low back pain clinical practice guidelines 2021
low back pain clinical practice guidelines 2021
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low back pain clinical practice guidelines 2021
The median year of publication was 2020 (range, 2015-2021). Due to the heterogeneity between studies, a meta-analysis was not performed. VA/DoD clinical practice guideline for diagnosis and treatment of low Back pain. Traditional Medicine welcomes all attendees, presenters, and exhibitors from all over the world to Participate at upcoming physically Events We are glad to invite you all to attend and register for 12th International Conference and Exhibition on Traditional, Complementary & Alternative Medicine which is going to be held during October 27-28, 2022 Three appraisals (17.6%) involved four AGREE II raters and the remaining involved two or three. The global burden of low back pain: estimates from the Global Burden of Disease 2010 study. Low Back Pain | 2019. CINHAL, PubMed, EMBASE, PEDro, Google Scholar, Government websites, Scientific Association websites were searched until April 2019. LBP Low back pain, CPG Clinical practice guideline, MSK Musculoskeletal, NASS North American Spine Society, NR Not reported, aqualitative synthesis due to missing data, binformation found in the previous publication [41], A total of 43/106 CPGs (40.6%) were overlapping in 17 appraisals (i.e., assessed by at least two appraisals) and 23 CPGs [4265] had been assessed by at least three appraisals. In response to the global burden of LBP, major medical societies or specialized working groups have developed clinical practice guidelines (CPGs) for its diagnosis and management [3, 4]. The psychosocial aspects are significant determinants of disability and deserve our attention from the start. The registered protocol study is available in OSF repository (https://osf.io/rz7nh/). These guideline products are no longer viewed as guidance for current medical practice, and are provided for archival purposes only. Managing athletic hip and groin pain: What are the recommendations? An evidence-based clinical guideline for the diagnosis and treatment of lumbar disc herniation with radiculopathy. Lawson DO, Puljak L, Pieper D, Schandelmaier S, Collins GS, Brignardello-Petersen R, et al. Bargeri S, Iannicelli V, Castellini G, Cinquini M, Gianola S. AGREE II appraisals of clinical practice guidelines in rehabilitation showed poor reporting and moderate variability in quality ratings when users apply different cuff-offs: a methodological study. The NASS Clinical Practice Guideline Committee is trained in evidence analysis and uses an evidence-based guideline development methodology. The 2007 clinical practice guideline for LBP summarizes the evidence as to what is important, what works, what we know, and what we Murad MH, Wang Z. about navigating our updated article layout. This domain presents broad assessment of patient values, preferences, and experiences (e.g., patients/public participation in a CPG development group, external review, interview or literature review), which could be perceived as valid alternative strategies and not a combination of actions. This implies a potential waste of time and resources, since many appraisals assessed the same CPGs. . 2022 PhysioX Pte Ltd. All Rights Reserved. The authors t thank J.D. Includes any guidance, advice and quality standards. We strive to accurately diagnose and treat the root cause of our patients concerns in order for them to return to their desired functional status. Method The searches for clinical practice guidelines were performed for . Learn more When no response was received, we calculated the domain scores based on AGREE II item scores according to the AGREE II formulas [9]. Institute for Clinical Systems Improvement. LBP has bio-psychosocial components. AGREE Next Steps Consortium. (2021). (24). 2017. The .gov means its official. Clinical practice guidelines for the treatment and management of low back pain: a systematic review of quantity and quality. Visit the Clinical . Geneva: World Health Organization; 2014. A critical appraisal of clinical practice guidelines for the treatment of lumbar spinal stenosis. Diagnosis and Treatment of Adult Isthmic Spondylolisthesis. Hoffmann-Esser W, Siering U, Neugebauer EAM, Lampert U, Eikermann M. Systematic review of current guideline appraisals performed with the Appraisal of Guidelines for Research & Evaluation II instrument-a third of AGREE II users apply a cut-off for guideline quality. It summarises the updated recommendations from NICE for the assessment and management of low back pain and sciatica. Qaseem A, Wilt TJ, McLean RM, Forciea MA, Denberg TD, Clinical Guidelines Committee of the American College of P et al. A systematic review of US spending on healthcare between 1996 and 2013 found that, after diabetes and ischemic heart disease, low . The protocol is available on the public Open Science Framework (OSF) repository at https://osf.io/rz7nh/. Health care providers' understanding of self-management support for people with chronic low back pain in Ethiopia: an interpretive description. government site. Acute low back pain: guidelines for clinical care [with consumer summary]. Statistical significance was set at P < 0.05. This report summarized the state-of-the-art scientific knowledge for each predefined area of the guidelines from a critical review of selected literature. Pillastrini P, Gardenghi I, Bonetti F, Capra F, Guccione A, Mugnai R, Violante FS. Nonetheless, perfect/substantial agreement in 78% of AGREE II ratings confirmed the CPG quality. Treasure Island (FL): StatPearls Publishing; 2022 Jan. 514-530. . Yaman ME, Gudeloglu A, Senturk S, Yaman ND, Tolunay T, Ozturk Y, et al. Evidence-based treatment recommendations for neck and low back pain across Europe: a systematic review of guidelines. Chou R, Qaseem A, Snow V, Casey D, Cross JT, Jr, Shekelle P, et al. Table Table66 presents the variability in the most often overlapping CPGs (assessed by at least 5 appraisals) Overall assessment 1 varied the most in the KCE 2017 [43] (IQR 23 on a 0-100 scale) and the least in the NICE 2016 [63] (IQR 9.4 on a 0-100 scale). Chest pain should be described as cardiac, possibly cardiac, or noncardiac rather than as typical or atypical. Ottawa Panel evidence-based clinical practice guidelines on therapeutic massage for low back pain. A multidisciplinary steering committee of 11 health care professionals developed 71 seed . The MIST guidelines: the Lumbar Spinal Stenosis Consensus Group guidelines for minimally invasive spine treatment. The cost of this is enormous. A critical appraisal of the quality of low back pain practice guidelines using the AGREE II tool and comparison with previous evaluations: a EuroAIM initiative. Low Back Pain | 2021. . Low back pain and sciatica in over 16s: assessment . The author(s) read and approved the final manuscript. Meroni R, Piscitelli D, Ravasio C, Vanti C, Bertozzi L, De Vito G, et al. Bethesda, MD 20894, Web Policies Domain score variability of overlapping CPGs assessed by at least three appraisals, Variability is expressed as the IQR (quartile 3-quartile 1) of domain scores for overlapping CPGs. The sizeable sample of appraisals encompassing CPGs for LBP prevention, diagnosis, and treatment supports the external validity of our findings. Dagenais S, Tricco AC, Haldeman S. Synthesis of recommendations for the assessment and management of low back pain from recent clinical practice guidelines. Sex and gender considerations in low back pain clinical practice guidelines: a scoping review. Kreiner DS, Shaffer WO, Baisden JL, Gilbert TJ, Summers JT, Toton JF, et al. Supplementary documents may sometimes no longer be retrievable, especially if the CPG is outdated. The site is secure. Manual Therapy: Always a Passive Treatment? Liberati AAD, Tetzlaff J, Mulrow C, Gtzsche PC, Ioannidis JP, et al. Keywords: Version 1. Systematic reviewsauthors can apply AGREE II in their critical appraisal of CPGs for LBP [1317], but stakeholders, clinicians, and policy makers may find it difficult to discern the highest quality CPG when appraisals give different quality ratings of overlapping CPGs. Castellini G, Iannicelli V, Briguglio M, Corbetta D, Sconfienza LM, Banfi G, Gianola S. BMC Health Serv Res. Careers. Low back pain (LBP) is a common musculoskeletal condition, a leading cause of disability, and one of the costliest medical conditions. Bankart repairs: How to help athletes return to sport, Persistent knee pain and stiffness after injury or surgery, Knee pain in the growing child: Osgood-Schlatter disease. Clinical and methodological competences should always be well balanced among raters,and reported to ensure adherence to high standards. Finally, three independent investigators screened the documents for the selected inclusion criteria and reviewed the retrieved documents by means of the AGREE II instrument. Implementing a new physiotherapist-led primary care model for low back pain: a qualitative study of patient and primary care team perspectives. Franz K, van Wijnen H. YY physiotherapeutic clinical guidelines for the management of nonspecific low back pain literature review. In general, variability can be partly explained by the different number of items in each domain, the number of raters, and the subjective rating of AGREE II items that can be differently weighted as leniency and strictness bias [98]. Critical appraisal of international guidelines for the screening and treatment of asymptomatic peripheral artery disease: a systematic review. doi: 10.5694/mja2.50881. The symptoms and severity of a Covid-19 infection vary significantly. Chest pain is the most common symptom among both men and women diagnosed with acute coronary syndrome (ACS). Table Table11 presents the general characteristics of the 17 appraisals. Published products on this topic (25) Guidance We use the best available evidence to develop recommendations that guide decisions in health, public health and social care. 2011. Overall, NICE 2016 [63] and CCGPP 2016 [55] ranked first and second, respectively. Conflict of interest can arise for anyone involved in CPG development (funders, systematic review authors, panel members, patients or their representatives, peer reviewers, researchers) [90] and have an impact on biased recommendations with consequences for patients [91, 92]. A third reviewer was consulted to resolve reviewer disagreement. 5 For a visual summary, please see infographic. 2017. This stunning statistic has an explanation which was published in 2021 in the Journal of the American Medical Association Network Open, in an article titled (25): A plausible explanation for the discrepancy in the degree of agreement on CPGs is that the AGREE II tool includes different information within a single item. 835 0 obj <>/Filter/FlateDecode/ID[<1FF7ED61C8447F0F1CEE9DB16E2B06F8><1BF3DC3805400542A0C7DA6E5BD8CD39>]/Index[821 32]/Info 820 0 R/Length 85/Prev 713760/Root 822 0 R/Size 853/Type/XRef/W[1 3 1]>>stream Finally, due to missing data (overall assessment 1 not reported in 35% of appraisals; overall assessment 2 not reported in 76% of appraisals) and heterogeneity of reporting (1-7 point or 0-100 point scales; final recommendation for use or raw recommendation for use), we found it difficult to synthesize agreements and provide implications for clinical practice. Exercises: which ones are worth trying, for which patients, and when? Bussieres AE, Stewart G, Al-Zoubi F, Decina P, Descarreaux M, Haskett D, et al. Affiliation, member role, and management of potential conflict of interest in the recommendation process must be transparently reported to improve judgment consistency. Reassessment of clinical practice guidelines: go gently into that good night. Published guidance on this topic (17) New in the last 6 months (3) Accessibility Clipboard, Search History, and several other advanced features are temporarily unavailable. The Modified Downs and Black checklist was utilized to determine study quality. The Low Back Pain Clinical Care Standard aims to improve the early assessment, management, review and appropriate referral of patients with this common health condition. Baggott and Kenneth Adolf Britsch for language revision and the appraisals authors who helped us to track down missing data. Legend. Neuroimag Clin N The Global Spine Care Initiative: applying evidence-based guidelines on the non-invasive management of back and neck pain to low- and middle-income communities. The study was supported by the Italian Ministry of Health Linea 3 Valutazione della qualit delle attuali linee guida in ortopedia e in riabilitazione. We defined perfect agreement when all appraisals gave the same judgment for the same category (e.g., all judged high quality for the same CPGs, IRR=1). Silvia Gianola and Silvia Bargeri contributed equally to this work. In the United States, LBP remains one of the most common reasons to seek health care and, along with neck pain, is the medical condition associated with the highest overall costs. 2020 Oct 22;20(1):970. doi: 10.1186/s12913-020-05827-w. Vader K, Donnelly C, French SD, Grady C, Hill JC, Tripp DA, Williams A, Miller J. BMC Prim Care. We used the average intraclass correlation coefficient (ICC) with 95% confidence interval (CI) of the six domain scores to formulate agreement between overlapping CPGs [22]. Interventions for the Management of Acute and Chronic Low Back Pain: Revision 2021 Clinical Practice Guidelines Linked to the International Classification of Functioning, Disability and Health From the Academy of Orthopaedic Physical Therapy of the American Physical Therapy Association Authors Journal of Orthopaedic & Sports Physical Therapy Globally, LBP is highly prevalent and a leading cause of disability. Chronic low back pain represents a major problem throughout the world which is increasing largely because of the aging world population. When reported by the appraisers, quality ratings (high, moderate, low) were also extracted. Guideline summary review: an evidence-based clinical guideline for the diagnosis and treatment of degenerative lumbar spondylolisthesis. Brosseau L, Wells GA, Poitras S, Tugwell P, Casimiro L, Novikov M, et al. The funding sources had no controlling role in the study design, data collection, analysis, interpretation or report writing. The overall quality of these Clinical practice Guidelines was moderately variable. Interventions for the management of acute and chronic low back pain: Revision 2021. Questions? Joint Bone Spine. Low back pain is categorized by how long symptoms last. It is critical that health care practitioners take . Design and planning the methods to generate the results: SG, GC, SB, RM, MC, VI. Most cases of back pain are mechanical in origin and respond to activity modification, rest, ice, and heat. Variability of each of the six domain scores for the overlapping CPGs (assessed by at least three appraisals) is reported as mean IQR. Wong JJ, Cote P, Sutton DA, Randhawa K, Yu H, Varatharajan S, et al. Norris SL, Holmer HK, Ogden LA, Burda BU. Van der Wees PJ, Moore AP, Powers CM, Stewart A, Nijhuis-van der Sanden MW, de Bie RA. Zhao H, Liu B, Liu Z, Xie L-m, Fang Y-g, Zhu Y, et al. Adult acute and subacute low back pain. NASS encourages widespread circulation and implementation of the evidence-based recommendations made in NASS guidelines. Rayyan software [20] was used to manage screening and selection. Another factor that could explain variability is the suboptimal use of the AGREE II tool: 65% of the CPG appraisals in our sample did not provide information on whether the raters had received training in use of the AGREE II tool [99] and only 18% involved at least four raters, as recommended in the AGREE II manual [9]. Franchini M, Molinaro S, Caiolfa M, Salvatori M, Pieroni S. Int J Environ Res Public Health. Objective The aim of this study was to provide an overview of the recommendations regarding the diagnosis and treatment contained in current clinical practice guidelines for patients with non-specific low back pain in primary care. [. Domain 1: Scope and Purpose, Domain 2: Stakeholder involvement, Domain 3: Rigour of Development, Domain 4: Clarity of presentation, Domain 5: Applicability, Domain 6: Editorial Independence. Picelli A, Buzzi MG, Cisari C, Gandolfi M, Porru D, Bonadiman S, et al. Several AGREE II domains demonstrated low scores, particularly the "applicability" and "monitoring and auditing criteria" are the domains most susceptible to amendments in future.Implications for rehabilitationClinicians should be aware that among recently published/updated clinical practice guidelines for the management of chronic low back pain in primary care only few were deemed to have high quality.Increasing evidence suggests the efficacy for self-management to improve low back pain outcome.Physical treatments are recommended in order to improve low back pain outcome while many physical modalities such as TENS, ultrasound, laser therapy are not.Psychological treatments are recommended and should be included as part of a broader treatment plan. Context The use of clinical-practice guidelines is a suggested method for improving health outcomes by the earlier provision of necessary and effective medical interventions. An official website of the United States government. The .gov means its official. Low back pain is a common musculoskeletal condition seen in Physiotherapy clinics. Front Cell Dev Biol. Implementation of CPGs is not always considered an integrated activity of CPG development. PMC legacy view Our findings suggest that before conducting a new appraisal, researchers should check systematic review registers for existing appraisals. acute-subacute-chronic-low-back-pain-clinical-practice Mar-2021 Diagnosis and Treatment of Low Back Pain (2020) North American Spine Society (NASS) Faas A. Bartko JJ. Analysis and interpretation (statistics, evaluation and presentation of the results): SB, VI, SG, GC, RM, MC. Reporting of AGREE II assessment was heterogeneous and generally of poor quality: overall assessment 1 (overall CPG quality) was rated in 11 appraisals (64.7%) and overall assessment 2 (recommendation for use) in four (23.5%). Conflicts of interest disclosure forms and management in critical care clinical practice guidelines. Low back pain. Accessibility Chou R, Cote P, Randhawa K, Torres P, Yu H, Nordin M, et al. Chou R, Loeser JD, Owens DK, Rosenquist RW, Atlas SJ, Baisden J, et al. Overlapping was defined as how many times a CPG was re-assessed for quality in different appraisals using the AGREE II tool. A user-friendly clinical practice guideline summary for managing low back pain in South Africa. The rating of all six domains was reported in 14 appraisals (82.4%) [17, 2535, 37, 40] and the rating of 23 item scores in two [36, 39]. Lee J, Gupta S, Price C, Baranowski A. Conflict of interest in clinical practice guideline development: a systematic review. Supervision: SG, GC, RM, MC. eCollection 2021. This guideline replaces the National Institute for Health and Care Excellence (NICE) guideline on early management of low back pain in adults (2009) and expands its remit. Results National clinical guidelines recommend a biopsychosocial approach to the management of people with NSLBP (Foster et al., 2018). Raters may focus their attention on some aspects more than others because there is no composite weight of judgement [55]. The authors declare no competing interests. NASS strongly encourages use of appropriately trained translators with an excellent knowledge of the English language, an excellent knowledge of the target language, significant experience in both languages, cultures and medicine, and ideally some content knowledge. Low Back Pain and Sciatica in Over 16s: Assessment and Management. The London: Royal College of General Practitioners. ACL reconstruction is not for all A need for improved patient selection. Nordin M, Randhawa K, Torres P, Yu HN, Haldeman S, Brady O, et al. Low back pain (LBP) is a common symptom presenting in both primary care and across many specialties. Disclaimer, National Library of Medicine Hence, in order to select an effective and preferably also efficient treatment in daily clinical practice, LBP patients should be classified clinically as Department of Veterans Affairs and the Department of Defense . The site is secure. It is also strongly recommended that translators implement a rigorous procedure for verifying the accuracy of translations via a multiple forward translation process or a back-translation process with careful comparisons between documents. The systematic search retrieved 254 records. This summary contains information on the use of this test in individuals aged 18 to 60 years old with mechanical low back pain (LBP). For example, one would expect patient involvement on a LBP CPG development panel rather than consultation of the literature on patient values. Chiodo A, Alvarez D, Graziano G, Haig A, Harrison R, Park P, et al. The study was conducted according to the guidelines for reporting meta-epidemiological methodology research [18] sincethe specific reporting checklist for methods research studies is currently under development (MethodologIcal STudy reporting Checklist[MISTIC]) [19]. 2021 Oct 5;18(19):10457. doi: 10.3390/ijerph181910457. Low back pain (LBP) is a major contributor to years lived with disability and a leading cause of limited activity and absence from work [1, 2]. Ng JY, Mohiuddin U. 852 0 obj <>stream Some issues with AGREE II validity may arise (e.g., AGREE II video tutorials; My AGREE PLUS platform) [100] when the training resources are not consistently updated. We foundpoor and heterogeneous reporting of recommendations for use (i.e., overall assessment 2), which generates unclear information about their application in clinical practice.
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