Evidence map›Paper›PMID 39970070›Full record

Trial reportScandinavian journal of work, environment & health2025

Cost analysis comparing guideline-oriented biopsychosocial management to usual care for low-back pain: a cluster-randomized trial in occupational health primary care.

Maija Paukkunen, Jaro Karppinen, Birgitta Öberg, Leena Ala-Mursula, Eveliina Heikkala, Katja Ryynänen, Riikka Holopainen, Samuel Booth, Neill Booth, Allan Abbott

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in Scandinavian journal of work, environment & health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the 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.

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. Trial
  2. Trial
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

10 authors.

Maija PaukkunenResearch Unit of Health Sciences and Technology, PO Box 8000, University of Oulu, 90014, Oulu, Finland. maija.paukkunen@oulu.fi.
Jaro Karppinen
Birgitta Öberg
Leena Ala-Mursula
Eveliina Heikkala
Katja Ryynänen
Riikka Holopainen
Samuel Booth
Neill Booth
Allan Abbott

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThis study aimed to investigate the effect of a brief training intervention for occupational health services (OHS) professionals on multiprofessional resource utilization and the costs of biopsychosocial management of patients with low-back pain (LBP) compared to usual care among all participants and those in work disability-based risk groups.

methodsOHS utilization and back-related sick leave data were collected from electronic patient records over one-year follow-up comparing 232 patients in the intervention arm and 80 control-arm patients, stratified for risk of work disability based on the Örebro Musculoskeletal Pain Screening Questionnaire. We estimated costs using linear mixed models by multiplying unit costs (in euros) by each type of OHS resource use (visits to physicians, physiotherapists, nurses, use of imaging) and the number of sick leaves. Estimated mean cost differences with confidence intervals (CI) were reported using bootstrapping to deal with skewed cost data.

resultsThe median number of visits to physicians and physiotherapists in the intervention versus control arms was 1 [interquartile range (IQR) 0-3] and 2 (IQR 1-4) versus 2 (IQR 1-3) and 1 (IQR 0-2), respectively. The intervention arm accrued lower physician costs (€-43, 95% CI €-82- -3, P=0.034) and higher physiotherapist costs (€55, 95% CI €26-84, P<0.001) compared to the control arm. There was no statistically significant difference in average total costs between the arms (€-1908, 95% CI €-6734-2919). In the low- and medium-risk groups of work disability, physiotherapist costs were higher in the intervention than control arm, but no statistically significant differences were observed between the arms in the total resource utilization or sickness absence costs.

conclusionsBrief biopsychosocial training may support shifting OHS resources towards multiprofessional physiotherapist-driven care, instead of solely physician-driven care, for management of patients with LBP in differing risk groups of work disability with no substantial differences in total costs.

Indexed as

Low Back PainOccupational Health ServicesPrimary Health CareAdultCosts and Cost AnalysisFemaleHumansMaleMiddle AgedSick Leave

Identifiers

PMID39970070
PMCPMC12070492

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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.