Application of a Diagnosis-Based Clinical Decision Guide
in Patients with Low Back Pain
SOURCE: Chiropractic & Manual Therapies 2011 (Oct 22); 19: 26
By Donald R Murphy, DC, DACAN, and Eric L Hurwitz, DC, PhD
Rhode Island Spine Center, 600 Pawtucket Avenue, Pawtucket, RI 02860 USA
Low back pain (LBP) affects approximately 80% of adults at some time in life  and occurs in all ages [2, 3]. Despite billions being spent on various diagnostic and treatment approaches, the prevalence and disability related to LBP has continued to increase . There has been a recent movement toward comparative effectiveness research , i.e., research that determines which treatment approaches are most effective for a given patient population. In addition, there is increased recognition of the importance of practice-based research which generates data in a “real world” environment as a tool for conducting comparative effectiveness research [6, 7]. This movement calls for greater participation of private practice environments in clinical research .
One of the reasons often given for the meager benefits that have been found with various LBP treatments is that these treatments are generally applied generically, without regard for specific characteristics of each patient, whereas the LBP population is a heterogeneous group, requiring individualized care . Developing a strategy by which treatments can be targeted to the specific needs of patients has been identified as a research priority [9, 10].
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