1
|
Fenton JJ, Fang SY, Ray M, Kennedy J, Padilla K, Amundson R, Elton D, Haldeman S, Lisi AJ, Sico J, Wayne PM, Romano PS. Longitudinal Care Patterns and Utilization Among Patients With New-Onset Neck Pain by Initial Provider Specialty. Spine (Phila Pa 1976) 2023; 48:1409-1418. [PMID: 37526092 DOI: 10.1097/brs.0000000000004781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 07/05/2023] [Indexed: 08/02/2023]
Abstract
STUDY DESIGN Retrospective cohort study. OBJECTIVE To compare utilization patterns for patients with new-onset neck pain by initial provider specialty. SUMMARY OF BACKGROUND DATA Initial provider specialty has been associated with distinct care patterns among patients with acute back pain; little is known about care patterns among patients with acute neck pain. METHODS De-identified administrative claims and electronic health record data were derived from the Optum Labs Data Warehouse, which contains longitudinal health information on over 200M enrollees and patients representing a mixture of ages and geographical regions across the United States. Patients had outpatient visits for new-onset neck pain from October 1, 2016 to September 30, 2019, classified by initial provider specialty. Utilization was assessed during a 180-day follow-up period, including subsequent neck pain visits, diagnostic imaging, and therapeutic interventions. RESULTS The cohort included 770,326 patients with new-onset neck pain visits. The most common initial provider specialty was chiropractor (45.2%), followed by primary care (33.4%). Initial provider specialty was strongly associated with the receipt of subsequent neck pain visits with the same provider specialty. Rates and types of diagnostic imaging and therapeutic interventions during follow-up also varied widely by initial provider specialty. While uncommon after initial visits with chiropractors (≤2%), CT, or MRI scans occurred in over 30% of patients with initial visits with emergency physicians, orthopedists, or neurologists. Similarly, 6.8% and 3.4% of patients initially seen by orthopedists received therapeutic injections and major surgery, respectively, compared with 0.4% and 0.1% of patients initially seen by a chiropractor. CONCLUSION Within a large national cohort, chiropractors were the initial provider for a plurality of patients with new-onset neck pain. Compared with patients initially seen by physician providers, patients treated initially by chiropractors or therapists received fewer and less costly imaging services and were less likely to receive invasive therapeutic interventions during follow-up. LEVEL OF EVIDENCE 3.
Collapse
Affiliation(s)
- Joshua J Fenton
- Department of Family and Community Medicine, University of California, Davis, Sacramento, CA
- Center for Healthcare Policy and Research, University of California, Davis, Sacramento, CA
| | - Shao-You Fang
- Center for Healthcare Policy and Research, University of California, Davis, Sacramento, CA
| | - Monika Ray
- Center for Healthcare Policy and Research, University of California, Davis, Sacramento, CA
- Division of General Internal Medicine, University of California, Davis, Sacramento, CA
| | - John Kennedy
- Center for Healthcare Policy and Research, University of California, Davis, Sacramento, CA
| | - Katrine Padilla
- Center for Healthcare Policy and Research, University of California, Davis, Sacramento, CA
| | | | | | | | | | - Jason Sico
- Yale University, School of Medicine
- Headache Centers of Excellence Program, Veterans Health Administration, New Haven, CT
| | | | - Patrick S Romano
- Center for Healthcare Policy and Research, University of California, Davis, Sacramento, CA
- Division of General Internal Medicine, University of California, Davis, Sacramento, CA
| |
Collapse
|
2
|
Green BN, Johnson CD, Crawford C, Tavares PA, Murnaghan K, Haldeman S, Hurwitz EL, Yang H, de Luca K. Association between spinal and non-spinal health conditions reported in epidemiological studies: a scoping review protocol. BMJ Open 2023; 13:e075382. [PMID: 37788930 DOI: 10.1136/bmjopen-2023-075382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/05/2023] Open
Abstract
INTRODUCTION The increasing prevalence of coexisting health conditions poses a challenge to healthcare providers and healthcare systems. Spinal pain (eg, neck and back pain) and spinal pathologies (eg, osteoporotic fractures and degenerative spinal disease) exist concurrently with other non-spinal health conditions (NSHC). However, the scope of what associations may exist among these co-occurring conditions is unclear. Therefore, this scoping review aims to map the epidemiological literature that reports associations between spine-related pain and pathologies (SPPs) and NSHCs. METHODS AND ANALYSIS This scoping review will follow the JBI protocol and Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. We will systematically search the literature using key words and MeSH terms for SPPs and NSHCs. Terminology/vocabulary for NSHCs will include those for communicable and non-communicable diseases as reported by WHO Global Burden of Disease reports. Five databases will be searched from inception: MEDLINE, EMBASE, APA PsycInfo, Scopus and Web of Science Core Collection. Papers published in English, in peer-reviewed journals, including measures of association between SPPs and NSHCs and using observational epidemiologic study designs will be included. Excluded will be studies of cadaveric, animal or health behaviours; studies with no measures of association and non-observational epidemiologic studies. Results will include the number of studies, the studies that have evaluated the measures of association and the frequency of the studied associations between SPPs and NSHCs. Results will be reported in tables and diagrams. Themes of comorbidities will be synthesised into a descriptive report. ETHICS AND DISSEMINATION This scoping review was deemed exempt from ethics review. This review will provide a comprehensive overview of the literature that reports associations between SPPs and NSHCs to inform future research initiatives and practices. Results will be disseminated through publication in peer-reviewed journals and research conferences. REGISTRATION DETAILS https://osf.io/w49u3.
Collapse
Affiliation(s)
- Bart N Green
- Employer Based Integrated Primary Care Health Centers, Qualcomm Health Center, Stanford Health Care, San Diego, California, USA
- National University of Health Sciences, Lombard, Illinois, USA
| | | | | | | | - Kent Murnaghan
- Canadian Memorial Chiropractic College, Toronto, Ontario, Canada
| | - Scott Haldeman
- Department of Neurology, University of California Irvine, Orange, California, USA
- World Spine Care, Tustin, California, USA
| | - Eric L Hurwitz
- Office of Public Health Studies, Thompson School of Social Work & Public Health, University of Hawaii at Mānoa, Honolulu, Hawaii, USA
| | - Haiou Yang
- University of California, Irvine, California, USA
| | - Katie de Luca
- CQUniversity Brisbane, Brisbane, Queensland, Australia
| |
Collapse
|
3
|
Whedon JM, Petersen CL, Schoellkopf WJ, Haldeman S, MacKenzie TA, Lurie JD. The association between cervical artery dissection and spinal manipulation among US adults. Eur Spine J 2023; 32:3497-3504. [PMID: 37422607 PMCID: PMC10591258 DOI: 10.1007/s00586-023-07844-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 05/23/2023] [Accepted: 06/23/2023] [Indexed: 07/10/2023]
Abstract
PURPOSE Cervical artery dissection (CeAD), which includes both vertebral artery dissection (VAD) and carotid artery dissection (CAD), is the most serious safety concern associated with cervical spinal manipulation (CSM). We evaluated the association between CSM and CeAD among US adults. METHODS Through analysis of health claims data, we employed a case-control study with matched controls, a case-control design in which controls were diagnosed with ischemic stroke, and a case-crossover design in which recent exposures were compared to exposures in the same case that occurred 6-7 months earlier. We evaluated the association between CeAD and the 3-level exposure, CSM versus office visit for medical evaluation and management (E&M) versus neither, with E&M set as the referent group. RESULTS We identified 2337 VAD cases and 2916 CAD cases. Compared to population controls, VAD cases were 0.17 (95% CI 0.09 to 0.32) times as likely to have received CSM in the previous week as compared to E&M. In other words, E&M was about 5 times more likely than CSM in the previous week in cases, relative to controls. CSM was 2.53 (95% CI 1.71 to 3.68) times as likely as E&M in the previous week among individuals with VAD than among individuals experiencing a stroke without CeAD. In the case-crossover study, CSM was 0.38 (95% CI 0.15 to 0.91) times as likely as E&M in the week before a VAD, relative to 6 months earlier. In other words, E&M was approximately 3 times more likely than CSM in the previous week in cases, relative to controls. Results for the 14-day and 30-day timeframes were similar to those at one week. CONCLUSION Among privately insured US adults, the overall risk of CeAD is very low. Prior receipt of CSM was more likely than E&M among VAD patients as compared to stroke patients. However, for CAD patients as compared to stroke patients, as well as for both VAD and CAD patients in comparison with population controls and in case-crossover analysis, prior receipt of E&M was more likely than CSM.
Collapse
Affiliation(s)
- James M Whedon
- Health Services Research, Southern California University of Health Sciences, Whittier, CA, USA.
- The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Hanover, NH, USA.
| | - Curtis L Petersen
- The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Hanover, NH, USA
| | | | - Scott Haldeman
- Health Services Research, Southern California University of Health Sciences, Whittier, CA, USA
- Department of Neurology, University of California at Irvine, Irvine, CA, USA
| | - Todd A MacKenzie
- The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Hanover, NH, USA
| | - Jon D Lurie
- The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Hanover, NH, USA
| |
Collapse
|
4
|
de Luca K, Tavares P, Yang H, Hurwitz EL, Green BN, Dale H, Haldeman S. Spinal Pain, Chronic Health Conditions and Health Behaviors: Data from the 2016-2018 National Health Interview Survey. Int J Environ Res Public Health 2023; 20:5369. [PMID: 37047983 PMCID: PMC10094294 DOI: 10.3390/ijerph20075369] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 03/13/2023] [Accepted: 03/24/2023] [Indexed: 06/19/2023]
Abstract
Spinal pain and chronic health conditions are highly prevalent, burdensome, and costly conditions, both in the United States and globally. Using cross-sectional data from the 2016 through 2018 National Health Interview Survey (n = 26,926), we explored associations between spinal pain and chronic health conditions and investigated the influence that a set of confounders may have on the associations between spinal pain and chronic health conditions. Variance estimation method was used to compute weighted descriptive statistics and measures of associations with multinomial logistic regression models. All four chronic health conditions significantly increased the prevalence odds of spinal pain; cardiovascular conditions by 58%, hypertension by 40%, diabetes by 25% and obesity by 34%, controlling for all the confounders. For all chronic health conditions, tobacco use (45-50%), being insufficiently active (17-20%), sleep problems (180-184%), cognitive impairment (90-100%), and mental health conditions (68-80%) significantly increased the prevalence odds of spinal pain compared to cases without spinal pain. These findings provide evidence to support research on the prevention and treatment of non-musculoskeletal conditions with approaches of spinal pain management.
Collapse
Affiliation(s)
- Katie de Luca
- Discipline of Chiropractic, School of Health, Medical and Applied Science, CQ University, Brisbane, QLD 4701, Australia
| | - Patricia Tavares
- Department of Clinical Education, Canadian Memorial Chiropractic College, Toronto, ON M2H 3J1, Canada
| | - Haiou Yang
- Center for Occupational and Environmental Health, University of California, Irvine, CA 92093, USA
| | - Eric L. Hurwitz
- Office of Public Health Studies, Thompson School of Social Work & Public Health, University of Hawaii, Mānoa, Honolulu, HI 96822, USA
| | - Bart N. Green
- Employer Based Integrated Primary Care Health Centers, Stanford Health Care, San Diego, CA 92121, USA
- Department of Publications, National University of Health Sciences, Lombard, IL 60148, USA
| | - Hannah Dale
- Discipline of Chiropractic, School of Health, Medical and Applied Science, CQ University, Brisbane, QLD 4701, Australia
| | - Scott Haldeman
- Department of Neurology, University of California, Irvine, CA 92093, USA
| |
Collapse
|
5
|
Yang H, Hurwitz EL, Li J, de Luca K, Tavares P, Green B, Haldeman S. Bidirectional Comorbid Associations between Back Pain and Major Depression in US Adults. Int J Environ Res Public Health 2023; 20:4217. [PMID: 36901226 PMCID: PMC10002070 DOI: 10.3390/ijerph20054217] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 02/20/2023] [Accepted: 02/22/2023] [Indexed: 06/18/2023]
Abstract
Low back pain and depression have been globally recognized as key public health problems and they are considered co-morbid conditions. This study explores both cross-sectional and longitudinal comorbid associations between back pain and major depression in the adult population in the United States. We used data from the Midlife in the United States survey (MIDUS), linking MIDUS II and III with a sample size of 2358. Logistic regression and Poisson regression models were used. The cross-sectional analysis showed significant associations between back pain and major depression. The longitudinal analysis indicated that back pain at baseline was prospectively associated with major depression at follow-up (PR 1.96, CI: 1.41, 2.74), controlling for health behavioral and demographic variables. Major depression at baseline was also prospectively associated with back pain at follow-up (PR 1.48, CI: 1.04, 2.13), controlling for a set of related confounders. These findings of a bidirectional comorbid association fill a gap in the current understanding of these comorbid conditions and could have clinical implications for the management and prevention of both depression and low back pain.
Collapse
Affiliation(s)
- Haiou Yang
- Center for Occupational and Environmental Health, University of California, Irvine, CA 92617, USA
| | - Eric L. Hurwitz
- Office of Public Health Studies, Thompson School of Social Work & Public Health, University of Hawaii, Mānoa, Honolulu, HI 96822, USA
| | - Jian Li
- Department of Environmental Health Sciences, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA 90095, USA
- School of Nursing, University of California, Los Angeles, CA 90095, USA
| | - Katie de Luca
- Discipline of Chiropractic, School of Health, Medical and Applied Sciences, CQUniversity, Brisbane, QLD 4000, Australia
| | - Patricia Tavares
- Department of Clinical Education, Canadian Memorial Chiropractic College, Toronto, ON M2H 3J1, Canada
| | - Bart Green
- Employer Based Integrated Primary Care Health Centers, Stanford Health Care, National University of Health Sciences, San Diego, CA 92121, USA
| | - Scott Haldeman
- Department of Neurology, University of California, Irvine, CA 92868, USA
| |
Collapse
|
6
|
Yang H, Lu ML, Haldeman S, Swanson N. Psychosocial risk factors for low back pain in US workers: Data from the 2002-2018 quality of work life survey. Am J Ind Med 2023; 66:41-53. [PMID: 36420950 PMCID: PMC10123870 DOI: 10.1002/ajim.23444] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 10/31/2022] [Accepted: 11/03/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND Examining workplace psychosocial risk factors for back pain becomes increasingly important because of the changing nature of work and rising healthcare costs. Some psychosocial risk factors for back pain, such as work and family imbalance, exposure to a hostile work environment, and job insecurity, are understudied for the working population in the United States. METHODS Data used in this study came from the Quality of Work Life Survey (QWL), a supplementary module of the General Social Survey conducted in the United States. Data from the 2002, 2006, 2010, 2014, and 2018 QWL surveys were used in these analyses, giving a total sample size of 6661. Five domains of workplace psychosocial risk factors for back pain were examined, including job strain, low social support, work-family imbalance, exposure to a hostile work environment (harassment and discrimination), and job insecurity. The adjusted odds ratio (aOR) of each psychosocial risk factor for back pain with 95% confidence intervals (CI) was estimated using a multivariable logistic regression model after controlling for job physical factors, occupation, and demographic and socioeconomic characteristics. RESULTS Significant associations were found between back pain and several psychosocial factors including job strain (aOR 1.19; CI 1.00,1.41), work-family imbalance (aOR,1.42; CI 1.22,1.64), harassment (aOR 1.40; CI 1.15,1.71), and discrimination (aOR 1.20 CI 1.00,1.44). CONCLUSION This study contributes to the understanding of the relationship between a variety of workplace psychosocial factors and back pain. Our findings suggest directions in future longitudinal research to examine emerging workplace psychosocial factors for back pain.
Collapse
Affiliation(s)
- Haiou Yang
- Specialist, Center for Occupational and Environmental Health, University of California, Irvine, California, USA
| | - Ming-Lun Lu
- National Institute for Occupational Safety and Health, Cincinnati, Ohio, USA
| | - Scott Haldeman
- Department of Neurology, University of California, Irvine, California, USA
- Ontario Tech University, Toronto, Ontario, Canada
| | - Naomi Swanson
- National Institute for Occupational Safety and Health, Cincinnati, Ohio, USA
| |
Collapse
|
7
|
Whedon JM, Petersen CL, Li Z, Schoelkopf WJ, Haldeman S, MacKenzie TA, Lurie JD. Association between cervical artery dissection and spinal manipulative therapy -a medicare claims analysis. BMC Geriatr 2022; 22:917. [PMID: 36447166 PMCID: PMC9710172 DOI: 10.1186/s12877-022-03495-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 09/29/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Cervical artery dissection and subsequent ischemic stroke is the most serious safety concern associated with cervical spinal manipulation. METHODS We evaluated the association between cervical spinal manipulation and cervical artery dissection among older Medicare beneficiaries in the United States. We employed case-control and case-crossover designs in the analysis of claims data for individuals aged 65+, continuously enrolled in Medicare Part A (covering hospitalizations) and Part B (covering outpatient encounters) for at least two consecutive years during 2007-2015. The primary exposure was cervical spinal manipulation; the secondary exposure was a clinical encounter for evaluation and management for neck pain or headache. We created a 3-level categorical variable, (1) any cervical spinal manipulation, 2) evaluation and management but no cervical spinal manipulation and (3) neither cervical spinal manipulation nor evaluation and management. The primary outcomes were occurrence of cervical artery dissection, either (1) vertebral artery dissection or (2) carotid artery dissection. The cases had a new primary diagnosis on at least one inpatient hospital claim or primary/secondary diagnosis for outpatient claims on at least two separate days. Cases were compared to 3 different control groups: (1) matched population controls having at least one claim in the same year as the case; (2) ischemic stroke controls without cervical artery dissection; and (3) case-crossover analysis comparing cases to themselves in the time period 6-7 months prior to their cervical artery dissection. We made each comparison across three different time frames: up to (1) 7 days; (2) 14 days; and (3) 30 days prior to index event. RESULTS The odds of cervical spinal manipulation versus evaluation and management did not significantly differ between vertebral artery dissection cases and any of the control groups at any of the timepoints (ORs 0.84 to 1.88; p > 0.05). Results for carotid artery dissection cases were similar. CONCLUSION Among Medicare beneficiaries aged 65 and older who received cervical spinal manipulation, the risk of cervical artery dissection is no greater than that among control groups.
Collapse
Affiliation(s)
- James M Whedon
- Health Services Research, Southern California University of Health Sciences, 16200 Amber Valley Drive, 90604, Whittier, CA, USA.
| | - Curtis L Petersen
- The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Hanover, NH, USA
| | - Zhongze Li
- The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Hanover, NH, USA
| | | | - Scott Haldeman
- Department of Neurology, University of California at Irvine, Irvine, CA, USA
| | - Todd A MacKenzie
- The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Hanover, NH, USA
| | - Jon D Lurie
- The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Hanover, NH, USA
| |
Collapse
|
8
|
Costanzo G, Misaggi B, Ricciardi L, AlEissa SI, Tamai K, Alhelal F, Alqahtani Y, Alsobayel HI, Arand M, Balsano M, Blattert TR, Brayda-Bruno M, Busari JO, Campello M, Chhabra HS, Tamburrelli FC, Côté P, Darwono B, Kandziora F, La Maida GA, Muehlbauer EJ, Mulukutla RD, Pereira P, Rajasekaran S, Rothenfluh DA, Sullivan WJ, Truumees E, Dohring EJ, Pigott T, Shetty AP, Teli MGA, Wang JC, Ames C, Anema JR, Bang A, Cheung KMC, Gross DP, Haldeman S, Minisola S, Mullerpatan R, Negrini S, Salmi LR, Spinelli MS, Vlok A, Yankey KP, Zaina F, Alturkistany A, Franke J, Liljenqvist UR, Piccirillo M, Nordin M. SPINE20 recommendations 2021: spine care for people's health and prosperity. Eur Spine J 2022; 31:1333-1342. [PMID: 35391625 PMCID: PMC8989125 DOI: 10.1007/s00586-022-07194-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 12/18/2021] [Accepted: 03/19/2022] [Indexed: 02/07/2023]
Abstract
Purpose The focus of SPINE20 is to develop evidence-based policy recommendations for the G20 countries to work with governments to reduce the burden of spine disease, and disability. Methods On September 17–18, 2021, SPINE20 held its annual meeting in Rome, Italy. Prior to the meeting, the SPINE20 created six proposed recommendations. These recommendations were uploaded to the SPINE20 website 10 days before the meeting and opened to the public for comments. The recommendations were discussed at the meeting allowing the participants to object and provide comments. Results In total, 27 societies endorsed the following recommendations. SPINE20 calls upon the G20 countries: (1) to expand telehealth for the access to spine care, especially in light of the current situation with COVID-19. (2) To adopt value-based interprofessional spine care as an approach to improve patient outcomes and reduce disability. (3) To facilitate access and invest in the development of a competent rehabilitation workforce to reduce the burden of disability related to spine disorders. (4) To adopt a strategy to promote daily physical activity and exercises among the elderly population to maintain an active and independent life with a healthy spine, particularly after COVID-19 pandemic. (5) To engage in capacity building with emerging countries and underserved communities for the benefit of spine patients. (6) To promote strategies to transfer evidence-based advances into patient benefit through effective implementation processes. Conclusions SPINE20’s initiatives will make governments and decision makers aware of efforts to reduce needless suffering from disabling spine pain through education that can be instituted across the globe.
Collapse
Affiliation(s)
| | | | | | | | - Koji Tamai
- Department of Orthopedics, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan.
| | | | | | | | - Markus Arand
- Medical Faculty, University of Ulm, Ulm, Baden-Württemberg, Germany
| | | | | | | | - Jamiu O Busari
- Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Marco Campello
- New York University Grossman School of Medicine, New York, NY, USA
| | | | | | | | | | - Frank Kandziora
- Center for Spinal Surgery and Neurotraumatology, Frankfurt, Germany
| | | | | | | | | | | | | | | | | | | | | | | | | | - Jeffrey C Wang
- University of Southern California Spine Center, Los Angeles, CA, USA
| | | | | | - Anand Bang
- Society for Education, Action and Research in Community Health, Gadchiroli, Maharashtra, India
| | | | | | | | | | | | - Stefano Negrini
- University La Statale, Milan, Italy.,IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | | | | | - Adriaan Vlok
- Stellenbosch University, Cape Town, South Africa
| | | | - Fabio Zaina
- ISICO (Italian Scientific Spine Institute), Milan, Italy
| | - Ahmed Alturkistany
- King Faisal Specialist Hospital and Research Center, Jeddah, Saudi Arabia
| | - Jörg Franke
- Klinikum Magdeburg gGmbH, Magdeburg, Germany
| | | | | | | |
Collapse
|
9
|
Carragee EJ, Andersson GBJ, Belcourt RM, Eskay-Auerbach M, Goertz M, Haldeman S, Hegmann KT, Lessenger JE, Mayer T, Mueller KL, Murphy DR, Tellin WG, Thiese MS, Travis R, Weiss MS, Harris JS. Reply to Sayeed et al's Reply to Reply. J Occup Environ Med 2022; 64:e391-e392. [PMID: 35761429 DOI: 10.1097/jom.0000000000002548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
10
|
Vaughn G, Chau P, Artrip J, Ganta S, Abcede E, Haldeman S, Sekeres J, Nigro J, Bock M. Heart Transplantation in Infants with Congenital Heart Disease: Outcomes Stratified by Prior Surgery. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
|
11
|
Kizhakkeveettil A, Bezdjian S, Hurwitz EL, Toler AW, Rossi D, Uptmor S, Sagester K, Bangash M, MacKenzie TA, Lurie JD, Coulter I, Haldeman S, Whedon JM. Spinal Manipulation vs Prescription Drug Therapy for Chronic Low Back Pain: Beliefs, Satisfaction With Care, and Qualify of Life Among Older Medicare Beneficiaries. J Manipulative Physiol Ther 2022; 44:663-673. [DOI: 10.1016/j.jmpt.2021.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 12/30/2021] [Accepted: 12/30/2021] [Indexed: 11/27/2022]
|
12
|
Whedon JM, Kizhakkeveettil A, Toler AWJ, Bezdjian S, Rossi D, Uptmor S, MacKenzie TA, Lurie JD, Hurwitz EL, Coulter I, Haldeman S. Initial Choice of Spinal Manipulation Reduces Escalation of Care for Chronic Low Back Pain Among Older Medicare Beneficiaries. Spine (Phila Pa 1976) 2022; 47:E142-E148. [PMID: 34474443 PMCID: PMC8581066 DOI: 10.1097/brs.0000000000004118] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN We combined elements of cohort and crossover-cohort design. OBJECTIVE The objective of this study was to compare longterm outcomes for spinal manipulative therapy (SMT) and opioid analgesic therapy (OAT) regarding escalation of care for patients with chronic low back pain (cLBP). SUMMARY OF BACKGROUND DATA Current evidence-based guidelines for clinical management of cLBP include both OAT and SMT. For long-term care of older adults, the efficiency and value of continuing either OAT or SMT are uncertain. METHODS We examined Medicare claims data spanning a five-year period. We included older Medicare beneficiaries with an episode of cLBP beginning in 2013. All patients were continuously enrolled under Medicare Parts A, B, and D. We analyzed the cumulative frequency of encounters indicative of an escalation of care for cLBP, including hospitalizations, emergency department visits, advanced diagnostic imaging, specialist visits, lumbosacral surgery, interventional pain medicine techniques, and encounters for potential complications of cLBP. RESULTS SMT was associated with lower rates of escalation of care as compared to OAT. The adjusted rate of escalated care encounters was approximately 2.5 times higher for initial choice of OAT vs. initial choice of SMT (with weighted propensity scoring: rate ratio 2.67, 95% confidence interval 2.64-2.69, P < .0001). CONCLUSION Among older Medicare beneficiaries who initiated long-term care for cLBP with opioid analgesic therapy, the adjusted rate of escalated care encounters was significantly higher as compared to those who initiated care with spinal manipulative therapy.Level of Evidence: 3.
Collapse
Affiliation(s)
- James M Whedon
- Southern California University of Health Sciences, Whittier, CA, USA
| | | | - Andrew WJ Toler
- Southern California University of Health Sciences, Whittier, CA, USA
| | - Serena Bezdjian
- Southern California University of Health Sciences, Whittier, CA, USA
| | - Daniel Rossi
- Southern California University of Health Sciences, Whittier, CA, USA
| | - Sarah Uptmor
- Southern California University of Health Sciences, Whittier, CA, USA
| | | | - Jon D Lurie
- Geisel School of Medicine at Dartmouth, Hanover, NH, USA
| | - Eric L. Hurwitz
- Southern California University of Health Sciences, Whittier, CA, USA
| | - Ian Coulter
- Southern California University of Health Sciences, Whittier, CA, USA
| | - Scott Haldeman
- Southern California University of Health Sciences, Whittier, CA, USA
| |
Collapse
|
13
|
Travis R, Andersson GBJ, Belcourt RM, Carragee EJ, Eskay-Auerbach M, Goertz M, Haldeman S, Hegmann KT, Lessenger JE, Mayer T, Mueller KL, Murphy DR, Tellin WG, Thiese MS, Weiss MS, Harris JS. Reply to Sayeed et al. J Occup Environ Med 2022; 64:e84-e86. [PMID: 34873136 DOI: 10.1097/jom.0000000000002453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Russell Travis
- RACOEM Evidence-based Practice Spine Panel University of Utah Salt Lake City, Utah
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
14
|
Affiliation(s)
- Morgan Angotti
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA,International Spine Research and Innovation Initiative, Rush University Medical Center, Chicago, IL, USA
| | - G. Michael Mallow
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA,International Spine Research and Innovation Initiative, Rush University Medical Center, Chicago, IL, USA
| | - Arnold Wong
- International Spine Research and Innovation Initiative, Rush University Medical Center, Chicago, IL, USA,Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Scott Haldeman
- World Spine Care, Santa Ana, CA, USA,Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, ON, Canada,Department of Neurology, University of California, Irvine, CA, USA
| | - Howard S. An
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA,International Spine Research and Innovation Initiative, Rush University Medical Center, Chicago, IL, USA
| | - Dino Samartzis
- Department of Orthopaedic Surgery, Rush University Medical Center, Chicago, IL, USA,International Spine Research and Innovation Initiative, Rush University Medical Center, Chicago, IL, USA,Dino Samartzis, Department of Orthopaedic Surgery, Rush University Medical Center, Orthopaedic Building, Suite 204-G, 1611 W. Harrison Street, Chicago, IL 60612, USA.
| |
Collapse
|
15
|
Whedon JM, Kizhakkeveettil A, Toler A, MacKenzie TA, Lurie JD, Bezdjian S, Haldeman S, Hurwitz E, Coulter I. Long-Term Medicare Costs Associated With Opioid Analgesic Therapy vs Spinal Manipulative Therapy for Chronic Low Back Pain in a Cohort of Older Adults. J Manipulative Physiol Ther 2021; 44:519-526. [PMID: 34876298 DOI: 10.1016/j.jmpt.2021.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 09/18/2021] [Accepted: 09/20/2021] [Indexed: 12/29/2022]
Abstract
OBJECTIVES The purpose of this study was to compare Medicare healthcare expenditures for patients who received long-term treatment of chronic low back pain (cLBP) with either opioid analgesic therapy (OAT) or spinal manipulative therapy (SMT). METHODS We conducted a retrospective observational study using a cohort design for analysis of Medicare claims data. The study population included Medicare beneficiaries enrolled under Medicare Parts A, B, and D from 2012 through 2016. We assembled cohorts of patients who received long-term management of cLBP with OAT or SMT (such as delivered by chiropractic or osteopathic practitioners) and evaluated the comparative effect of OAT vs SMT upon expenditures, using multivariable regression to control for beneficiary characteristics and measures of health status, and propensity score weighting and binning to account for selection bias. RESULTS The study sample totaled 28,160 participants, of whom 77% initiated long-term care of cLBP with OAT, and 23% initiated care with SMT. For care of low back pain specifically, average long-term costs for patients who initiated care with OAT were 58% lower than those who initiated care with SMT. However, overall long-term healthcare expenditures under Medicare were 1.87 times higher for patients who initiated care via OAT compared with those initiated care with SMT (95% CI 1.65-2.11; P < .0001). CONCLUSIONS Adults aged 65 to 84 who initiated long-term treatment for cLBP via OAT incurred lower long-term costs for low back pain but higher long-term total healthcare costs under Medicare compared with patients who initiated long-term treatment with SMT.
Collapse
Affiliation(s)
- James M Whedon
- Health Services Research, Southern California University of Health Sciences, Whittier, California.
| | - Anupama Kizhakkeveettil
- Eastern Medicine Department, Southern California University of Health Sciences, Whittier, California
| | - Andrew Toler
- Eastern Medicine Department, Southern California University of Health Sciences, Whittier, California
| | - Todd A MacKenzie
- The Dartmouth Institute, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
| | - Jon D Lurie
- The Dartmouth Institute, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
| | - Serena Bezdjian
- Health Services Research, Southern California University of Health Sciences, Whittier, California
| | - Scott Haldeman
- Southern California University of Health Sciences, Whittier, California
| | - Eric Hurwitz
- Southern California University of Health Sciences, Whittier, California
| | - Ian Coulter
- Southern California University of Health Sciences, Whittier, California
| |
Collapse
|
16
|
Melka HA, Russell R, Whedon J, Haldeman S. Chiropractic Practice in the Continent of Africa: A Structured Online Survey of 608 Chiropractors. J Manipulative Physiol Ther 2021; 44:280-288. [PMID: 34090548 DOI: 10.1016/j.jmpt.2020.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2019] [Revised: 12/05/2019] [Accepted: 07/26/2020] [Indexed: 10/21/2022]
Abstract
OBJECTIVES The purpose of this study was to assess the status, supply, demographics, and characteristics of chiropractic practice in the continent of Africa. METHODS A survey consisting of questions on demographics, clinical practice, and patient profile was administered to 608 chiropractors practicing in the different countries of the African continent. Chiropractic association officers of each country were contacted via e-mail for assistance in the distribution of the survey link to chiropractors in their country. The initial questionnaire was pretested with a small group of chiropractors from 2 African countries-4 from Ethiopia and 6 from Botswana-to assess the validity of the questions. The legal status of the chiropractic practice was obtained from online resources. Descriptive statistics were conducted in Microsoft Excel. RESULTS Of the 54 countries in the continent of Africa, 23 countries were identified to have chiropractors. One hundred twenty-four surveys were returned from 15 countries with an overall response rate of 20.3% by clinicians with varying years in clinical practice. Nearly 84% of the chiropractors were between ages 26 and 50. More than 69% reported being a graduate of 1 of the 2 academic institutions located in Africa. Most chiropractors practice in South Africa. Most chiropractors practice in privately owned clinics, and 38% practice in multidisciplinary clinics. Nearly 92% reported using diversified technique and 27% used McKenzie exercises for treatment. Patients presented with a variety of conditions, predominantly chronic pain (59%). CONCLUSIONS This study provides a general overview on the status, supply, demographics, and characteristics of chiropractic practice in the continent of Africa. The supply of chiropractors in Africa is scarce and unevenly distributed. Although in the early stages of recognition, chiropractors in Africa are contributing to the care of people with musculoskeletal and spine-related disorders. Considering the high burden of spine pain, there appears to be potential for growth for chiropractic in the continent of Africa.
Collapse
Affiliation(s)
- Hiwot A Melka
- SCU Health Systems, Southern California University of Health Sciences, Whitter, California.
| | - Robb Russell
- SCU Health Systems, Southern California University of Health Sciences, Whitter, California
| | - James Whedon
- Health Services Research, Southern California University of Health Sciences, Whittier, California
| | - Scott Haldeman
- Department of Epidemiology, School of Public Health, University of California Los Angeles, Los Angeles, California; Department of Neurology, University of California, Irvine, Irvine, California; World Spine Care, Santa Ana, California
| |
Collapse
|
17
|
Briggs AM, Huckel Schneider C, Slater H, Jordan JE, Parambath S, Young JJ, Sharma S, Kopansky-Giles D, Mishrra S, Akesson KE, Ali N, Belton J, Betteridge N, Blyth FM, Brown R, Debere D, Dreinhöfer KE, Finucane L, Foster HE, Gimigliano F, Haldeman S, Haq SA, Horgan B, Jain A, Joshipura M, Kalla AA, Lothe J, Matsuda S, Mobasheri A, Mwaniki L, Nordin MC, Pattison M, Reis FJJ, Soriano ER, Tick H, Waddell J, Wiek D, Woolf AD, March L. Health systems strengthening to arrest the global disability burden: empirical development of prioritised components for a global strategy for improving musculoskeletal health. BMJ Glob Health 2021; 6:e006045. [PMID: 37904582 PMCID: PMC8215245 DOI: 10.1136/bmjgh-2021-006045] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 05/12/2021] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Despite the profound burden of disease, a strategic global response to optimise musculoskeletal (MSK) health and guide national-level health systems strengthening priorities remains absent. Auspiced by the Global Alliance for Musculoskeletal Health (G-MUSC), we aimed to empirically derive requisite priorities and components of a strategic response to guide global and national-level action on MSK health. METHODS Design: mixed-methods, three-phase design.Phase 1: qualitative study with international key informants (KIs), including patient representatives and people with lived experience. KIs characterised the contemporary landscape for MSK health and priorities for a global strategic response.Phase 2: scoping review of national health policies to identify contemporary MSK policy trends and foci.Phase 3: informed by phases 1-2, was a global eDelphi where multisectoral panellists rated and iterated a framework of priorities and detailed components/actions. RESULTS Phase 1: 31 KIs representing 25 organisations were sampled from 20 countries (40% low and middle income (LMIC)). Inductively derived themes were used to construct a logic model to underpin latter phases, consisting of five guiding principles, eight strategic priority areas and seven accelerators for action.Phase 2: of the 165 documents identified, 41 (24.8%) from 22 countries (88% high-income countries) and 2 regions met the inclusion criteria. Eight overarching policy themes, supported by 47 subthemes, were derived, aligning closely with the logic model.Phase 3: 674 panellists from 72 countries (46% LMICs) participated in round 1 and 439 (65%) in round 2 of the eDelphi. Fifty-nine components were retained with 10 (17%) identified as essential for health systems. 97.6% and 94.8% agreed or strongly agreed the framework was valuable and credible, respectively, for health systems strengthening. CONCLUSION An empirically derived framework, co-designed and strongly supported by multisectoral stakeholders, can now be used as a blueprint for global and country-level responses to improve MSK health and prioritise system strengthening initiatives.
Collapse
Affiliation(s)
- Andrew M Briggs
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Carmen Huckel Schneider
- Menzies Centre for Health Policy and Economics, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Helen Slater
- Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | | | - Sarika Parambath
- Menzies Centre for Health Policy and Economics, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - James J Young
- Department of Research, Canadian Memorial Chiropractic College, Toronto, Ontario, Canada
- Center for Muscle and Joint Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Saurab Sharma
- Department of Physiotherapy, Kathmandu University School of Medical Sciences, Dhulikhel, Kavre, Nepal
| | - Deborah Kopansky-Giles
- Department of Research, Canadian Memorial Chiropractic College, Toronto, Ontario, Canada
- Department of Family and Community Medicine, University of Toronto Faculty of Medicine, Toronto, Ontario, Canada
| | - Swatee Mishrra
- Sydney Musculoskeletal, Bone and Joint Health Alliance. Institute of Bone and Joint Research, Kolling Institute, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Kristina E Akesson
- Department of Clinical Sciences Malmö, Clinical and Molecular Osteoporosis Research Unit, Lund University, Malmö, Sweden
- Department of Orthopedics, Skane University Hospital, Malmö, Sweden
| | - Nuzhat Ali
- Health Improvement, Public Health England, London, UK
| | - Joletta Belton
- Global Alliance of Partners for Pain Advocacy, International Association for the Study of Pain, Washington, DC, USA
| | | | - Fiona M Blyth
- Menzies Centre for Health Policy and Economics, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Richard Brown
- World Federation of Chiropractic, Toronto, Ontario, Canada
| | - Demelash Debere
- Rehabilitation International (Africa Region), Addis Ababa, Ethiopia
| | - Karsten E Dreinhöfer
- Medical Park Berlin Humboldtmühle, Berlin, Germany
- Center for Musculoskeletal Surgery, Charité Universitätsmedizin, Berlin, Germany
- Global Alliance for Musculoskeletal Health, Berlin, Germany
| | - Laura Finucane
- International Federation of Orthopaedic Manipulative Physical Therapists Incorporated (IFOMPT), World Physiotherapy, London, UK
- Sussex MSK Partnership, Physiotherapy Department, National Health Service, Brighton, UK
| | - Helen E Foster
- Population Health Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Francesca Gimigliano
- Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Napoli, Italy
| | - Scott Haldeman
- Department of Neurology, University of California, Irvine, California, USA
- Southern California University of Health Sciences, Whittier, California, USA
- Faculty of Health Sciences, University of Ontario Institute of Technology, Toronto, Ontario, Canada
- World Spine Care, Santa Ana, California, USA
| | - Syed A Haq
- Rheumatology Department, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh
| | - Ben Horgan
- Consumer and Community Involvement Program, West Australian Health Translation Network, Perth, Western Australia, Australia
| | - Anil Jain
- Department of Physical Medicine and Rehabilitation, Santokba Durlabhji Memorial Hospital, Jaipur, India
| | | | - Asgar A Kalla
- Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Jakob Lothe
- Norwegian Council for Musculoskeletal Health, Oslo, Norway
| | - Shuichi Matsuda
- Department of Orthopaedic Surgery, Kyoto University, Kyoto, Japan
| | - Ali Mobasheri
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
- Department of Regenerative Medicine, State Research Institute Centre for Innovative Medicine, Vilnius, Lithuania
- Departments of Orthopedics, Rheumatology and Clinical Immunology, University Medical Center Utrecht, Utrecht, The Netherlands
- Department of Joint Surgery, First Affiliated Hospital of Sun Yat-sen University Guangzhou, Guangdong, People's Republic of China
| | | | - Margareta C Nordin
- Department of Orthopedic Surgery and Environmental Medicine, NYU Grossman School of Medicine, New York University, New York City, NY, USA
- Department of Occupational and Industrial Orthopedic Center, NYU Grossman School of Medicine, New York University, New York City, NY, USA
| | - Marilyn Pattison
- World Federation of Occupational Therapists (WFOT), London, UK
- MPOT/Access Fitness and Talking Matters, Adelaide, South Australia, Australia
| | - Felipe J J Reis
- Physical Therapy Department, Instituto Federal do Rio de Janeiro (IFRJ), Rio de Janeiro, Brazil
- Clinical Medicine Department, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
- Pain in Motion Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Enrique R Soriano
- Rheumatology Unit, Internal Medicine Services and University Institute, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
- Pan-American League of Associations for Rheumatology, Miami, Florida, USA
| | - Heather Tick
- Department of Family Medicine and Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, Washington, USA
- Academic Consortium for Integrative Medicine and Health, New Buffalo, Michigan, USA
| | - James Waddell
- Saint Michael's Hospital Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Dieter Wiek
- People with Arthritis and Rheumatism, European Alliance for Associations for Rheumatology (EULAR), Kilchberg, Switzerland
| | - Anthony D Woolf
- Bone and Joint Research Group, Royal Cornwall Hospitals Trust, Truro, UK
| | - Lyn March
- Sydney Musculoskeletal, Bone and Joint Health Alliance. Institute of Bone and Joint Research, Kolling Institute, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
- Department of Rheumatology, Royal North Shore Hospital, University of Sydney, Sydney, New South Wales, Australia
| |
Collapse
|
18
|
Hegmann KT, Travis R, Andersson GBJ, Belcourt RM, Carragee EJ, Eskay-Auerbach M, Galper J, Goertz M, Haldeman S, Hooper PD, Lessenger JE, Mayer T, Mueller KL, Murphy DR, Tellin WG, Thiese MS, Weiss MS, Harris JS. Invasive Treatments for Low Back Disorders. J Occup Environ Med 2021; 63:e215-e241. [PMID: 33769405 DOI: 10.1097/jom.0000000000001983] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE This abbreviated version of the American College of Occupational and Environmental Medicine's Low Back Disorders guideline reviews the evidence and recommendations developed for invasive treatments used to manage low back disorders. METHODS Comprehensive systematic literature reviews were accomplished with article abstraction, critiquing, grading, evidence table compilation, and guideline finalization by a multidisciplinary expert panel and extensive peer-review to develop evidence-based guidance. Consensus recommendations were formulated when evidence was lacking and often relied on analogy to other disorders for which evidence exists. A total of 47 high-quality and 321 moderate-quality trials were identified for invasive management of low back disorders. RESULTS Guidance has been developed for the invasive management of acute, subacute, and chronic low back disorders and rehabilitation. This includes 49 specific recommendations. CONCLUSION Quality evidence should guide invasive treatment for all phases of managing low back disorders.
Collapse
Affiliation(s)
- Kurt T Hegmann
- American College of Occupational and Environmental Medicine, Elk Grove Village, Illinois
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
19
|
Whedon JM, Haldeman S, Petersen CL, Schoellkopf W, MacKenzie TA, Lurie JD. Temporal Trends and Geographic Variations in the Supply of Clinicians Who Provide Spinal Manipulation to Medicare Beneficiaries: A Serial Cross-Sectional Study. J Manipulative Physiol Ther 2021; 44:177-185. [PMID: 33849727 PMCID: PMC10695632 DOI: 10.1016/j.jmpt.2021.02.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 02/03/2021] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Spinal manipulation (SM) is recommended for first-line treatment of patients with low back pain. Inadequate access to SM may result in inequitable spine care for older US adults, but the supply of clinicians who provide SM under Medicare is uncertain. The purpose of this study was to measure temporal trends and geographic variations in the supply of clinicians who provide SM to Medicare beneficiaries. METHODS Medicare is a US government-administered health insurance program that provides coverage primarily for older adults and people with disabilities. We used a serial cross-sectional design to examine Medicare administrative data from 2007 to 2015 for SM services identified by procedure code. We identified unique providers by National Provider Identifier and distinguished between chiropractors and other specialties by Physician Specialty Code. We calculated supply as the number of providers per 100 000 beneficiaries, stratified by geographic location and year. RESULTS Of all clinicians who provide SM to Medicare beneficiaries, 97% to 98% are doctors of chiropractic. The geographic supply of doctors of chiropractic providing SM services in 2015 ranged from 20/100 000 in the District of Columbia to 260/100 000 in North Dakota. The supply of other specialists performing the same services ranged from fewer than 1/100 000 in 11 states to 8/100 000 in Colorado. Nationally, the number of Medicare-active chiropractors declined from 47 102 in 2007 to 45 543 in 2015. The count of other clinicians providing SM rose from 700 in 2007 to 1441 in 2015. CONCLUSION Chiropractors constitute the vast majority of clinicians who bill for SM services to Medicare beneficiaries. The supply of Medicare-active SM providers varies widely by state. The overall supply of SM providers under Medicare is declining, while the supply of nonchiropractors who provide SM is growing.
Collapse
Affiliation(s)
- James M Whedon
- Health Services Research, Southern California University of Health Sciences, Whittier, California.
| | - Scott Haldeman
- Health Services Research, Southern California University of Health Sciences, Whittier, California
| | - Curtis L Petersen
- The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Hanover, New Hampshire
| | | | - Todd A MacKenzie
- The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Hanover, New Hampshire
| | - Jon D Lurie
- The Dartmouth Institute for Health Policy and Clinical Practice, Dartmouth College, Hanover, New Hampshire
| |
Collapse
|
20
|
Haldeman S, Nordin M, Tavares P, Mullerpatan R, Kopansky-Giles D, Setlhare V, Chou R, Hurwitz E, Treanor C, Hartvigsen J, Schneider M, Gay R, Moss J, Haldeman J, Gryfe D, Wilkey A, Brown R, Outerbridge G, Eberspaecher S, Carroll L, Engelbrecht R, Graham K, Cashion N, Ince S, Moon E. Distance Management of Spinal Disorders During the COVID-19 Pandemic and Beyond: Evidence-Based Patient and Clinician Guides From the Global Spine Care Initiative. JMIR Public Health Surveill 2021; 7:e25484. [PMID: 33471778 PMCID: PMC7891494 DOI: 10.2196/25484] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 11/30/2020] [Accepted: 01/19/2021] [Indexed: 12/18/2022] Open
Abstract
Background The COVID-19 pandemic has greatly limited patients' access to care for spine-related symptoms and disorders. However, physical distancing between clinicians and patients with spine-related symptoms is not solely limited to restrictions imposed by pandemic-related lockdowns. In most low- and middle-income countries, as well as many underserved marginalized communities in high-income countries, there is little to no access to clinicians trained in evidence-based care for people experiencing spinal pain. Objective The aim of this study is to describe the development and present the components of evidence-based patient and clinician guides for the management of spinal disorders where in-person care is not available. Methods Ultimately, two sets of guides were developed (one for patients and one for clinicians) by extracting information from the published Global Spine Care Initiative (GSCI) papers. An international, interprofessional team of 29 participants from 10 countries on 4 continents participated. The team included practitioners in family medicine, neurology, physiatry, rheumatology, psychology, chiropractic, physical therapy, and yoga, as well as epidemiologists, research methodologists, and laypeople. The participants were invited to review, edit, and comment on the guides in an open iterative consensus process. Results The Patient Guide is a simple 2-step process. The first step describes the nature of the symptoms or concerns. The second step provides information that a patient can use when considering self-care, determining whether to contact a clinician, or considering seeking emergency care. The Clinician Guide is a 5-step process: (1) Obtain and document patient demographics, location of primary clinical symptoms, and psychosocial information. (2) Review the symptoms noted in the patient guide. (3) Determine the GSCI classification of the patient’s spine-related complaints. (4) Ask additional questions to determine the GSCI subclassification of the symptom pattern. (5) Consider appropriate treatment interventions. Conclusions The Patient and Clinician Guides are designed to be sufficiently clear to be useful to all patients and clinicians, irrespective of their location, education, professional qualifications, and experience. However, they are comprehensive enough to provide guidance on the management of all spine-related symptoms or disorders, including triage for serious and specific diseases. They are consistent with widely accepted evidence-based clinical practice guidelines. They also allow for adequate documentation and medical record keeping.
These guides should be of value during periods of government-mandated physical or social distancing due to infectious diseases, such as during the COVID-19 pandemic. They should also be of value in underserved communities in high-, middle-, and low-income countries where there is a dearth of accessible trained spine care clinicians. These guides have the potential to reduce the overutilization of unnecessary and expensive interventions while empowering patients to self-manage uncomplicated spinal pain with the assistance of their clinician, either through direct in-person consultation or via telehealth communication.
Collapse
Affiliation(s)
- Scott Haldeman
- World Spine Care, Santa Ana, CA, United States.,Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, ON, Canada.,Department of Neurology, University of California, Irvine, CA, United States
| | - Margareta Nordin
- Department of Orthopedic Surgery, New York University, New York, NY, United States.,Department of Environmental Medicine, New York University, New York, NY, United States
| | - Patricia Tavares
- Department of Clinical Education, Canadian Memorial Chiropractic College, Toronto, ON, Canada
| | - Rajani Mullerpatan
- MGM School of Physiotherapy, MGM Institute of Health Sciences, Navi, Mumbai, India
| | - Deborah Kopansky-Giles
- Department of Research, Canadian Memorial Chiropractic College, Toronto, ON, Canada.,Department of Family & Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Vincent Setlhare
- Department of Family Medicine and Public Health Medicine, University of Botswana, Gaborone, Botswana
| | - Roger Chou
- Department of Medicine, Oregon Health & Science University, Portland, OR, United States.,Department of Medical Informatics & Clinical Epidemiology, Oregon Health & Science University, Portland, OR, United States
| | - Eric Hurwitz
- Office of Public Health Studies, University of Hawaii, Manoa, HI, United States
| | - Caroline Treanor
- Department of Physiotherapy, Beaumont Hospital, Dublin, Ireland.,Department of Neurosurgery, National Neurosurgical Spinal Service, Beaumont Hospital, Dublin, Ireland
| | - Jan Hartvigsen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Norway
| | - Michael Schneider
- School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, PA, United States.,Clinical and Translational Science Institute, University of Pittsburgh, Pittsburgh, PA, United States
| | - Ralph Gay
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Alix School of Medicine, Rochester, MN, United States
| | - Jean Moss
- Canadian Memorial Chiropractic College, Toronto, ON, Canada
| | | | - David Gryfe
- Canadian Memorial Chiropractic College, Toronto, ON, Canada
| | - Adam Wilkey
- World Spine Care Europe, Holmfirth, United Kingdom
| | - Richard Brown
- World Federation of Chiropractic, Toronto, ON, Canada
| | | | | | - Linda Carroll
- School of Public Health, University of Alberta, Edmonton, AB, Canada
| | | | - Kait Graham
- Volunteer Programs and Operations, World Spine Care, Ottawa, ON, Canada
| | - Nathan Cashion
- Digital Communications, World Spine Care, Oregon City, OR, United States
| | | | - Erin Moon
- World Spine Care Yoga Project, Vancouver, BC, Canada
| |
Collapse
|
21
|
Haldeman S, Nordin M, Chou R, Côté P, Hurwitz EL, Johnson CD, Randhawa K, Green BN, Kopansky-Giles D, Acaroğlu E, Ameis A, Cedraschi C, Aartun E, Adjei-Kwayisi A, Ayhan S, Aziz A, Bas T, Blyth F, Borenstein D, Brady O, Brooks P, Camilleri C, Castellote JM, Clay MB, Davatchi F, Dudler J, Dunn R, Eberspaecher S, Emmerich J, Farcy JP, Fisher-Jeffes N, Goertz C, Grevitt M, Griffith EA, Hajjaj-Hassouni N, Hartvigsen J, Hondras M, Kane EJ, Laplante J, Lemeunier N, Mayer J, Mior S, Mmopelwa T, Modic M, Moss J, Mullerpatan R, Muteti E, Mwaniki L, Ngandeu-Singwe M, Outerbridge G, Rajasekaran S, Shearer H, Smuck M, Sönmez E, Tavares P, Taylor-Vaisey A, Torres C, Torres P, van der Horst A, Verville L, Vialle E, Kumar GV, Vlok A, Watters W, Wong CC, Wong JJ, Yu H, Yüksel S. The Global Spine Care Initiative: World Spine Care executive summary on reducing spine-related disability in low- and middle-income communities. Eur Spine J 2018; 27:776-785. [PMID: 30151809 DOI: 10.1007/s00586-018-5722-x] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 08/06/2018] [Indexed: 12/25/2022]
Abstract
PURPOSE Spinal disorders, including back and neck pain, are major causes of disability, economic hardship, and morbidity, especially in underserved communities and low- and middle-income countries. Currently, there is no model of care to address this issue. This paper provides an overview of the papers from the Global Spine Care Initiative (GSCI), which was convened to develop an evidence-based, practical, and sustainable, spinal healthcare model for communities around the world with various levels of resources. METHODS Leading spine clinicians and scientists around the world were invited to participate. The interprofessional, international team consisted of 68 members from 24 countries, representing most disciplines that study or care for patients with spinal symptoms, including family physicians, spine surgeons, rheumatologists, chiropractors, physical therapists, epidemiologists, research methodologists, and other stakeholders. RESULTS Literature reviews on the burden of spinal disorders and six categories of evidence-based interventions for spinal disorders (assessment, public health, psychosocial, noninvasive, invasive, and the management of osteoporosis) were completed. In addition, participants developed a stratification system for surgical intervention, a classification system for spinal disorders, an evidence-based care pathway, and lists of resources and recommendations to implement the GSCI model of care. CONCLUSION The GSCI proposes an evidence-based model that is consistent with recent calls for action to reduce the global burden of spinal disorders. The model requires testing to determine feasibility. If it proves to be implementable, this model holds great promise to reduce the tremendous global burden of spinal disorders. These slides can be retrieved under Electronic Supplementary Material.
Collapse
Affiliation(s)
- Scott Haldeman
- Department of Epidemiology, School of Public Health, University of California Los Angeles, Los Angeles, CA, USA.,Department of Neurology, University of California, Irvine, Irvine, CA, USA.,World Spine Care, Santa Ana, CA, USA
| | - Margareta Nordin
- Departments of Orthopedic Surgery and Environmental Medicine, New York University, New York, NY, USA.,World Spine Care Europe, Holmfirth, UK
| | - Roger Chou
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, OR, USA.,Department of Medicine, Oregon Health and Science University, Portland, OR, USA
| | - Pierre Côté
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, ON, Canada.,UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, ON, Canada
| | - Eric L Hurwitz
- Office of Public Health Studies, University of Hawai'i, Mānoa, Honolulu, HI, USA
| | - Claire D Johnson
- National University of Health Sciences, Lombard, IL, USA. .,Qualcomm Health Center, Stanford Health Care, San Diego, CA, USA.
| | - Kristi Randhawa
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, ON, Canada.,UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, ON, Canada
| | - Bart N Green
- National University of Health Sciences, Lombard, IL, USA.,Qualcomm Health Center, Stanford Health Care, San Diego, CA, USA
| | - Deborah Kopansky-Giles
- Department of Research, Canadian Memorial Chiropractic College, Toronto, ON, Canada.,Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | | | - Arthur Ameis
- Certification Program in Insurance Medicine and MedicoLegal Expertise, Faculty of Medicine, University of Montreal, Toronto, ON, Canada
| | - Christine Cedraschi
- Division of General Medical Rehabilitation, Multidisciplinary Pain Centre, Geneva University Hospitals, Geneva, Switzerland.,Division of Clinical Pharmacology and Toxicology, Multidisciplinary Pain Centre, Geneva University Hospitals, Geneva, Switzerland
| | - Ellen Aartun
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, ON, Canada
| | - Afua Adjei-Kwayisi
- Ridge Regional Hospital, Ghana World Spine Care, Accra, Greater Accra, Ghana
| | - Selim Ayhan
- ARTES Spine Center, Acibadem University, Ankara, Turkey
| | - Amer Aziz
- Orthopaedics and Spine Department, Ghurki Trust Teaching Hospital Lahore Pakistan, Lahore, Punjab, Pakistan
| | - Teresa Bas
- Department of Surgery, Hospital Universitario and Politecnico La Fe, Valencia University, Valencia, Spain
| | - Fiona Blyth
- Concord Clinical School, University of Sydney, Concord, NSW, Australia
| | - David Borenstein
- Arthritis and Rheumatism Associates, The George Washington University Medical Center, Potomac, MD, USA
| | | | - Peter Brooks
- Centre for Health Policy, School of Population and Global Health, University of Melbourne, Toorak, Melbourne, VIC, Australia
| | | | - Juan M Castellote
- National School of Occupational Medicine, Carlos III Institute of Health, Madrid, Spain.,Physical Medicine and Rehabilitation Department, University Complutense, Madrid, Spain
| | - Michael B Clay
- Rehabilitation Care Line, Physical Medicine and Rehabilitation, Cincinnati Veterans Affairs Medical Center, Cincinnati, OH, USA
| | - Fereydoun Davatchi
- Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Tehran, Iran
| | - Jean Dudler
- Department of Rheumatology, HFR Fribourg - Hospital Cantonal, Fribourg, FR, Switzerland
| | - Robert Dunn
- Department of Orthopaedic Surgery, University of Cape Town, Cape Town, Western Cape, South Africa.,Groote Schuur Hospital, Cape Town, Western Cape, South Africa
| | | | - Juan Emmerich
- University of La Plata, La Plata, Buenos Aires, Argentina
| | - Jean Pierre Farcy
- Department of Orthopedic Surgery (retired), New York University, Piermont, NY, USA
| | - Norman Fisher-Jeffes
- Groote Schuur Hospital, Cape Town, Western Cape, South Africa.,Panorama Medi Clinic, Cape Town, Western Cape, South Africa
| | - Christine Goertz
- Palmer College of Chiropractic, Davenport, IA, USA.,The Spine Institute for Quality, Davenport, IA, USA
| | | | | | | | - Jan Hartvigsen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark
| | - Maria Hondras
- Department of Anesthesiology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Edward J Kane
- College of Rehabilitative Sciences, Doctor of Physical Therapy Program, University of St. Augustine for Health Sciences, San Marcos, CA, USA
| | - Julie Laplante
- School of Sociological and Anthropological Studies, University of Ottawa, Ottawa, ON, Canada
| | | | - John Mayer
- U.S. Spine and Sport Foundation, San Diego, CA, USA
| | - Silvano Mior
- Canadian Memorial Chiropractic College, Toronto, ON, Canada
| | - Tiro Mmopelwa
- ARTES Ankara Spine Centre, Life Gaborone Hospital, Gaborone, Botswana
| | - Michael Modic
- Cleveland Clinic, Lerner College of Medicine, Cleveland, OH, USA
| | - Jean Moss
- Canadian Memorial Chiropractic College, President Emerita, Toronto, ON, Canada
| | - Rajani Mullerpatan
- MGM School of Physiotherapy, Mahatma Gandhi Mission Institute of Health Sciences, Navi Mumbai, Maharashtra, India
| | - Elijah Muteti
- Moi University/Moi Teaching and Referral Hospital, Eldoret, Kenya
| | | | - Madeleine Ngandeu-Singwe
- Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Yaounde, Center Region, Cameroon
| | - Geoff Outerbridge
- World Spine Care and Canadian Memorial Chiropractic College, Chelsea, QC, Canada
| | | | - Heather Shearer
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, ON, Canada
| | - Matthew Smuck
- Department of Orthopaedic Surgery, Stanford University, Redwood City, CA, USA
| | - Erkin Sönmez
- Department of Neurological Surgery, Başkent University School of Medicine, Ankara, Turkey
| | | | - Anne Taylor-Vaisey
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, ON, Canada
| | - Carlos Torres
- Department of Medical Imaging, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
| | - Paola Torres
- Exercise Science Laboratory, School of Kinesiology, Faculty of Medicine, Universidad Finis Terrae, Santiago, Chile
| | - Alexander van der Horst
- Department of Surgery, University of Namibia, Windhoek, Namibia.,Central Hospital, Windhoek, Namibia
| | - Leslie Verville
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, ON, Canada.,UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, ON, Canada
| | | | | | - Adriaan Vlok
- Division of Neurosurgery, University of Stellenbosch, Bellville, Western Cape, South Africa
| | - William Watters
- Department of Orthopedic, Weill Cornell Medical School and Institute of Academic Medicine, Houston Methodist Hospital, Houston, TX, USA.,Department of Orthopedic Surgery, University of Texas Medical Branch, Galveston, TX, USA
| | | | - Jessica J Wong
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, ON, Canada
| | - Hainan Yu
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, ON, Canada.,UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, ON, Canada
| | - Selcen Yüksel
- Department of Biostatistics, Ankara Yildirim Beyazit University Medical School, Ankara, Turkey
| |
Collapse
|
22
|
Kopansky-Giles D, Johnson CD, Haldeman S, Chou R, Côté P, Green BN, Nordin M, Acaroğlu E, Ameis A, Cedraschi C, Hurwitz EL, Ayhan S, Borenstein D, Brady O, Brooks P, Davatchi F, Dunn R, Goertz C, Hajjaj-Hassouni N, Hartvigsen J, Hondras M, Lemeunier N, Mayer J, Mior S, Moss J, Mullerpatan R, Muteti E, Mwaniki L, Ngandeu-Singwe M, Outerbridge G, Randhawa K, Torres C, Torres P, Vlok A, Wong CC. The Global Spine Care Initiative: resources to implement a spine care program. Eur Spine J 2018; 27:915-924. [PMID: 30151804 DOI: 10.1007/s00586-018-5725-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 08/06/2018] [Indexed: 01/28/2023]
Abstract
PURPOSE The purpose of this report is to describe the development of a list of resources necessary to implement a model of care for the management of spine-related concerns anywhere in the world, but especially in underserved communities and low- and middle-income countries. METHODS Contents from the Global Spine Care Initiative (GSCI) Classification System and GSCI care pathway papers provided a foundation for the resources list. A seed document was developed that included resources for spine care that could be delivered in primary, secondary and tertiary settings, as well as resources needed for self-care and community-based settings for a wide variety of spine concerns (e.g., back and neck pain, deformity, spine injury, neurological conditions, pathology and spinal diseases). An iterative expert consensus process was used using electronic surveys. RESULTS Thirty-five experts completed the process. An iterative consensus process was used through an electronic survey. A consensus was reached after two rounds. The checklist of resources included the following categories: healthcare provider knowledge and skills, materials and equipment, human resources, facilities and infrastructure. The list identifies resources needed to implement a spine care program in any community, which are based upon spine care needs. CONCLUSION To our knowledge, this is the first international and interprofessional attempt to develop a list of resources needed to deliver care in an evidence-based care pathway for the management of people presenting with spine-related concerns. This resource list needs to be field tested in a variety of communities with different resource capacities to verify its utility. These slides can be retrieved under Electronic Supplementary Material.
Collapse
Affiliation(s)
- Deborah Kopansky-Giles
- Department of Research, Canadian Memorial Chiropractic College, Toronto, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Claire D Johnson
- National University of Health Sciences, Lombard, IL, USA.
- Qualcomm Health Center, Stanford Health Care, San Diego, CA, USA.
| | - Scott Haldeman
- Department of Epidemiology, School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
- Department of Neurology, University of California, Irvine, Irvine, CA, USA
- World Spine Care, Santa Ana, CA, USA
| | - Roger Chou
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, OR, USA
- Department of Medicine, Oregon Health and Science University, Portland, OR, USA
| | - Pierre Côté
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Canada
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Canada
| | - Bart N Green
- National University of Health Sciences, Lombard, IL, USA
- Qualcomm Health Center, Stanford Health Care, San Diego, CA, USA
| | - Margareta Nordin
- Departments of Orthopedic Surgery and Environmental Medicine, New York University, New York, NY, USA
- World Spine Care Europe, Holmfirth, UK
| | | | - Arthur Ameis
- Certification Program in Insurance Medicine and MedicoLegal Expertise, University of Montreal Faculty of Medicine, Toronto, ON, Canada
| | - Christine Cedraschi
- Division of General Medical Rehabilitation, Multidisciplinary Pain Centre, Geneva University Hospitals, Geneva, Switzerland
- Division of Clinical Pharmacology and Toxicology, Multidisciplinary Pain Centre, Geneva University Hospitals, Geneva, Switzerland
| | - Eric L Hurwitz
- Office of Public Health Studies, University of Hawai'I, Mānoa, Honolulu, HI, USA
| | - Selim Ayhan
- ARTES Spine Center, Acibadem University, Ankara, Turkey
| | - David Borenstein
- Arthritis and Rheumatism Associates, The George Washington University Medical Center, Potomac, MD, USA
| | | | - Peter Brooks
- Centre for Health Policy, School of Population and Global Health, University of Melbourne, Toorak, Melbourne, VIC, Australia
| | - Fereydoun Davatchi
- Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Tehran, Iran
| | - Robert Dunn
- Department of Orthopaedic Surgery, University of Cape Town, Cape Town, Western Cape, South Africa
- Groote Schuur Hospital, Cape Town, Western Cape, South Africa
| | - Christine Goertz
- Palmer College of Chiropractic, Davenport, IA, USA
- The Spine Institute for Quality, Davenport, IA, USA
| | | | - Jan Hartvigsen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark
| | - Maria Hondras
- Department of Anesthesiology, University of Kansas Medical Center, Kansas City, KS, USA
| | | | - John Mayer
- U.S. Spine and Sport Foundation, San Diego, CA, USA
| | - Silvano Mior
- Canadian Memorial Chiropractic College, Toronto, ON, Canada
| | - Jean Moss
- Canadian Memorial Chiropractic College, President Emerita, Toronto, ON, Canada
| | - Rajani Mullerpatan
- MGM School of Physiotherapy, Mahatma Gandhi Mission Institute of Health Sciences, Navi Mumbai, Maharashtra, India
| | - Elijah Muteti
- Moi University/Moi Teaching and Referral Hospital, Eldoret, Kenya
| | | | - Madeleine Ngandeu-Singwe
- Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Yaounde, Center Region, Cameroon
| | - Geoff Outerbridge
- World Spine Care and Canadian Memorial Chiropractic College, Chelsea, QC, Canada
| | - Kristi Randhawa
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Canada
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Canada
| | - Carlos Torres
- University of Ottawa, Ottawa, ON, Canada
- Department of Medical Imaging, The Ottawa Hospital, Ottawa, ON, Canada
| | - Paola Torres
- Exercise Science Laboratory, School of Kinesiology, Faculty of Medicine, Universidad Finis Terrae, Santiago, Chile
| | - Adriaan Vlok
- Division of Neurosurgery, University of Stellenbosch, Bellville, Western Cape, South Africa
| | | |
Collapse
|
23
|
Haldeman S, Johnson CD, Chou R, Nordin M, Côté P, Hurwitz EL, Green BN, Kopansky-Giles D, Cedraschi C, Aartun E, Acaroğlu E, Ameis A, Ayhan S, Blyth F, Borenstein D, Brady O, Davatchi F, Goertz C, Hajjaj-Hassouni N, Hartvigsen J, Hondras M, Lemeunier N, Mayer J, Mior S, Mmopelwa T, Modic M, Mullerpatan R, Mwaniki L, Ngandeu-Singwe M, Outerbridge G, Randhawa K, Sönmez E, Torres C, Torres P, Watters W, Yu H. The Global Spine Care Initiative: classification system for spine-related concerns. Eur Spine J 2018; 27:889-900. [PMID: 30151807 DOI: 10.1007/s00586-018-5724-8] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 08/06/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE The purpose of this report is to describe the development of a classification system that would apply to anyone with a spine-related concern and that can be used in an evidence-based spine care pathway. METHODS Existing classification systems for spinal disorders were assembled. A seed document was developed through round-table discussions followed by a modified Delphi process. International and interprofessional clinicians and scientists with expertise in spine-related conditions were invited to participate. RESULTS Thirty-six experts from 15 countries participated. After the second round, there was 95% agreement of the proposed classification system. The six major classifications included: no or minimal symptoms (class 0); mild symptoms (i.e., neck or back pain) but no interference with activities (class I); moderate or severe symptoms with interference of activities (class II); spine-related neurological signs or symptoms (class III); severe bony spine deformity, trauma or pathology (class IV); and spine-related symptoms or destructive lesions associated with systemic pathology (class V). Subclasses for each major class included chronicity and severity when different interventions were anticipated or recommended. CONCLUSIONS An international and interprofessional group developed a comprehensive classification system for all potential presentations of people who may seek care or advice at a spine care program. This classification can be used in the development of a spine care pathway, in clinical practice, and for research purposes. This classification needs to be tested for validity, reliability, and consistency among clinicians from different specialties and in different communities and cultures. These slides can be retrieved under Electronic Supplementary Material.
Collapse
Affiliation(s)
- Scott Haldeman
- Department of Epidemiology, School of Public Health, University of California Los Angeles, Los Angeles, CA, USA.,Department of Neurology, University of California, Irvine, Irvine, CA, USA.,World Spine Care, Santa Ana, CA, USA
| | - Claire D Johnson
- National University of Health Sciences, Lombard, IL, USA. .,Qualcomm Health Center, Stanford Health Care, San Diego, CA, USA.
| | - Roger Chou
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, OR, USA.,Department of Medicine, Oregon Health and Science University, Portland, OR, USA
| | - Margareta Nordin
- Departments of Orthopedic Surgery and Environmental Medicine, New York University, New York, NY, USA.,World Spine Care Europe, Holmfirth, UK
| | - Pierre Côté
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Canada.,UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Canada
| | - Eric L Hurwitz
- Office of Public Health Studies, University of Hawai'i, Mānoa, Honolulu, HI, USA
| | - Bart N Green
- National University of Health Sciences, Lombard, IL, USA.,Qualcomm Health Center, Stanford Health Care, San Diego, CA, USA
| | - Deborah Kopansky-Giles
- Department of Research, Canadian Memorial Chiropractic College, Toronto, ON, Canada.,Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Christine Cedraschi
- Division of General Medical Rehabilitation, Multidisciplinary Pain Centre, Geneva University Hospitals, Geneva, Switzerland.,Division of Clinical Pharmacology and Toxicology, Multidisciplinary Pain Centre, Geneva University Hospitals, Geneva, Switzerland
| | - Ellen Aartun
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Canada
| | | | - Arthur Ameis
- Faculty of Medicine, Certification Program in Insurance Medicine and MedicoLegal Expertise, University of Montreal, Toronto, ON, Canada
| | - Selim Ayhan
- ARTES Spine Center, Acibadem University, Ankara, Turkey
| | - Fiona Blyth
- Concord Clinical School, University of Sydney, Concord, NSW, Australia
| | - David Borenstein
- Arthritis and Rheumatism Associates, The George Washington University Medical Center, Potomac, MD, USA
| | | | - Fereydoun Davatchi
- Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Tehran, Iran
| | - Christine Goertz
- Palmer College of Chiropractic, Davenport, IA, USA.,The Spine Institute for Quality, Davenport, IA, USA
| | | | - Jan Hartvigsen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark
| | - Maria Hondras
- Department of Anesthesiology, University of Kansas Medical Center, Kansas City, KS, USA
| | | | - John Mayer
- U.S. Spine and Sport Foundation, San Diego, CA, USA
| | - Silvano Mior
- Canadian Memorial Chiropractic College, Toronto, ON, Canada
| | - Tiro Mmopelwa
- ARTES Ankara Spine Centre, Life Gaborone Hospital, Gaborone, Botswana
| | - Michael Modic
- Cleveland Clinic, Lerner College of Medicine, Cleveland, OH, USA
| | - Rajani Mullerpatan
- Mahatma Gandhi Mission Institute of Health Sciences, MGM School of Physiotherapy, Navi Mumbai, Maharashtra, India
| | | | - Madeleine Ngandeu-Singwe
- Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Yaounde, Center Region, Cameroon
| | - Geoff Outerbridge
- World Spine Care and Canadian Memorial Chiropractic College, Chelsea, QC, Canada
| | - Kristi Randhawa
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Canada.,UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Canada
| | - Erkin Sönmez
- Department of Neurological Surgery, School of Medicine, Başkent University, Ankara, Turkey
| | - Carlos Torres
- Department of Medical Imaging, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
| | - Paola Torres
- Exercise Science Laboratory, School of Kinesiology, Faculty of Medicine, Universidad Finis Terrae, Santiago, Chile
| | - William Watters
- Department of Orthopedic, Weill Cornell Medical School and Institute of Academic Medicine, Houston Methodist Hospital, Houston, TX, USA.,Department of Orthopedic Surgery, University of Texas Medical Branch, Galveston, TX, USA
| | - Hainan Yu
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Canada.,UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Canada
| |
Collapse
|
24
|
Johnson CD, Haldeman S, Nordin M, Chou R, Côté P, Hurwitz EL, Green BN, Kopansky-Giles D, Randhawa K, Cedraschi C, Ameis A, Acaroğlu E, Aartun E, Adjei-Kwayisi A, Ayhan S, Aziz A, Bas T, Blyth F, Borenstein D, Brady O, Brooks P, Camilleri C, Castellote JM, Clay MB, Davatchi F, Dudler J, Dunn R, Eberspaecher S, Emmerich J, Farcy JP, Fisher-Jeffes N, Goertz C, Grevitt M, Griffith EA, Hajjaj-Hassouni N, Hartvigsen J, Hondras M, Kane EJ, Laplante J, Lemeunier N, Mayer J, Mior S, Mmopelwa T, Modic M, Moss J, Mullerpatan R, Muteti E, Mwaniki L, Ngandeu-Singwe M, Outerbridge G, Rajasekaran S, Shearer H, Smuck M, Sönmez E, Tavares P, Taylor-Vaisey A, Torres C, Torres P, van der Horst A, Verville L, Vialle E, Kumar GV, Vlok A, Watters W, Wong CC, Wong JJ, Yu H, Yüksel S. The Global Spine Care Initiative: methodology, contributors, and disclosures. Eur Spine J 2018; 27:786-795. [PMID: 30151808 DOI: 10.1007/s00586-018-5723-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 08/06/2018] [Indexed: 12/19/2022]
Abstract
PURPOSE The purpose of this report is to describe the Global Spine Care Initiative (GSCI) contributors, disclosures, and methods for reporting transparency on the development of the recommendations. METHODS World Spine Care convened the GSCI to develop an evidence-based, practical, and sustainable healthcare model for spinal care. The initiative aims to improve the management, prevention, and public health for spine-related disorders worldwide; thus, global representation was essential. A series of meetings established the initiative's mission and goals. Electronic surveys collected contributorship and demographic information, and experiences with spinal conditions to better understand perceptions and potential biases that were contributing to the model of care. RESULTS Sixty-eight clinicians and scientists participated in the deliberations and are authors of one or more of the GSCI articles. Of these experts, 57 reported providing spine care in 34 countries, (i.e., low-, middle-, and high-income countries, as well as underserved communities in high-income countries.) The majority reported personally experiencing or having a close family member with one or more spinal concerns including: spine-related trauma or injury, spinal problems that required emergency or surgical intervention, spinal pain referred from non-spine sources, spinal deformity, spinal pathology or disease, neurological problems, and/or mild, moderate, or severe back or neck pain. There were no substantial reported conflicts of interest. CONCLUSION The GSCI participants have broad professional experience and wide international distribution with no discipline dominating the deliberations. The GSCI believes this set of papers has the potential to inform and improve spine care globally. These slides can be retrieved under Electronic Supplementary Material.
Collapse
Affiliation(s)
- Claire D Johnson
- National University of Health Sciences, Lombard, IL, USA. .,Qualcomm Health Center, Stanford Health Care, San Diego, CA, USA.
| | - Scott Haldeman
- Department of Epidemiology, School of Public Health, University of California Los Angeles, Los Angeles, CA, USA.,Department of Neurology, University of California, Irvine, Irvine, CA, USA.,World Spine Care, Santa Ana, CA, USA
| | - Margareta Nordin
- Departments of Orthopedic Surgery and Environmental Medicine, New York University, New York, NY, USA.,World Spine Care Europe, Holmfirth, UK
| | - Roger Chou
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, OR, USA.,Department of Medicine, Oregon Health and Science University, Portland, OR, USA
| | - Pierre Côté
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Canada.,UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Canada
| | - Eric L Hurwitz
- Office of Public Health Studies, University of Hawaii, Mānoa, Honolulu, HI, USA
| | - Bart N Green
- National University of Health Sciences, Lombard, IL, USA.,Qualcomm Health Center, Stanford Health Care, San Diego, CA, USA
| | - Deborah Kopansky-Giles
- Department of Research, Canadian Memorial Chiropractic College, North York, ON, Canada.,Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Kristi Randhawa
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Canada.,UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Canada
| | - Christine Cedraschi
- Division of General Medical Rehabilitation, Multidisciplinary Pain Centre, Geneva University Hospitals, Geneva, Switzerland.,Division of Clinical Pharmacology and Toxicology, Multidisciplinary Pain Centre, Geneva University Hospitals, Geneva, Switzerland
| | - Arthur Ameis
- University of Montreal Faculty of Medicine Certification Program in Insurance Medicine and MedicoLegal Expertise, Toronto, ON, Canada
| | | | - Ellen Aartun
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Canada
| | - Afua Adjei-Kwayisi
- Ghana World Spine Care, Ridge Regional Hospital, Accra, Greater Accra, Ghana
| | - Selim Ayhan
- ARTES Spine Center, Acibadem University, Ankara, Turkey
| | - Amer Aziz
- Orthopaedics and Spine Department, Ghurki Trust Teaching Hospital Lahore Pakistan, Lahore, Punjab, Pakistan
| | - Teresa Bas
- Department of Surgery, Hospital Universitario and Politecnico La Fe, Valencia University, Valencia, Spain
| | - Fiona Blyth
- Concord Clinical School, University of Sydney, Concord, NSW, Australia
| | - David Borenstein
- Arthritis and Rheumatism Associates, The George Washington University Medical Center, Potomac, MD, USA
| | | | - Peter Brooks
- Centre for Health Policy, School of Population and Global Health, University of Melbourne, Toorak, Melbourne, VIC, Australia
| | | | - Juan M Castellote
- National School of Occupational Medicine, Carlos III Institute of Health and Physical Medicine and Rehabilitation Department, University Complutense, Madrid, Spain
| | - Michael B Clay
- Rehabilitation Care Line, Physical Medicine and Rehabilitation, Cincinnati Veterans Affairs Medical Center, Cincinnati, OH, USA
| | - Fereydoun Davatchi
- Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Tehran, Iran
| | - Jean Dudler
- Department of Rheumatology, HFR Fribourg - Hospital Cantonal, Fribourg, FR, Switzerland
| | - Robert Dunn
- Department of Orthopaedic Surgery, University of Cape Town and Groote Schuur Hospital, Cape Town, Western Cape, South Africa
| | | | - Juan Emmerich
- University of La Plata, La Plata, Buenos Aires, Argentina
| | | | - Norman Fisher-Jeffes
- Panorama Medi Clinic, Cape Town, Western Cape, South Africa.,Groote Schuur Hospital, Cape Town, Western Cape, South Africa
| | - Christine Goertz
- Palmer College of Chiropractic and The Spine Institute for Quality, Davenport, IA, USA
| | | | | | | | - Jan Hartvigsen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,Nordic Institute of Chiropractic and Clinical Biomechanics, Odense, Denmark
| | - Maria Hondras
- Department of Anesthesiology, University of Kansas Medical Center, Kansas City, KS, USA
| | - Edward J Kane
- College of Rehabilitative Sciences, Doctor of Physical Therapy Program, University of St. Augustine for Health Sciences, San Marcos, CA, USA
| | - Julie Laplante
- School of Sociological and Anthropological Studies, University of Ottawa, Ottawa, ON, Canada
| | | | - John Mayer
- U.S. Spine and Sport Foundation, San Diego, CA, USA
| | - Silvano Mior
- Canadian Memorial Chiropractic College, Toronto, ON, Canada
| | - Tiro Mmopelwa
- ARTES Ankara Spine Centre, Life Gaborone Hospital, Gaborone, Botswana
| | - Michael Modic
- Cleveland Clinic, Lerner College of Medicine, Cleveland, OH, USA
| | - Jean Moss
- Canadian Memorial Chiropractic College, President Emerita, Toronto, ON, Canada
| | - Rajani Mullerpatan
- MGM School of Physiotherapy, Mahatma Gandhi Mission Institute of Health Sciences, Navi Mumbai, Maharashtra, India
| | - Elijah Muteti
- Moi University/Moi Teaching and Referral Hospital, Eldoret, Kenya
| | | | - Madeleine Ngandeu-Singwe
- Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Yaounde, Center Region, Cameroon
| | - Geoff Outerbridge
- World Spine Care and Canadian Memorial Chiropractic College, Chelsea, QC, Canada
| | | | - Heather Shearer
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Canada
| | - Matthew Smuck
- Department of Orthopaedic Surgery, Stanford University, Redwood City, CA, USA
| | - Erkin Sönmez
- Department of Neurological Surgery, Başkent University School of Medicine, Ankara, Turkey
| | | | - Anne Taylor-Vaisey
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Canada
| | - Carlos Torres
- Department of Medical Imaging, University of Ottawa, The Ottawa Hospital, Ottawa, ON, Canada
| | - Paola Torres
- Exercise Science Laboratory, School of Kinesiology, Faculty of Medicine, Universidad Finis Terrae, Santiago, Chile
| | - Alexander van der Horst
- Department of Surgery, University of Namibia, Windhoek, Namibia.,Central Hospital, Windhoek, Namibia
| | - Leslie Verville
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Canada.,UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Canada
| | | | - Gomatam Vijay Kumar
- Head of Neurosurgery, AMRI Hospitals, Salt Lake, Kolkata, West Bengal, India
| | - Adriaan Vlok
- Division of Neurosurgery, University of Stellenbosch, Bellville, Western Cape, South Africa
| | - William Watters
- Department of Orthopedic, Weill Cornell Medical School and Institute of Academic Medicine, Houston Methodist Hospital, Houston, TX, USA.,Department of Orthopedic Surgery, University of Texas Medical Branch, Galveston, TX, USA
| | | | - Jessica J Wong
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Canada
| | - Hainan Yu
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Canada.,UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Canada
| | - Selcen Yüksel
- Department of Biostatistics, Ankara Yildirim Beyazit University Medical School, Ankara, Turkey
| |
Collapse
|
25
|
Haldeman S, Johnson CD, Chou R, Nordin M, Côté P, Hurwitz EL, Green BN, Cedraschi C, Acaroğlu E, Kopansky-Giles D, Ameis A, Adjei-Kwayisi A, Ayhan S, Blyth F, Borenstein D, Brady O, Brooks P, Camilleri C, Castellote JM, Clay MB, Davatchi F, Dunn R, Goertz C, Griffith EA, Hondras M, Kane EJ, Lemeunier N, Mayer J, Mmopelwa T, Modic M, Moss J, Mullerpatan R, Muteti E, Mwaniki L, Ngandeu-Singwe M, Outerbridge G, Randhawa K, Shearer H, Sönmez E, Torres C, Torres P, Verville L, Vlok A, Watters W, Wong CC, Yu H. The Global Spine Care Initiative: care pathway for people with spine-related concerns. Eur Spine J 2018; 27:901-914. [PMID: 30151811 DOI: 10.1007/s00586-018-5721-y] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Accepted: 08/06/2018] [Indexed: 12/29/2022]
Abstract
PURPOSE The purpose of this report is to describe the development of an evidence-based care pathway that can be implemented globally. METHODS The Global Spine Care Initiative (GSCI) care pathway development team extracted interventions recommended for the management of spinal disorders from six GSCI articles that synthesized the available evidence from guidelines and relevant literature. Sixty-eight international and interprofessional clinicians and scientists with expertise in spine-related conditions were invited to participate. An iterative consensus process was used. RESULTS After three rounds of review, 46 experts from 16 countries reached consensus for the care pathway that includes five decision steps: awareness, initial triage, provider assessment, interventions (e.g., non-invasive treatment; invasive treatment; psychological and social intervention; prevention and public health; specialty care and interprofessional management), and outcomes. The care pathway can be used to guide the management of patients with any spine-related concern (e.g., back and neck pain, deformity, spinal injury, neurological conditions, pathology, spinal diseases). The pathway is simple and can be incorporated into educational tools, decision-making trees, and electronic medical records. CONCLUSION A care pathway for the management of individuals presenting with spine-related concerns includes evidence-based recommendations to guide health care providers in the management of common spinal disorders. The proposed pathway is person-centered and evidence-based. The acceptability and utility of this care pathway will need to be evaluated in various communities, especially in low- and middle-income countries, with different cultural background and resources. These slides can be retrieved under Electronic Supplementary Material.
Collapse
Affiliation(s)
- Scott Haldeman
- Department of Epidemiology, School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
- Department of Neurology, University of California, Irvine, Irvine, CA, USA
- World Spine Care, Santa Ana, CA, USA
| | - Claire D Johnson
- National University of Health Sciences, Lombard, IL, USA.
- Qualcomm Health Center, Stanford Health Care, San Diego, CA, USA.
| | - Roger Chou
- Department of Medical Informatics and Clinical Epidemiology and Department of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Margareta Nordin
- Departments of Orthopedic Surgery and Environmental Medicine, New York University, New York, NY, USA
- World Spine Care Europe, Holmfirth, UK
| | - Pierre Côté
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Canada
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Canada
| | - Eric L Hurwitz
- Office of Public Health Studies, University of Hawai'i, Mānoa, Honolulu, HI, USA
| | - Bart N Green
- National University of Health Sciences, Lombard, IL, USA
- Qualcomm Health Center, Stanford Health Care, San Diego, CA, USA
| | - Christine Cedraschi
- Division of General Medical Rehabilitation and Division of Clinical Pharmacology and Toxicology, Multidisciplinary Pain Centre, Geneva University Hospitals, Geneva, Switzerland
| | | | - Deborah Kopansky-Giles
- Department of Research, Canadian Memorial Chiropractic College, North York, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
| | - Arthur Ameis
- Faculty of Medicine Certification Program in Insurance Medicine and MedicoLegal Expertise, University of Montreal, Toronto, ON, Canada
| | - Afua Adjei-Kwayisi
- Ridge Regional Hospital, Ghana World Spine Care, Accra, Greater Accra, Ghana
| | - Selim Ayhan
- ARTES Spine Center, Acibadem University, Ankara, Turkey
| | - Fiona Blyth
- Concord Clinical School, University of Sydney, Concord, NSW, Australia
| | - David Borenstein
- Arthritis and Rheumatism Associates, The George Washington University Medical Center, Potomac, MD, USA
| | | | - Peter Brooks
- Centre for Health Policy, School of Population and Global Health, University of Melbourne, Toorak, Melbourne, VIC, Australia
| | | | - Juan M Castellote
- National School of Occupational Medicine, Carlos III Institute of Health and Physical Medicine and Rehabilitation, University of Complutense, Madrid, Madrid, Spain
| | - Michael B Clay
- Rehabilitation Care Line, Physical Medicine and Rehabilitation, Cincinnati Veterans Affairs Medical Center, Cincinnati, OH, USA
| | - Fereydoun Davatchi
- Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Tehran, Iran
| | - Robert Dunn
- Department of Orthopaedic Surgery, University of Cape Town and Groote Schuur Hospital, Cape Town, Western Cape, South Africa
| | - Christine Goertz
- Palmer College of Chiropractic, Davenport, IA, USA
- The Spine Institute for Quality, Davenport, IA, USA
| | | | - Maria Hondras
- Department of Anesthesiology, University of Kansas, Medical Center, Kansas City, KS, USA
| | - Edward J Kane
- College of Rehabilitative Sciences, Doctor of Physical Therapy Program, University of St. Augustine for Health Sciences, San Marcos, CA, USA
| | | | - John Mayer
- U.S. Spine & Sport Foundation, San Diego, CA, USA
| | - Tiro Mmopelwa
- ARTES Ankara Spine Centre, Life Gaborone Hospital, Gaborone, Botswana
| | - Michael Modic
- Cleveland Clinic, Lerner College of Medicine, Cleveland, OH, USA
| | - Jean Moss
- Canadian Memorial Chiropractic College, President Emerita, Toronto, ON, Canada
| | - Rajani Mullerpatan
- Mahatma Gandhi Mission Institute of Health Sciences, MGM School of Physiotherapy, Navi Mumbai, Maharashtra, India
| | - Elijah Muteti
- Moi University/Moi Teaching & Referral Hospital, Eldoret, Kenya
| | | | - Madeleine Ngandeu-Singwe
- Faculty of Medicine and Biomedical Sciences, The University of Yaoundé I, Yaoundé, Center Region, Cameroon
| | - Geoff Outerbridge
- World Spine Care and Canadian Memorial Chiropractic College, Chelsea, QC, Canada
| | - Kristi Randhawa
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Canada
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Canada
| | - Heather Shearer
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Canada
| | - Erkin Sönmez
- Department of Neurological Surgery, Başkent University School of Medicine, Ankara, Turkey
| | - Carlos Torres
- Department of Medical Imaging, The Ottawa Hospital, University of Ottawa, Ottawa, ON, Canada
| | - Paola Torres
- Exercise Science Laboratory, School of Kinesiology, Faculty of Medicine, Universidad Finis Terrae, Santiago, Chile
| | - Leslie Verville
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Canada
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Canada
| | - Adriaan Vlok
- Division of Neurosurgery, University of Stellenbosch, Bellville, Western Cape, South Africa
| | - William Watters
- Department of Orthopedic Weill Cornell Medical School and Institute of Academic Medicine, Houston Methodist Hospital, Houston, TX, USA
- Department of Orthopedic Surgery, University of Texas Medical Branch, Galveston, TX, USA
| | | | - Hainan Yu
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Canada
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Canada
| |
Collapse
|
26
|
Green BN, Johnson CD, Haldeman S, Griffith E, Clay MB, Kane EJ, Castellote JM, Rajasekaran S, Smuck M, Hurwitz EL, Randhawa K, Yu H, Nordin M. A scoping review of biopsychosocial risk factors and co-morbidities for common spinal disorders. PLoS One 2018; 13:e0197987. [PMID: 29856783 PMCID: PMC5983449 DOI: 10.1371/journal.pone.0197987] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Accepted: 05/11/2018] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE The purpose of this review was to identify risk factors, prognostic factors, and comorbidities associated with common spinal disorders. METHODS A scoping review of the literature of common spinal disorders was performed through September 2016. To identify search terms, we developed 3 terminology groups for case definitions: 1) spinal pain of unknown origin, 2) spinal syndromes, and 3) spinal pathology. We used a comprehensive strategy to search PubMed for meta-analyses and systematic reviews of case-control studies, cohort studies, and randomized controlled trials for risk and prognostic factors and cross-sectional studies describing associations and comorbidities. RESULTS Of 3,453 candidate papers, 145 met study criteria and were included in this review. Risk factors were reported for group 1: non-specific low back pain (smoking, overweight/obesity, negative recovery expectations), non-specific neck pain (high job demands, monotonous work); group 2: degenerative spinal disease (workers' compensation claim, degenerative scoliosis), and group 3: spinal tuberculosis (age, imprisonment, previous history of tuberculosis), spinal cord injury (age, accidental injury), vertebral fracture from osteoporosis (type 1 diabetes, certain medications, smoking), and neural tube defects (folic acid deficit, anti-convulsant medications, chlorine, influenza, maternal obesity). A range of comorbidities was identified for spinal disorders. CONCLUSION Many associated factors for common spinal disorders identified in this study are modifiable. The most common spinal disorders are co-morbid with general health conditions, but there is a lack of clarity in the literature differentiating which conditions are merely comorbid versus ones that are risk factors. Modifiable risk factors present opportunities for policy, research, and public health prevention efforts on both the individual patient and community levels. Further research into prevention interventions for spinal disorders is needed to address this gap in the literature.
Collapse
Affiliation(s)
- Bart N. Green
- Qualcomm Health Center, Stanford Health Care, San Diego, California, United States of America
- Publications Department, National University of Health Sciences, Lombard, Illinois, United States of America
| | - Claire D. Johnson
- Publications Department, National University of Health Sciences, Lombard, Illinois, United States of America
| | - Scott Haldeman
- Department of Neurology, University of California, Irvine, California, United States of America
- Department of Epidemiology, School of Public Health, University of California, Los Angeles, California, United States of America
- World Spine Care, Santa Ana, California, United States of America
| | - Erin Griffith
- Emergency Medicine, Carlsbad, California, United States of America
| | - Michael B. Clay
- Rehabilitation Care Line, Physical Medicine and Rehabilitation, Cincinnati Veterans Affairs Medical Center, Cincinnati, Ohio, United States of America
| | - Edward J. Kane
- College of Rehabilitative Sciences, Doctor of Physical Therapy Program, University of St. Augustine for Health Sciences, San Marcos, California, United States of America
| | - Juan M. Castellote
- National School of Occupational Medicine, Carlos III Institute of Health, Complutense University of Madrid, Madrid, Spain
| | | | - Matthew Smuck
- Section of Physical Medicine and Rehabilitation and Department of Orthopaedic Surgery, Stanford University, Redwood City, California, United States of America
| | - Eric L. Hurwitz
- Office of Public Health Studies, University of Hawai`i, Mānoa, Honolulu, Hawaii, United States of America
| | - Kristi Randhawa
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, University of Ontario Institute of Technology, Toronto, Ontario, Canada
- Department of Undergraduate Education, Canadian Memorial Chiropractic College, Toronto, Ontario, Canada
| | - Hainan Yu
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, University of Ontario Institute of Technology, Toronto, Ontario, Canada
| | - Margareta Nordin
- World Spine Care, Santa Ana, California, United States of America
- Department of Orthopedic Surgery, New York University, New York, New York, United States of America
- Department of Environmental Medicine, New York University, New York, New York, United States of America
| |
Collapse
|
27
|
Nordin M, Randhawa K, Torres P, Yu H, Haldeman S, Brady O, Côté P, Torres C, Modic M, Mullerpatan R, Cedraschi C, Chou R, Acaroğlu E, Hurwitz EL, Lemeunier N, Dudler J, Taylor-Vaisey A, Sönmez E. The Global Spine Care Initiative: a systematic review for the assessment of spine-related complaints in populations with limited resources and in low- and middle-income communities. Eur Spine J 2018; 27:816-827. [DOI: 10.1007/s00586-017-5446-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 12/20/2017] [Accepted: 12/21/2017] [Indexed: 10/17/2022]
|
28
|
Hurwitz EL, Randhawa K, Yu H, Côté P, Haldeman S. The Global Spine Care Initiative: a summary of the global burden of low back and neck pain studies. Eur Spine J 2018; 27:796-801. [PMID: 29480409 DOI: 10.1007/s00586-017-5432-9] [Citation(s) in RCA: 300] [Impact Index Per Article: 50.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/09/2017] [Accepted: 12/16/2017] [Indexed: 02/07/2023]
Abstract
PURPOSE This article summarizes relevant findings related to low back and neck pain from the Global Burden of Disease (GBD) reports for the purpose of informing the Global Spine Care Initiative. METHODS We reviewed and summarized back and neck pain burden data from two studies that were published in Lancet in 2016, namely: "Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015" and "Global, regional, and national disability-adjusted life years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015." RESULTS In 2015, low back and neck pain were ranked the fourth leading cause of disability-adjusted life years (DALYs) globally just after ischemic heart disease, cerebrovascular disease, and lower respiratory infection {low back and neck pain DALYs [thousands]: 94 941.5 [95% uncertainty interval (UI) 67 745.5-128 118.6]}. In 2015, over half a billion people worldwide had low back pain and more than a third of a billion had neck pain of more than 3 months duration. Low back and neck pain are the leading causes of years lived with disability in most countries and age groups. CONCLUSION Low back and neck pain prevalence and disability have increased markedly over the past 25 years and will likely increase further with population aging. Spinal disorders should be prioritized for research funding given the huge and growing global burden. These slides can be retrieved under Electronic Supplementary Material.
Collapse
Affiliation(s)
- Eric L Hurwitz
- Office of Public Health Studies, University of Hawai`i, Mānoa, Honolulu, HI, USA.
| | - Kristi Randhawa
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Canada.,UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Canada
| | - Hainan Yu
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Canada.,UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Canada
| | - Pierre Côté
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Canada.,UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Canada
| | - Scott Haldeman
- Department of Epidemiology, School of Public Health, University of California Los Angeles, Los Angeles, CA, USA.,Department of Neurology, University of California, Irvine, CA, USA.,World Spine Care, Santa Ana, CA, USA
| |
Collapse
|
29
|
Acaroğlu E, Nordin M, Randhawa K, Chou R, Côté P, Mmopelwa T, Haldeman S. The Global Spine Care Initiative: a summary of guidelines on invasive interventions for the management of persistent and disabling spinal pain in low- and middle-income communities. Eur Spine J 2018; 27:870-878. [PMID: 29322309 DOI: 10.1007/s00586-017-5392-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2017] [Revised: 10/03/2017] [Accepted: 11/08/2017] [Indexed: 11/25/2022]
Abstract
PURPOSE The purpose of this study was to synthesize recommendations on the use of common elective surgical and interventional procedures for individuals with persistent and disabling non-radicular/axial with or without myelopathy, radicular back pain, cervical myelopathy, symptomatic spinal stenosis, and fractures due to osteoporosis. This review was to inform a clinical care pathway on the patient presentations where surgical interventions could reasonably be considered. METHODS We synthesized recommendations from six evidence-based clinical practice guidelines and one appropriate use criteria guidance for the surgical and interventional management of persistent and disabling spine pain. RESULTS Lower priority surgery/conditions include fusion for lumbar/non-radicular neck pain and higher priority surgery/conditions include discectomy/decompressive surgery for cervical or lumbar radiculopathy, cervical myelopathy, and lumbar spinal stenosis. Epidural steroid injections are less expensive than most surgeries with fewer harms; however, benefits are small and short lived. Vertebroplasty should be considered over kyphoplasty as an option for patients with severe pain and disability due to osteoporotic vertebral compression fracture. CONCLUSION Elective surgery and interventional procedures could be limited in medically underserved areas and low- and middle-income countries due to a lack of resources and surgeons and thus surgical and interventional procedures should be prioritized within these settings. There are non-invasive alternatives that produce similar outcomes and are a recommended option where surgical procedures are not available. These slides can be retrieved under Electronic Supplementary Material.
Collapse
Affiliation(s)
| | - Margareta Nordin
- Departments of Orthopedic Surgery and Environmental Medicine, New York University, New York, NY, USA
- World Spine Care Europe, Holmfirth, UK
| | - Kristi Randhawa
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Canada
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Canada
| | - Roger Chou
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, OR, USA
- Department of Medicine, Oregon Health and Science University, Portland, OR, USA
| | - Pierre Côté
- Faculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Canada
- UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Toronto, Canada
| | - Tiro Mmopelwa
- ARTES Ankara Spine Centre, Life Gaborone Hospital, Gaborone, Botswana
| | - Scott Haldeman
- Department of Epidemiology, School of Public Health, University of California Los Angeles, Los Angeles, USA
- Department of Neurology, University of California, Irvine, Irvine, USA
- World Spine Care, Santa Ana, CA, USA
| |
Collapse
|
30
|
Hurwitz EL, Randhawa K, Torres P, Yu H, Verville L, Hartvigsen J, Côté P, Haldeman S. The Global Spine Care Initiative: a systematic review of individual and community-based burden of spinal disorders in rural populations in low- and middle-income communities. Eur Spine J 2017; 27:802-815. [DOI: 10.1007/s00586-017-5393-z] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 10/31/2017] [Accepted: 11/06/2017] [Indexed: 12/14/2022]
|
31
|
Outerbridge G, Eberspaecher S, Haldeman S. World Spine Care: providing sustainable, integrated, evidence-based spine care in underserved communities around the world. J Can Chiropr Assoc 2017; 61:196-206. [PMID: 29430048 PMCID: PMC5799839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
| | - Stefan Eberspaecher
- World Spine Care
- Department of Orthopedics, Princess Marina Hospital, Botswana Ministry of Health and Wellness
| | - Scott Haldeman
- World Spine Care
- Department of Neurology, University of California
- Department of Epidemiology, School of Public Health, University of California
| |
Collapse
|
32
|
Acaroğlu E, Mmopelwa T, Yüksel S, Ayhan S, Nordin M, Randhawa K, Haldeman S. The Global Spine Care Initiative: a consensus process to develop and validate a stratification scheme for surgical care of spinal disorders as a guide for improved resource utilization in low- and middle-income communities. Eur Spine J 2017; 27:879-888. [PMID: 29038871 DOI: 10.1007/s00586-017-5332-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 09/19/2017] [Accepted: 10/04/2017] [Indexed: 11/30/2022]
Abstract
PURPOSE The purpose of this study was to develop a stratification scheme for surgical spinal care to serve as a framework for referrals and distribution of patients with spinal disorders. METHODS We used a modified Delphi process. A literature search identified experts for the consensus panel and the panel was expanded by inviting spine surgeons known to be global opinion leaders. After creating a seed document of five hierarchical levels of surgical care, a four-step modified Delphi process (question validation, collection of factors, evaluation of factors, re-evaluation of factors) was performed. RESULTS Of 78 invited experts, 19 participated in round 1, and of the 19, 14 participated in 2, and 12 in 3 and 4. Consensus was fairly heterogeneous for levels of care 2-4 (moderate resources). Only simple assessment methods based on the clinical skills of the medical personnel were considered feasible and safe in low-resource settings. Diagnosis, staging, and treatment were deemed feasible and safe in a specialized spine center. Accurate diagnostic workup was deemed feasible and safe for lower levels of care complexity (from level 3 upwards) compared to non-invasive procedures (level 4) and the full range of invasive procedures (level 5). CONCLUSION This study introduces a five-level stratification scheme for the surgical care of spinal disorders. This stratification may provide input into the Global Spine Care Initiative care pathway that will be applied in medically underserved areas and low- and middle-income countries. These slides can be retrieved under Electronic Supplementary Material.
Collapse
Affiliation(s)
| | - Tiro Mmopelwa
- ARTES Spine Centre Ankara, Life Gaborone Hospital, Gaborone, Botswana
| | - Selcen Yüksel
- Department of Biostatistics, Ankara Yildirim Beyazit University Medical School, Ankara, Turkey
| | | | - Margareta Nordin
- Department of Orthopedic Surgery and Environmental Medicine, New York University, New York, NY, USA.,World Spine Care Europe, Holmfirth, UK
| | - Kristi Randhawa
- University of Ontario Institute of Technology (UOIT)-Canadian Memorial Chiropractic College (CMCC) Centre for Disability Prevention and Rehabilitation, Toronto, ON, Canada
| | - Scott Haldeman
- Department of Epidemiology, School of Public Health, University of California Los Angeles, Santa Ana, CA, USA.,Department of Neurology, University of California, Irvine and President, World Spine Care, Santa Ana, CA, USA
| |
Collapse
|
33
|
Brady O, Nordin M, Hondras M, Outerbridge G, Kopansky-Giles D, Côté P, da Silva S, Ford T, Eberspaecher S, Acaroğlu E, Mmopelwa T, Hurwitz EL, Haldeman S. Global Forum: Spine Research and Training in Underserved, Low and Middle-Income, Culturally Unique Communities: The World Spine Care Charity Research Program's Challenges and Facilitators. J Bone Joint Surg Am 2016; 98:e110. [PMID: 28002378 DOI: 10.2106/jbjs.16.00723] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The World Spine Care (WSC), established by volunteers from 5 continents, is dedicated to providing sustainable, evidence-based spine care to individuals and communities in low and middle-income countries consistent with available health-care resources and integrated within the local culture. The research committee approves and oversees the WSC's collaborative research and training projects worldwide and serves to create a sustainable research community for underserved populations focused on preventing disability from spinal disorders. The purpose of this article is to describe 4 projects overseen by the WSC research committee and to discuss several challenges and specific facilitators that allowed successful completion of initiatives. These novel projects, which involved establishing spine surgery expertise and data collection in the WSC clinics and surrounding communities, all met their aims. This was achieved by overcoming language and resource challenges, adapting to local customs, and taking time to build mutual respect and to nurture relationships with local investigators and stakeholders.
Collapse
Affiliation(s)
- O'Dane Brady
- 1World Spine Care, Santa Ana, California 2Departments of Orthopedic Surgery and Environmental Medicine, New York University, New York, NY 3Department of Sports Science and Clinical Biomechanics, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark 4Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada 5Graduate Education and Research, Canadian Memorial Chiropractic College, Toronto, Ontario, Canada 6Faculty of Health Sciences, University of Ontario Institute of Technology (UOIT), Oshawa, Ontario, Canada 7UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, Canadian Memorial Chiropractic College, Toronto, Ontario, Canada 8World Spine Care, Moca, Dominican Republic 9Ankara ARTES Spine Center, Ankara, Turkey 10Mahalapye District Hospital, Mahalapye, Botswana 11Department of Epidemiology, Office of Public Health Studies, University of Hawaii at Manoa, Honolulu, Hawaii 12Department of Epidemiology, School of Public Health, University of California, Los Angeles, Los Angeles, California 13Department of Neurology, University of California, Irvine, Irvine, California
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
34
|
Cassidy JD, Boyle E, Côté P, Hogg-Johnson S, Bondy SJ, Haldeman S. Risk of Carotid Stroke after Chiropractic Care: A Population-Based Case-Crossover Study. J Stroke Cerebrovasc Dis 2016; 26:842-850. [PMID: 27884458 DOI: 10.1016/j.jstrokecerebrovasdis.2016.10.031] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 09/07/2016] [Accepted: 10/23/2016] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Chiropractic manipulation is a popular treatment for neck pain and headache, but may increase the risk of cervical artery dissection and stroke. Patients with carotid artery dissection can present with neck pain and/or headache before experiencing a stroke. These are common symptoms seen by both chiropractors and primary care physicians (PCPs). We aimed to assess the risk of carotid artery stroke after chiropractic care by comparing association between chiropractic and PCP visits and subsequent stroke. METHODS A population-based, case-crossover study was undertaken in Ontario, Canada. All incident cases of carotid artery stroke admitted to hospitals over a 9-year period were identified. Cases served as their own controls. Exposures to chiropractic and PCP services were determined from health billing records. RESULTS We compared 15,523 cases to 62,092 control periods using exposure windows of 1, 3, 7, and 14 days prior to the stroke. Positive associations were found for both chiropractic and PCP visits and subsequent stroke in patients less than 45 years of age. These associations tended to increase when analyses were limited to visits for neck pain and headache-related diagnoses. There was no significant difference between chiropractic and PCP risk estimates. We found no association between chiropractic visits and stroke in those 45 years of age or older. CONCLUSIONS We found no excess risk of carotid artery stroke after chiropractic care. Associations between chiropractic and PCP visits and stroke were similar and likely due to patients with early dissection-related symptoms seeking care prior to developing their strokes.
Collapse
Affiliation(s)
- J David Cassidy
- Department of Sports Science and Clinical Biomechanics, Faculty of Health, University of Southern Denmark, Odense, Denmark; Division of Health Care and Outcomes Research, Krembil Research Institute, University Health Network, Toronto, Ontario, Canada; Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
| | - Eleanor Boyle
- Department of Sports Science and Clinical Biomechanics, Faculty of Health, University of Southern Denmark, Odense, Denmark; Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Pierre Côté
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Faculty of Health Sciences, University of Ontario Institute of Technology and UOIT-CMCC Centre for Disability Prevention and Rehabilitation, Oshawa, Ontario, Canada
| | - Sheilah Hogg-Johnson
- Institute for Work and Health, Toronto, Ontario, Canada; Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Susan J Bondy
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Scott Haldeman
- Department of Neurology, University of California, Irvine, California
| |
Collapse
|
35
|
Davies R, McCulloch M, Haldeman S, Pizarro C. Short-term waitlist survival without mechanical circulatory support in children. Progress in Pediatric Cardiology 2016. [DOI: 10.1016/j.ppedcard.2016.08.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
36
|
Yang H, Haldeman S, Lu ML, Baker D. Low Back Pain Prevalence and Related Workplace Psychosocial Risk Factors: A Study Using Data From the 2010 National Health Interview Survey. J Manipulative Physiol Ther 2016; 39:459-472. [PMID: 27568831 PMCID: PMC5530370 DOI: 10.1016/j.jmpt.2016.07.004] [Citation(s) in RCA: 107] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2016] [Accepted: 07/13/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The objectives of this study were to estimate prevalence of low back pain, to investigate associations between low back pain and a set of emerging workplace risk factors, and to identify worker groups with an increased vulnerability for low back pain in the United States. METHODS The data used for this cross-sectional study came from the 2010 National Health Interview Survey, which was designed to collect data on health conditions and related risk factors from the US civilian population. The variance estimation method was used to compute weighted data for prevalence of low back pain. Multivariable logistic regression analyses stratified by sex and age were performed to determine the odds ratios (ORs) and the 95% confidence interval (CI) for low back pain. The examined work-related psychosocial risk factors included work-family imbalance, exposure to a hostile work environment, and job insecurity. Work hours, occupation, and other work organizational factors (nonstandard work arrangements and alternative shifts) were also examined. RESULTS The prevalence of self-reported low back pain in the previous 3 months among workers in the United States was 25.7% in 2010. Female or older workers were at increased risk of experiencing low back pain. We found significant associations between low back pain and a set of psychosocial factors, including work-family imbalance (OR 1.27, CI 1.15-1.41), exposure to hostile work (OR 1.39, CI 1.25-1.55), and job insecurity (OR 1.44, CI 1.24-1.67), while controlling for demographic characteristics and other health-related factors. Older workers who had nonstandard work arrangements were more likely to report low back pain. Women who worked 41 to 45 hours per week and younger workers who worked >60 hours per week had an increased risk for low back pain. Workers from several occupation groups, including male health care practitioners, female and younger health care support workers, and female farming, fishing, and forestry workers, had an increased risk of low back pain. CONCLUSIONS This study linked low back pain to work-family imbalance, exposure to a hostile work environment, job insecurity, long work hours, and certain occupation groups. These factors should be considered by employers, policymakers, and health care practitioners who are concerned about the impact of low back pain in workers.
Collapse
Affiliation(s)
- Haiou Yang
- Center for Occupational and Environmental Health, University of California, Irvine, CA.
| | - Scott Haldeman
- Neurology Department, University of California, Irvine, California; Department of Epidemiology, School of Public Health, University of California, Los Angeles, CA
| | - Ming-Lun Lu
- Division of Applied Research and Technology, National Institute of Occupational Safety and Health, Cincinnati, OH
| | - Dean Baker
- Center for Occupational and Environmental Health, University of California, Irvine, CA
| |
Collapse
|
37
|
Yang H, Hitchcock E, Haldeman S, Swanson N, Lu ML, Choi B, Nakata A, Baker D. Workplace psychosocial and organizational factors for neck pain in workers in the United States. Am J Ind Med 2016; 59:549-60. [PMID: 27184340 PMCID: PMC4979741 DOI: 10.1002/ajim.22602] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2016] [Indexed: 01/04/2023]
Abstract
BACKGROUND Neck pain is a prevalent musculoskeletal condition among workers in the United States. This study explores a set of workplace psychosocial and organization-related factors for neck pain. METHODS Data used for this study come from the 2010 National Health Interview Survey which provides a representative sample of the US population. To account for the complex sampling design, the Taylor linearized variance estimation method was used. Logistic regression models were constructed to measure the associations. RESULTS This study demonstrated significant associations between neck pain and a set of workplace risk factors, including work-family imbalance, exposure to a hostile work environment and job insecurity, non-standard work arrangements, multiple jobs, and long work hours. CONCLUSION Workers with neck pain may benefit from intervention programs that address issues related to these workplace risk factors. Future studies exploring both psychosocial risk factors and physical risk factors with a longitudinal design will be important. Am. J. Ind. Med. 59:549-560, 2016. © 2016 Wiley Periodicals, Inc.
Collapse
Affiliation(s)
- Haiou Yang
- Center for Occupational and Environmental Health, University of California, Irvine, California
| | - Edward Hitchcock
- Division of Applied Research and Technology, National Institute of Occupational Safety and Health, Cincinnati, Ohio
| | - Scott Haldeman
- Department of Neurology, University of California, Irvine, California
- Department of Epidemiology, School of Public Health, University of California, Los Angeles, California
| | - Naomi Swanson
- Division of Applied Research and Technology, National Institute of Occupational Safety and Health, Cincinnati, Ohio
| | - Ming-Lun Lu
- Division of Applied Research and Technology, National Institute of Occupational Safety and Health, Cincinnati, Ohio
| | - BongKyoo Choi
- Center for Occupational and Environmental Health, University of California, Irvine, California
| | - Akinori Nakata
- School of Health Sciences, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Dean Baker
- Center for Occupational and Environmental Health, University of California, Irvine, California
| |
Collapse
|
38
|
Haldeman S, McAndrews GP, Goertz C, Sportelli L, Hamm AW, Johnson C. The McAndrews Leadership Lecture: February 2015, by Dr Scott Haldeman. Challenges of the Past, Challenges of the Present. J Chiropr Humanit 2015; 22:30-46. [PMID: 26770177 PMCID: PMC4685229 DOI: 10.1016/j.echu.2015.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2015] [Revised: 09/17/2015] [Accepted: 09/20/2015] [Indexed: 05/12/2023]
Abstract
The McAndrews Leadership Lecture was developed by the American Chiropractic Association to honor the legacy of Jerome F. McAndrews, DC, and George P. McAndrews, JD, and their contributions to the chiropractic profession. This article is a transcription of the presentation made by Dr Scott Haldeman on February 28, 2015, in Washington, DC, at the National Chiropractic Leadership Conference.
Collapse
Affiliation(s)
- Scott Haldeman
- President, World Spine Care, Clinical Professor, Department of Neurology, University of California, Irvine, CA
- Adjunct Professor, Department of Epidemiology, School of Public Health, University of California, Los Angeles, CA
| | | | - Christine Goertz
- Vice Chancellor, Research and Health Policy, Palmer College of Chiropractic and Palmer Center for Chiropractic Research, Davenport, IA
| | | | - Anthony W. Hamm
- President, American Chiropractic Association, Arlington, VA
- Private Practice, Goldsboro, NC
| | - Claire Johnson
- Professor, National University of Health Sciences, Lombard, IL
- Corresponding author at: 200 E Roosevelt Rd, Lombard, IL, 60148. Tel.: + 1 630 297 3290.200 E Roosevelt RdLombardIL60148
| |
Collapse
|
39
|
Haldeman S, Nordin M, Outerbridge G, Hurwitz EL, Hondras M, Brady O, Kopansky-Giles D, Ford T, Acaroğlu E. Creating a sustainable model of spine care in underserved communities: the World Spine Care (WSC) charity. Spine J 2015; 15:2303-11. [PMID: 26096472 DOI: 10.1016/j.spinee.2015.06.046] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Revised: 05/11/2015] [Accepted: 06/12/2015] [Indexed: 02/03/2023]
Affiliation(s)
- Scott Haldeman
- Department of Neurology, University of California, 200 S. Manchester Ave., Suite 206, Irvine, CA, 92868, USA; Department of Epidemiology, School of Public Health, University of California, 650 Charles Young Drive, South Box 951772, Los Angeles, CA, 90095, USA; World Spine Care, 801 North Tustin Avenue, Suite 202, Santa Ana, 92705, CA, USA
| | - Margareta Nordin
- World Spine Care, 801 North Tustin Avenue, Suite 202, Santa Ana, 92705, CA, USA; Department of Orthopedic Surgery, Occupational and Industrial Orthopedic Center (OIOC), New York University, 63 Downing Street, New York, NY 10014, USA.
| | - Geoff Outerbridge
- World Spine Care, 801 North Tustin Avenue, Suite 202, Santa Ana, 92705, CA, USA
| | - Eric L Hurwitz
- Office of Public Health Studies, University of Hawaii at Manoa, 1960 East-West Road, Biomedical Sciences D201, Honolulu, HI, 96822, USA
| | - Maria Hondras
- Department of Sports Science and Clinical Biomechanics, Faculty of Health Sciences, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
| | - O'Dane Brady
- World Spine Care, 801 North Tustin Avenue, Suite 202, Santa Ana, 92705, CA, USA
| | - Deborah Kopansky-Giles
- Chiropractic Program, Department of Family and Community Medicine, St. Michael's Hospital, 80 Bond Health Centre, Level 1 Room 12, Toronto, Ontario, Canada, M5B 1X2; Graduate Education and Research, Canadian Memorial Chiropractic College, 6100 Leslie Street, Toronto, Ontario, Canada, M2H 3J1
| | - Timothy Ford
- World Spine Care, Mahalapye District Hospital, P.O. Box 49, Mahalapye, Botswana
| | - Emre Acaroğlu
- Ankara Spine Center, İran Caddesi 45/2 Kavaklıdere 06700, Ankara, Turkey
| |
Collapse
|
40
|
Dagenais S, Brady O, Haldeman S, Manga P. A systematic review comparing the costs of chiropractic care to other interventions for spine pain in the United States. BMC Health Serv Res 2015; 15:474. [PMID: 26482271 PMCID: PMC4615617 DOI: 10.1186/s12913-015-1140-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2015] [Accepted: 10/09/2015] [Indexed: 11/10/2022] Open
Abstract
Background Although chiropractors in the United States (US) have long suggested that their approach to managing spine pain is less costly than other health care providers (HCPs), it is unclear if available evidence supports this premise. Methods A systematic review was conducted using a comprehensive search strategy to uncover studies that compared health care costs for patients with any type of spine pain who received chiropractic care or care from other HCPs. Only studies conducted in the US and published in English between 1993 and 2015 were included. Health care costs were summarized for studies examining: 1. private health plans, 2. workers’ compensation (WC) plans, and 3. clinical outcomes. The quality of studies in the latter group was evaluated using a Consensus on Health Economic Criteria (CHEC) list. Results The search uncovered 1276 citations and 25 eligible studies, including 12 from private health plans, 6 from WC plans, and 7 that examined clinical outcomes. Chiropractic care was most commonly compared to care from a medical physician, with few details about the care received. Heterogeneity was noted among studies in patient selection, definition of spine pain, scope of costs compared, study duration, and methods to estimate costs. Overall, cost comparison studies from private health plans and WC plans reported that health care costs were lower with chiropractic care. In studies that also examined clinical outcomes, there were few differences in efficacy between groups, and health care costs were higher for those receiving chiropractic care. The effects of adjusting for differences in sociodemographic, clinical, or other factors between study groups were unclear. Conclusions Although cost comparison studies suggest that health care costs were generally lower among patients whose spine pain was managed with chiropractic care, the studies reviewed had many methodological limitations. Better research is needed to determine if these differences in health care costs were attributable to the type of HCP managing their care. Electronic supplementary material The online version of this article (doi:10.1186/s12913-015-1140-5) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Simon Dagenais
- Spine Research LLC, 540 Main Street #7, Winchester, MA, 01890, USA.
| | | | - Scott Haldeman
- World Spine Care, Santa Ana, CA, USA. .,Department of Neurology, College of Medicine, University of California, Irvine, USA. .,Department of Epidemiology, School of Public Health, University of California, Los Angeles, USA.
| | - Pran Manga
- Telfer School of Management, University of Ottawa, Ottawa, Ontario, Canada.
| |
Collapse
|
41
|
Davies R, Gidding S, McCulloch M, Haldeman S, Pizarro C. High BMI Predicts Poor Outcomes in DCM But Not CHD Patients: The Differential Impact of Obesity on Outcomes in Pediatric Heart Transplantation. J Heart Lung Transplant 2015. [DOI: 10.1016/j.healun.2015.01.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
|
42
|
Hondras M, Myburgh C, Hartvigsen J, Haldeman S, Johannessen H. How can we assess the burden of muscle, bone and joint conditions in rural Botswana: context and methods for the MuBoJo focused ethnography. Chiropr Man Therap 2015; 23:11. [PMID: 25780559 PMCID: PMC4361207 DOI: 10.1186/s12998-015-0056-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Accepted: 01/27/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Musculoskeletal diseases are the most common causes of long-term pain and disability worldwide and a growing international public health concern. However, the everyday burden and impact of musculoskeletal conditions are not well understood, especially among people living in low- and middle-income countries in Africa. Since 2011, World Spine Care, a nongovernmental organisation, has collaborated with the Botswana Ministry of Health to open spine care centres and to conduct research. The broad aim of the Muscle, Bone and Joint (MuBoJo) research project is to examine the sociocultural, organisational and clinical characteristics for the burden of living with and caring for people living with musculoskeletal conditions in rural Botswana. In this paper, we describe the community context, theoretical framework, and research methods to address the project aim with a qualitative study. METHODS/DESIGN This focused ethnography is based on eight months (November 2011, April 2013, October 2013-March 2014) of fieldwork in Botswana. The project was theoretically informed by the concepts of explanatory models of illness, social suffering, and biographical disruption. Data collection included fieldnotes, non-participant and participant observations, and informal and in-depth interviews with villagers and healthcare providers. Villager interviews were typically conducted in Setswana with an interpreter. Audio recordings were transcribed verbatim in the language spoken with Setswana contextually translated into English. Computer software supported qualitative data management. Analysis is ongoing using constant comparison and a template organising style to facilitate pattern-finding and reveal insights for the burden and care of musculoskeletal conditions. DISCUSSION Findings from the MuBoJo Project will document the context of musculoskeletal burden, illness beliefs, self-care behaviours, and healthcare options in a Botswana rural village. These data will inform ongoing efforts to establish spine care clinics for underserved populations in low-middle income countries and sustain these healthcare services through local providers and volunteer health professionals. This study also will generate new knowledge about the burden and impact of muscle, bone and joint disorders for cross-cultural comparisons and patient-centred interventions. CONCLUSIONS Our systematic and transparent methodology to conduct musculoskeletal research in more than one language and in a cross-cultural setting may be useful for investigators and NGO healthcare personnel.
Collapse
Affiliation(s)
- Maria Hondras
- />Department of Sports Science and Clinical Biomechanics, Faculty of Health Sciences, University of Southern Denmark, Campusvej 55, Odense M, Denmark
- />World Spine Care, 801 North Tustin Avenue, Suite 202, Santa Ana, California, USA
| | - Corrie Myburgh
- />Department of Sports Science and Clinical Biomechanics, Faculty of Health Sciences, University of Southern Denmark, Campusvej 55, Odense M, Denmark
| | - Jan Hartvigsen
- />Department of Sports Science and Clinical Biomechanics, Faculty of Health Sciences, University of Southern Denmark, Campusvej 55, Odense M, Denmark
- />World Spine Care, 801 North Tustin Avenue, Suite 202, Santa Ana, California, USA
- />Nordic Institute of Chiropractic and Clinical Biomechanics, Campusvej 55, Odense M, Denmark
| | - Scott Haldeman
- />World Spine Care, 801 North Tustin Avenue, Suite 202, Santa Ana, California, USA
- />Department of Neurology, University of California, Irvine, California USA
- />Department of Epidemiology, School of Public Health, University of California, Los Angeles, California USA
| | - Helle Johannessen
- />Department of Public Health, Faculty of Health Sciences, University of Southern Denmark, J.B. Winsløws Vej 9B, 5000 Odense C, Denmark
| |
Collapse
|
43
|
Haldeman S, Chapman-Smith D. Award-winning articles and posters from the World Federation of Chiropractic's 12th Biennial Congress 2013. J Manipulative Physiol Ther 2014; 37:1-6. [PMID: 24373381 DOI: 10.1016/j.jmpt.2013.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This editorial reviews the original research submissions to the World Federation of Chiropractic's 12th Biennial Congress held in Durban, South Africa from April 10 - 13, 2013, and the four award-winning scientific articles in the NCMIC Louis Sportelli Research Awards competition at the Congress which are published in this issue of the Journal of Manipulative and Physiological Therapeutics.
Collapse
Affiliation(s)
- Scott Haldeman
- Chairman, Research Council, World Federation of Chiropractic, Department of Neurology, University of California, Irvine, Calif.
| | - David Chapman-Smith
- Secretary General, World Federation of Chiropractic, Toronto, Ontario, Canada
| |
Collapse
|
44
|
Davies R, McCulloch M, Haldeman S, Gidding S, Pizarro C. Low Body Mass Index Is Associated with Increased Waitlist Mortality Among Children Listed for Heart Transplantation. J Heart Lung Transplant 2014. [DOI: 10.1016/j.healun.2014.01.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
|
45
|
Brady O, Haldeman S. Commentary: we can tell where it hurts, but can we tell where the pain is coming from or where we should manipulate? Chiropr Man Therap 2013; 21:35. [PMID: 24499590 PMCID: PMC4029163 DOI: 10.1186/2045-709x-21-35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2013] [Accepted: 10/17/2013] [Indexed: 11/10/2022] Open
Abstract
The shared decision making process has become increasingly important in the management of spinal disorders where there remains a variety of treatment options. Spinal manipulative therapy (SMT) is often recommended as a conservative option by evidence based clinical practice guidelines and a treatment modality frequently utilized by chiropractors and other clinicians who offer SMT to their patients. This article serves as a commentary to a review of the methods that are often used by chiropractors to determine the site for applying their manipulative intervention. Though it may be easy to criticize any review of this type of literature and point out shortcomings there are strong take away messages for the clinician interested in employing SMT as a part of their treatment protocol. Most notably, clinicians can be reassured that a history on the localization of pain, tissue palpation, provocative testing, range of motion testing and the demonstration by the patient of the locus and description of pain have reasonable consistency between observers. What this paper does not inform us on is the nature of the lesion causing the pain or where the manipulation should be applied to obtain the best outcome.
Collapse
Affiliation(s)
- O’Dane Brady
- World Spine Care, PO Box 49, Mahalapye, Botswana
| | - Scott Haldeman
- University of California, Irvine, USA,University of California, Los Angeles, USA
| |
Collapse
|
46
|
Davies RR, Haldeman S, Pizarro C. Regional variation in survival before and after pediatric heart transplantation--an analysis of the UNOS database. Am J Transplant 2013; 13:1817-29. [PMID: 23714390 DOI: 10.1111/ajt.12259] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2012] [Revised: 02/21/2013] [Accepted: 03/14/2013] [Indexed: 01/25/2023]
Abstract
Geographic variation occurs in a variety of health outcomes. Regional influences on outcomes before and after listing for pediatric heart transplantation have not been assessed. Review of the UNOS dataset identified 5398 pediatric (≤ 18 years) patients listed for heart transplantation 2000-2011. Patients were stratified based on the region of listing. Regional-level variables were correlated with individual risk-adjusted outcomes. Mean time spent on the waitlist varied from 91.0 ± 163 days (Region 6 [R6]) to 248.1 ± 493 days (R4, p < 0.0001). Regions with more transplant centers (p < 0.0001) and fewer transplants (p = 0.0015) had higher waitlist mortality. Risk-adjusted individual waitlist mortality varied from 6.9% (R1, CI 6.2-7.8) to 19.2% (R5, CI 18.0-20.6). Waitlist mortality was higher for individuals awaiting transplant in regions with more listings per center (OR 1.04, CI 1.01-1.08) and lower in regions with more donors per center (OR 0.95, CI 0.90-0.99 per donor). Posttransplant risk-adjusted survival varied across regions (R4: 5.4%, CI 4.2-7.4; R7: 18.0%, CI 12.4-32.5), but regional variables were not correlated with outcomes. Outcomes among children undergoing heart transplantation vary by region. Factors leading to increased competition for donor allografts are associated with poorer waitlist survival. Equitable allocation of cardiac allografts requires further investigation of these findings.
Collapse
Affiliation(s)
- R R Davies
- Nemours Cardiac Center, Nemours/A.I. duPont Hospital for Children, Wilmington, DE, USA.
| | | | | |
Collapse
|
47
|
Haldeman S, Bracher ESB. Sociedade Brasileira de Coluna e Federação Mundial de Quiropraxia: uma nova parceria científica. Coluna/Columna 2013. [DOI: 10.1590/s1808-18512013000100001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
|
48
|
Abstract
Hazard RG, Spratt KF, McDonough CM, et al. Patient-centered evaluation of outcomes from rehabilitation for chronic disabling spinal disorders: the impact of personal goal achievement on patient satisfaction. Spine J 2012;12:1132-7 (in this issue).
Collapse
Affiliation(s)
- Scott Haldeman
- Department of Neurology, University of California, Irvine, Irvine, CA 92697, USA.
| |
Collapse
|
49
|
Abstract
Schofield DJ, Shrestha RN, Percival R, et al. The personal and national costs of early retirement because of spinal disorders: impacts on income, taxes, and government support payments. Spine J 2012;12:1111-8 (in this issue).
Collapse
Affiliation(s)
- Simon Dagenais
- Palladian Health, 2732 Transit Rd, West Seneca, NY 14224, USA
| | | |
Collapse
|
50
|
Haldeman S, Chapman-Smith D. Award-winning articles and posters from the World Federation of Chiropractic's 11th Biennial Congress 2011. J Manipulative Physiol Ther 2012; 35:2-6. [PMID: 22240309 DOI: 10.1016/j.jmpt.2011.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2011] [Accepted: 07/16/2011] [Indexed: 11/30/2022]
Abstract
This editorial reviews the scientific sessions and announces the 4 award-winning scientific articles from the World Federation of Chiropractic 11th Biennial Congress held in Rio de Janeiro from April 6, to 9, 2011, that are published in this issue of the Journal of Manipulative and Physiological Therapeutics.
Collapse
|