Evidence map›Paper›PMID 35300677›Full record

ArticleBMC health services research2022

Second opinions for spinal surgery: a scoping review.

Giovanni E Ferreira, Joshua Zadro, Chang Liu, Ian A Harris, Chris G Maher

Registry-linked trialAbstract readScoping Review
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC health services research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07788872 (MORESP, MOre REalistic Spine Patients), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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.

NCT07788872 nanot yet recruitingnot on this mapstarted 2026, after this paper: background citation

MORESP, MOre REalistic Spine Patients: Assessing the Effect of a Predictive Tool ("Dialogue Support") in Relation to Expectations, Post-surgical Outcomes and Surgery Cancellations in Patients With Lumbar Degenerative Spinal Disorders, as Well as Inter-rater Reliability Between Surgeons.

TypeinterventionalSponsorUniversity Hospital, AkershusRan2026 to 2031Enrolled440ConditionsSpinal Stenosis Lumbar, Disc Herniation, Lumbar, Degenrative Disc DiseaseArmsDialogue Support Consultation
3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  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

5 authors.

Giovanni E FerreiraInstitute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, Australia. giovanni.ferreira@sydney.edu.au.
Joshua ZadroInstitute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, Australia.
Chang LiuInstitute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, Australia.
Ian A HarrisInstitute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, Australia.
Chris G MaherInstitute for Musculoskeletal Health, The University of Sydney and Sydney Local Health District, Sydney, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSecond opinions have the goal of clarifying uncertainties around diagnosis or management, particularly when healthcare decisions are complex, unpleasant, and carry considerable risks. Second opinions might be particularly useful for people recommended surgery for their back pain as surgery has at best a limited role in the management of back pain.

methodsWe conducted a scoping review. Two independent researchers screened PubMed, EMBASE, Cochrane CENTRAL and CINAHL from inception to May 6th, 2021. Studies of any design published in any language were eligible provided they described a second opinion intervention for people with spinal pain (low back or neck pain with or without radicular pain) either considering surgery or to whom surgery had been recommended. We assessed the methodological quality with the Downs & Black scale. Outcomes were: i) characteristics of second opinion services for people considering or who have been recommended spinal surgery, ii) agreement between first and second opinions in terms of diagnoses, need for surgery and type of surgery, iii) whether they reduce surgery and improve patient outcomes; and iv) the costs and healthcare use associated with these services. Outcomes were presented descriptively.

resultsWe screened 6341 records, read 27 full-texts, and included 12 studies (all observational; 11 had poor methodological quality; one had fair). Studies described patient, doctor, and insurance-initiated second opinion services. Diagnostic agreement between first and second opinions varied from 53 to 96%. Agreement for need for surgery between first and second opinions ranged from 0 to 83%. Second opinion services may reduce surgery rates in the short-term, but it is unclear whether these reductions are sustained in the long-term or if patients only delay surgery. Second opinion services may reduce costs and healthcare use (e.g. imaging), but might increase others (e.g. injections).

conclusionsSecond opinion services typically recommend less surgical treatments compared to first opinions and may reduce surgery rates in the short-term, but it is unclear whether these reductions are sustained in the long-term or if patients only delay surgery. There is a need for high-quality randomised trials to determine the value of second opinion services for reducing spinal surgery.

Indexed as

PhysiciansReferral and ConsultationDelivery of Health CareHumansMotivationHealth services researchLow back pain, neck pain, spine surgeryOrthopaedicsOrthopaedic surgery

Identifiers

PMID35300677
PMCPMC8932184

What OpenQuestion holds

Textmetadata
LicenceCC BY
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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.