Spine
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Randomized Controlled Trial Multicenter Study
SPORT lumbar intervertebral disk herniation and back pain: does treatment, location, or morphology matter?
Diskectomy candidates with at least 6 weeks of sciatica and confirmatory imaging were enrolled in a randomized or observational cohort. ⋯ Diskectomy resulted in greater improvement in back pain than nonoperative treatment, and this difference was maintained at 2 years for all herniation locations and morphologies.
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Best evidence synthesis. ⋯ The Bone and Joint Decade 2000-2010 Task Force on Neck Pain and its Associated Disorders undertook a best evidence synthesis to establish a baseline of the current best evidence on the epidemiology, assessment and classification of neck pain, as well as interventions and prognosis for this symptom. This article reports the methods used and the outcomes from the review. We found that 46% of the research literature was of acceptable scientific quality to inform clinical practice, policy-making, and future research.
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Randomized Controlled Trial Comparative Study
Economic evaluation of an intensive group training protocol compared with usual care physiotherapy in patients with chronic low back pain.
Economic evaluation from a societal perspective conducted alongside a randomized controlled trial with a follow-up of 52 weeks. ⋯ The results of this economic evaluation showed no difference in total costs between the protocol group and the guideline group. The differences in effects were small and not statistically significant. At present, national implementation of the protocol is not recommended.
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Observation and survey of values, beliefs, and conflicts of interest. ⋯ This study describes a process used to assess values, beliefs, and conflicts of interest among members of a scientific task force, and how this was used to create "guiding principles" to assist the research team in deliberations, particularly when conflict arose. Most members of the Neck Pain Task Force had potential conflicts of interest with various stakeholders, but there was marked diffusion of these potential conflicts and no evidence that any funder or other vested interest stakeholder was likely to have a significant impact on the deliberations or conclusions of the Neck Pain Task Force.
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Iterative discussion and consensus by a multidisciplinary task force scientific secretariat reviewing scientific evidence on neck pain and its associated disorders. ⋯ The Scientific Secretariat found the conceptual model helpful in interpreting the available scientific evidence. We believe it can assist people with neck pain, researchers, clinicians, and policy makers in framing their questions and decisions.