Evidence map›Paper›PMID 37989377›Full record

ArticleBMJ open2023

Clinical Observation, Management and Function Of low back pain Relief Therapies (COMFORT): A cluster randomised controlled trial protocol.

Christina Abdel Shaheed, Rowena Ivers, Lisa Vizza, Andrew McLachlan, Patrick J Kelly, Fiona Blyth, Fiona Stanaway, Philip James Clare, Rachel Thompson, Thomas Lung and 14 more

Open access · goldAbstract readClinical Trial Protocol
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
0.5field-weighted citation impact, top 31% 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

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

  1. Patient and family engagement interventions in primary care patient safety: systematic review and meta-analysis of randomised controlled trials.The British journal of general practice : the journal of the Royal College of General Practitioners · 2025
    Pooled it
  2. Article
  3. 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

24 authors at 9 institutions in 2 countries.

Christina Abdel ShaheedSydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia christina.abdelshaheed@sydney.edu.au.ORCID 0000-0003-1258-5125
Rowena IversGraduate School of Medicine, University of Wollongong, Sydney, New South Wales, Australia.ORCID 0000-0001-7847-9734
Lisa VizzaSydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.ORCID 0000-0002-0995-9635
Andrew McLachlanSydney Pharmacy School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.ORCID 0000-0003-4674-0242
Patrick J KellySydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.
Fiona BlythSydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.ORCID 0000-0003-1128-6756
Fiona StanawaySydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.ORCID 0000-0003-2104-3010
Philip James ClareSydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.ORCID 0000-0002-2009-7386
Rachel ThompsonSydney School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.ORCID 0000-0002-1009-0746
Thomas LungSydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.ORCID 0000-0001-9978-6311
Louisa DegenhardtNational Drug and Alcohol Research Centre (NDARC), Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia.ORCID 0000-0002-8513-2218
Sharon ReidSpecialty of Addiction Medicine, Central Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.ORCID 0000-0002-0859-5614
Bradley MartinDivision of Pharmaceutical Evaluation and Policy, University of Arkansas for Medical Sciences College of Pharmacy, Arkansas, Arkansas, USA.ORCID 0000-0001-8402-3098
Michael WrightCentre for Health Economics Research Evaluation, University of Technology Sydney, Sydney, New South Wales, Australia.ORCID 0000-0003-2708-4753
Rawa OsmanQuality Use of Medicines (QUM) Connect, Sydney, New South Wales, Australia.ORCID 0000-0003-2090-8123
Simon FrenchDepartment of Chiropractic, Macquarie University, Sydney, New South Wales, Australia.ORCID 0000-0002-7061-7706
Kirsten McCafferySydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.ORCID 0000-0003-2696-5006
Gabrielle CampbellSchool of Psychology, University of Queensland, Queensland, Queensland, Australia.ORCID 0000-0002-0851-0748
Hazel JenkinsDepartment of Chiropractic, Macquarie University, Sydney, New South Wales, Australia.ORCID 0000-0002-0535-687X
Stephanie MathiesonSydney Musculoskeletal Health, University of Sydney, Sydney, New South Wales, Australia.ORCID 0000-0002-7335-8842
Monika BoogsPainaustralia Consumer Advisory Group, Canberra, ACT, Australia.
Jarrod McMaughPharmaceutical Society of Australia, Canberra, ACT, Australia.ORCID 0000-0002-2000-2068
Carol BennettAlliance for Gambling Reform, National, Victoria, Australia.
Christopher MaherSydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.ORCID 0000-0002-1628-7857
The University of Sydney · AUMacquarie University · AUAustralian Diabetes Society · AUAustralian National University · AUThe University of Queensland · AUUniversity of Arkansas for Medical Sciences · USUniversity of Technology Sydney · AUUniversity of Wollongong · AUUNSW Sydney · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionLow back pain (LBP) is commonly treated with opioid analgesics despite evidence that these medicines provide minimal or no benefit for LBP and have an established profile of harms. International guidelines discourage or urge caution with the use of opioids for back pain; however, doctors and patients lack practical strategies to help them implement the guidelines. This trial will evaluate a multifaceted intervention to support general practitioners (GPs) and their patients with LBP implement the recommendations in the latest opioid prescribing guidelines. METHODS AND ANALYSIS: This is a cluster randomised controlled trial that will evaluate the effect of educational outreach visits to GPs promoting opioid stewardship alongside non-pharmacological interventions including heat wrap and patient education about the possible harms and benefits of opioids, on GP prescribing of opioids medicines dispensed. At least 40 general practices will be randomised in a 1:1 ratio to either the intervention or control (no outreach visits; GP provides usual care). A total of 410 patient-participants (205 in each arm) who have been prescribed an opioid for LBP will be enrolled via participating general practices. Follow-up of patient-participants will occur over a 1-year period. The primary outcome will be the cumulative dose of opioid dispensed that was prescribed by study GPs over 1 year from the enrolment visit (in morphine milligram equivalent dose). Secondary outcomes include prescription of opioid medicines, benzodiazepines, gabapentinoids, non-steroidal anti-inflammatory drugs by study GPs or any GP, health services utilisation and patient-reported outcomes such as pain, quality of life and adverse events. Analysis will be by intention to treat, with a health economics analysis also planned. ETHICS AND DISSEMINATION: The trial received ethics approval from The University of Sydney Human Research Ethics Committee (2022/511). The results will be disseminated via publications in journals, media and conference presentations. TRIAL REGISTRATION NUMBER: ACTRN12622001505796.

Indexed as

General PractitionersLow Back PainAnalgesics, OpioidHumansPractice Patterns, Physicians'Quality of LifeRandomized Controlled Trials as TopicAnalgesics, OpioidBack painPrimary Health CareProtocols & guidelines

Identifiers

PMID37989377
PMCPMC10668201
OpenAlexW4388871239

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.