Evidence map›Paper›PMID 34991627›Full record

Observational studyChiropractic & manual therapies2022

Efficiency of primary spine care as compared to conventional primary care: a retrospective observational study at an Academic Medical Center.

Serena Bezdjian, James M Whedon, Robb Russell, Justin M Goehl, Louis A Kazal

Open access · goldAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Chiropractic & manual therapies, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
3.7field-weighted citation impact, top 7% 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, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Article
  4. Article
  5. Review
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

5 authors at 2 institutions in 1 country.

Serena BezdjianSouthern California University of Health Sciences, Whittier, CA, 90604, USA. SerenaBezdjian@scuhs.edu.ORCID 0000-0003-4755-4257
James M WhedonSouthern California University of Health Sciences, Whittier, CA, 90604, USA.
Robb RussellSouthern California University of Health Sciences, Whittier, CA, 90604, USA.
Justin M GoehlGeisel School of Medicine at Dartmouth, Hanover, NH, 03755, USA.
Louis A KazalGeisel School of Medicine at Dartmouth, Hanover, NH, 03755, USA.
Southern California University of Health Sciences · USDartmouth College · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPrimary Spine Care (PSC) is an innovative model for the primary management of patients with spine-related disorders (SRDs), with a focus on the use of non-pharmacological therapies which now constitute the recommended first-line approach to back pain. PSC clinicians serve as the initial or early point of contact for spine patients and utilize evidence-based spine care pathways to improve outcomes and reduce escalation of care (EoC; e.g., spinal injections, diagnostic imaging, hospitalizations, referrals to a specialist). The present study examined 6-month outcomes to evaluate the efficiency of care for patients who received PSC as compared to conventional primary care. We hypothesized that patients seen by a PSC clinician would have lower rates of EoC compared to patients who received usual care by a primary care (PC) clinician.

methodsThis was a retrospective observational study. We evaluated 6-month outcomes for two groups seen and treated for an SRD between February 01, 2017 and January 31, 2020. Patient groups were comprised of N = 1363 PSC patients (Group A) and N = 1329 PC patients (Group B). We conducted Pearson chi-square and logistic regression (adjusting for patient characteristics that were unbalanced between the two groups) to determine associations between the two groups and 6-month outcomes.

resultsWithin six months of an initial visit for an SRD, a statistically significantly smaller proportion of PSC patients utilized healthcare resources for spine care as compared to the PC patients. When adjusting for patient characteristics, those who received care from the PSC clinician were less likely within 6 months of an initial visit to be hospitalized (OR = .47, 95% CI .23-.97), fill a prescription for an opioid analgesic (OR = .43; 95% CI .29-.65), receive a spinal injection (OR = .56, 95% CI .33-.95), or have a visit with a specialist (OR = .48, 95% CI .35-.67) as compared to those who received usual primary care.

conclusionsPatients who received PSC in an academic primary care clinic experienced significantly less escalation of their spine care within 6 months of their initial visit. The PSC model may offer a more efficient approach to the primary care of spine problems for patients with SRDs, as compared to usual primary care.

Indexed as

Back PainPrimary Health CareAcademic Medical CentersHumansReferral and ConsultationRetrospective StudiesAcademic primary care clinicChiropracticEfficiencyLow back painPrimary carePrimary spine careSpine pain escalation of careSpine-related disorders

Identifiers

PMID34991627
PMCPMC8740480
OpenAlexW4205918043

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.