potentially improve the care of LBP patients, reduce inappropriate imaging without increasing health-care costs, and decrease indirect costs by reducing work disability. Using the BCT we will be able to evaluate the effectiveness of the improvement strategy for the entire care pathway.

trial registrationISRCTN,ISRCTN13273552, retrospectively registered 13/05/2019.

Indexed as

Low Back PainPain MeasurementPatient Care ManagementAdultBenchmarkingFemaleHumansImplementation ScienceMaleModels, BiopsychosocialPatient-Centered CarePatient Reported Outcome MeasuresBenchmarking controlled studyBiopsychosocial approachClassification-based approachImplementation researchLow back painPrimary careSTarT Back tool

Identifiers

PMID32252643
PMCPMC7137427
OpenAlexW3014743522

What OpenQuestion holds

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LicenceCC BY
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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.