Evidence map›Paper›PMID 39373005›Full record

ArticleSurgical neurology international2024

Value-based healthcare in management of chronic back pain: A multidisciplinary- and lean-based approach.

Nicola Montemurro, Nunzio Zotti, Jacopo Guercini, Giuliano De Carolis, Chiara Leoni, Roberto Marotta, Renata Tomei, Angelo Baggiani, Adriana Paolicchi, Simone Lazzini and 1 more

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In one paragraph

Article in Surgical neurology international, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–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.

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

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

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

11 authors.

Nicola MontemurroDepartment of Neurosurgery, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy.
Nunzio ZottiDepartment of Translational Research and the New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.
Jacopo GuerciniDepartment of Economic Finance, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy.
Giuliano De CarolisAnaesthesiology and Pain Therapy Unit, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy.
Chiara LeoniAnaesthesiology and Pain Therapy Unit, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy.
Roberto MarottaDepartment of Health Technical Professions, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy.
Renata TomeiUnit of Transfusion Medicine and Transplantation Biology, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy.
Angelo BaggianiDepartment of Translational Research and the New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.
Adriana PaolicchiAnaesthesiology and Pain Therapy Unit, Azienda Ospedaliero Universitaria Pisana, Pisa, Italy.
Simone LazziniDepartment of Economics and Management, University of Pisa, Pisa, Italy.
Francesca Di SerafinoDepartment of Translational Research and the New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Chronic back pain stands as the most common musculoskeletal disorder and a primary cause of disability in people under 45 years old. Multidisciplinary consultation offers an efficient approach to chronic back pain management compared to traditional therapeutic-rehabilitative paths. This paper aims to show the benefit of a diagnostic-therapeutic multidisciplinary program pathway for patients with chronic back pain. Methods: Twenty-six patients who underwent a second-level multidisciplinary consultation with a neurosurgeon and a pain therapist at our University Hospital were retrospectively identified from April 2023 to September 2023. The second-level multidisciplinary consultation is a second step consultation after a first consultation with a single specialist doctor (neurosurgeon, orthopedic, and pain therapist) who did not get the diagnosis and/or did not solve the painful symptom after medical or surgical treatment. Clinical outcomes, patient experience, and cost-effectiveness analysis were assessed using lean healthcare tools. Results: With the introduction of second-level multidisciplinary consultation, patients were assessed by multiple physicians during a single visit, reducing the costs of individual visits, reducing the time to obtain the diagnosis, and facilitating early agreement on a diagnostic-therapeutic plan. The lean value-based healthcare approach showed an average of 45 working days lost per single patient and a total cost per single patient with chronic back pain of € 1069 for the national health system for an average Lead time of 18 months. Questionnaire analysis on service quality and utility, along with overall satisfaction, revealed excellent resolution of back pain in 53.8% of cases and partial resolution of back pain in 11.5% of cases after second-level multidisciplinary consultation. Conclusion: Our multidisciplinary approach to chronic back pain has significantly improved healthcare efficiency. This new proposed clinical model reduces waiting times and costs and improves patient experience by improving clinical outcomes in the management of chronic back pain.

Indexed as

Chronic back painLean-based approachMultidisciplinary managementValue-based healthcare

Identifiers

PMID39373005
PMCPMC11450888

What OpenQuestion holds

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Registered trials

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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.