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Systematic review of randomized controlled trials of clinical prediction rules for physical therapy in low back pain

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Patel, Shilpa, Friede, Tim, Froud, Robert J., Evans, David J. and Underwood, Martin (2013) Systematic review of randomized controlled trials of clinical prediction rules for physical therapy in low back pain. Spine, Volume 38 (Number 9). pp. 762-769. doi:10.1097/BRS.0b013e31827b158f ISSN 0362-2436.

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Official URL: http://dx.doi.org/10.1097/BRS.0b013e31827b158f

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Abstract

Objective: The objective of this review was to evaluate randomised controlled trials validating the effects of a clinical prediction rule for patients with non-specific low back pain. The outcomes of interest were any back pain or pain related measures.

Summary of background data: Low back pain is a common and costly condition. Interventions for back pain seem to have, at best, small to moderate mean beneficial effects. Identifying sub-groups of patients who may respond better to certain treatments may help to improve clinical outcomes in back pain. The development of clinical prediction rules is an attempt to determine who will respond best to certain treatments.

Methods: We conducted electronic searches of MEDLINE (1980-2009), EMBASE (1980-2009), PSYCINFO (1980-2009), AMED (1980-2009), PubMed (1980-2009), ISI Web of Knowledge (1980-2009) and the Cochrane Library (1980-2009). The reference lists of relevant articles were searched for further references.

Results: We identified 1,821 potential citations; three papers were included. The results from the available data do not support the use of clinical prediction rules in the management of non-specific low back pain.

Conclusion: There is a lack of good quality randomised controlled trials validating the effects of a clinical prediction rule for low back pain. Furthermore, there is no agreement on appropriate methodology for the validation and impact analysis. The evidence for, and development of, the existing prediction rules is generally weak.

Item Type: Journal Article
Divisions: Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Journal or Publication Title: Spine
Publisher: Lippincott Williams & Wilkins
ISSN: 0362-2436
Official Date: 2013
Dates:
DateEvent
2013Published
Volume: Volume 38
Number: Number 9
Page Range: pp. 762-769
DOI: 10.1097/BRS.0b013e31827b158f
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Restricted or Subscription Access

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