Evidence map›Paper›PMID 34003285›Full record

ArticlePhysical therapy2021

A Cognitive Functional Therapy+ Pathway Versus an Interdisciplinary Pain Management Pathway for Patients With Severe Chronic Low Back Pain (CONFeTTI Trial): Protocol for a Pragmatic Randomized Controlled Trial.

Henrik Bjarke Vaegter, Jannick Vaaben Johansen, Liza Sopina, Anne Smith, Peter Kent, Kira Søndberg Fuglsang, Jesper Fredslund Pedersen, Rob Schutze, Peter O'Sullivan, Gitte Handberg and 4 more

Open access · hybridAbstract readClinical Trial Protocol
In one paragraph

Article in Physical therapy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
0.3field-weighted citation impact, top 39% 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

2 citing papers in PubMed, 1 synthesis or guideline pooled it, 4 citations in OpenAlex.

  1. Models of care for managing non-specific low back pain.The Cochrane database of systematic reviews · 2025
    Pooled it
  2. Article
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

14 authors at 6 institutions in 5 countries.

Henrik Bjarke VaegterPain Research Group, Pain Center, Odense University Hospital, Odense, Denmark.
Jannick Vaaben JohansenPain Research Group, Pain Center, Odense University Hospital, Odense, Denmark.
Liza SopinaResearch Unit for General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark.
Anne SmithSchool of Physiotherapy and Exercise Science, Curtin University, Perth, Australia.
Peter KentSchool of Physiotherapy and Exercise Science, Curtin University, Perth, Australia.
Kira Søndberg FuglsangPain Center, Odense University Hospital, Odense, Denmark.
Jesper Fredslund PedersenPain Research Group, Pain Center, Odense University Hospital, Odense, Denmark.
Rob SchutzeSchool of Physiotherapy and Exercise Science, Curtin University, Perth, Australia.
Peter O'SullivanSchool of Physiotherapy and Exercise Science, Curtin University, Perth, Australia.
Gitte HandbergPain Research Group, Pain Center, Odense University Hospital, Odense, Denmark.
Francis FatoyeDepartment of Health Professions, Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, United Kingdom.
Kasper UssingSpine Center of Southern Denmark, Hospital of Lillebaelt, Middelfart, Denmark.
Irene StegemejerPain Research Group, Pain Center, Odense University Hospital, Odense, Denmark.
Jonas Bloch ThorlundResearch Unit for General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark.
Curtin University · AUOdense University Hospital · DKUniversity of Southern Denmark · DKLillebaelt Hospital · DKManchester Metropolitan University · GBNippon Paint (Japan) · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveChronic low back pain (cLBP) is the leading cause of disability. Interdisciplinary pain management is recommended for patients with severe/high-impact cLBP. Such programs are expensive, not easily accessible, and have limited effect; therefore, new cost-effective strategies are warranted. Cognitive functional therapy (CFT) has shown promising results but has not been compared with an interdisciplinary pain management approach. The primary aim of this randomized controlled trial is to investigate if a pathway starting with CFT including psychologist support (CFT+) with the option of additional usual care (if needed) is superior in improving disability and more cost-effective at 12 months compared with an interdisciplinary pain management pathway (usual care).

methodsThis pragmatic, 2-arm, parallel-group randomized controlled trial will randomly allocate patients (n = 176) aged 18 to 75 years referred to an interdisciplinary pain center due to severe cLBP to 1 of 2 groups (1:1 ratio). Participants randomized to CFT+ will participate in a 3-month functional rehabilitation pathway with the option of additional usual care (if needed), and participants randomized to the interdisciplinary pain management pathway will participate in an individualized program of longer duration designed to best suit the individual's situation, needs, and resources. The primary outcome is the proportion of participants with an 8-point improvement in the Oswestry Disability Index score at 12 months. Exploratory outcomes are change in Oswestry Disability Index scores over time and an economic analysis of quality-adjusted life years using the 3-level version of the EuroQol EQ-5D. IMPACT: The study evaluates the cost-effectiveness of CFT+ with the option of additional usual care (if needed) for individuals with severe cLBP. Findings can potentially improve future care pathways and reduce cost for the health care system.

Indexed as

Interdisciplinary CommunicationAdultChronic DiseaseCognitive Behavioral TherapyCombined Modality TherapyFemaleHumansLow Back PainMaleMiddle AgedPain ManagementPatient Care TeamPhysical Therapy ModalitiesPragmatic Clinical Trials as TopicRandomized Controlled Trials as TopicResearch DesignCognitive Functional TherapyCosts and Cost AnalysisHealth Care CostsInterdisciplinary Pain ManagementLow Back Pain

Identifiers

PMID34003285
PMCPMC8427714
OpenAlexW3162387968

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.