Stratified models of care
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Stratified care for back pain involves targeting treatment to subgroups of patients based on their key characteristics such as prognostic factors, likely response to treatment and underlying mechanisms. It aims to tailor therapeutic decisions in ways that maximise treatment benefit, reduce harm and increase health-care efficiency by offering the right treatment to the right patient at the right time. From being called the ‘Holy Grail’ of back pain research over a decade ago, stratified care is becoming the zeitgeist in research and clinical practice. In this chapter, we introduce and evaluate the quality and underpinning evidence for three examples of stratified care for back pain to highlight their general principles, research design issues and clinical practice implications. We include consideration of their merits for implementation in practice. We conclude with a set of remaining, key research questions.
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Schäfer, Axel (2009)Background summary. Leg pain is a common complaint in relation to low back pain (LBP), present in up to 65% of all patients with LBP. Radiating leg pain is an important predictor for chronicity of LBP and an indicator of ...
Is the duration of pre-operative conservative treatment associated with the clinical outcome following surgical decompression for lumbar spinal stenosis? A study based on the Spine Tango RegistryZweig, T.; Enke, J.; Mannion, A.; Sobottke, R.; Melloh, Markus; Freeman, B.; Aghayev, E. (2016)Background: The incidence of lumbar spinal stenosis (LSS) continues to rise, with both conservative and surgical management representing options for its treatment. The timing of surgery for LSS varies from shortly after ...
'I call it stinkin' thinkin'': A qualitative analysis of metacognition in people with chronic low back pain and elevated catastrophizingSchütze, R.; Rees, Clare; Slater, H.; Smith, A.; O'Sullivan, P. (2017)© 2017 The British Psychological Society.Objectives: Pain catastrophizing is widely studied in quantitative pain research because of its strong link with poor pain outcomes, although the exact nature of this construct ...