Therapeutic trials for low back pain.
Little consensus exists regarding the indications for and effectiveness of many back pain treatments. This clinical uncertainty arises because most back pain research has been flawed by poor methodology. The authors discuss strategies for improving the quality of back pain research on treatment efficacy. Design features, including randomized treatment allocation, independent outcome assessors, comprehensive outcome measures, appropriate statistical analyses, and close patient follow-up can increase study validity. Complete descriptions of enrollment criteria, patient characteristics, and clinical interventions can increase the generalizability of results. Although large scale trials often involve university centers, community-based researchers can collaborate on randomized trials or conduct valuable cohort studies.
Hoffman
R M
RM
Department of Medicine, University of Washington, Seattle.
Turner
J A
JA
Cherkin
D C
DC
Deyo
R A
RA
Herron
L D
LD
D002986:Clinical Trials as Topic; D015331:Cohort Studies; D005500:Follow-Up Studies; D006801:Humans; D017116:Low Back Pain / Q000628:therapy*; D017063:Outcome Assessment, Health Care; D010043:Outcome and Process Assessment, Health Care; D016032:Randomized Controlled Trials as Topic; D015203:Reproducibility of Results; D012107:Research Design