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Cited by 116Meta-analysis and systematic reviewsMusculoskeletal pain and rehabilitationClinical practice guidelines implementation

The DOI matches its Crossref record; 48 of the 49 references it cites were found in a registry or an index.

A Critical Review of Reviews on the Treatment of Chronic Low Back Pain

Furlan, Andrea D., Clarke, Judy, Esmail, Rosmin, Sinclair, Sandra, Irvin, Emma, Bombardier, Claire·2001·Spine
DOI 10.1097/00007632-200104010-00018
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Abstract

STUDY DESIGN: Systematic literature review. OBJECTIVE: To critically appraise the methodology of systematic reviews of conservative therapies for chronic nonspecific low back pain and to study the relation between the methodologic quality and other characteristics of these reviews. SUMMARY OF BACKGROUND DATA: Systematic reviews offer a concise summary of the evidence on treatment effectiveness, but flaws in their methodology can lead to invalid conclusions with serious implications for quality of patient care. METHODS: Searches of MEDLINE, EMBASE, Psychinfo, and the Cochrane Library were conducted. Titles, abstracts, and articles were reviewed by two blinded authors using three inclusion criteria: 1) chronic nonspecific low back pain, 2) systematic review, and 3) conservative treatment intervention. Data were extracted from each review by three authors. RESULTS: The search strategy retrieved 1102 titles and abstracts; 109 met inclusion criteria. A review of the full text of these articles excluded an additional 73 articles. Data abstraction and methodologic assessment were conducted on 36 articles reviewing 19 discrete interventions. The average quality score was 4.1, ranging from 1 (low) to 7 (high). There was a trend for recent reviews to be of higher quality. Fifty-six percent of the reviews had positive conclusions, but they had lower quality scores compared with those that had negative or uncertain conclusions. There were 27 (73%) qualitative and 10 (27%) quantitative summaries of results. CONCLUSIONS: Although the overall quality of systematic reviews was satisfactory, the quality of the individual papers included in the reviews varied considerably. The reviews often provided contradictory evidence on the effectiveness of a wide range of commonly used conservative interventions for chronic nonspecific low back pain. These findings illustrate the pitfalls of systematic reviews where there are a number of low-quality trials and underscore the need for high-quality primary trials that will allow for more conclusive reviews.

Overview

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Crossref · 10.1097/00007632-200104010-00018

Cites

48 of 48 references verified0 citation errors · 0 not checkable

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Citations

Cites

Show all 49 references

Research works printed but not linked: 12

  1. Anderson, 1992, J Manipulative Physiol Ther, 15, 181
  2. Assendelft, 1992, J Manipulative Physiol Ther, 15, 487
  3. Assendelft, 1996, J Manipulative Physiol Ther, 19, 499
  4. Beckerman, 1993, Br J Gen Pract, 43, 73
  5. Bijlsma, 1999, Clin Exp Rheumatol, 17, 40
  6. Brown, 1996, J Am Board Fam Pract, 9, 191
  7. Hopayian, 1999, Br J Gen Pract, 49, 57
  8. Jadad, 1997, Can Med Assoc J, 156, 1411
  9. Koes, 1994, Eur J Phys Med Rehab, 4, 86
  10. Nachemson, 1992, Clin Orthop, &NA;, 8
  11. Skovron, 1992, Rheumatol, 6, 559
  12. Turner, 1993, J Fam Pract, 37, 545

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Metadata

Authors
Furlan, A. D., Clarke, J., Esmail, R., Sinclair, S., Irvin, E., & Bombardier, C.
Affiliations
Mount Sinai Hospital (CA)
Corresponding author
  • Furlan, Andrea D.
  • Clarke, Judy
  • Sinclair, Sandra
  • Irvin, Emma
  • Bombardier, Claire
ORCID
Venue
Spine
Publisher
Ovid Technologies (Wolters Kluwer Health)
Published
2001-04
Volume
26
Issue
7
Pages
E155-E162
ISSN
0362-2436 (ISSN-L)
DOI
10.1097/00007632-200104010-00018
OpenAlex
W2078757204
Cited by
116
References
49
Citations by year
2024: 1 · 2023: 2 · 2022: 1 · 2021: 2 · 2020: 1 · 2019: 1 · 2018: 1 · 2017: 4 · 2016: 1 · 2015: 1 · 2014: 2 · 2013: 4 · 2012: 3
FWCI
2.29
Type
journal article
Language
en
Open access
closed
Locations
  • Spine (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Meta-analysis and systematic reviews
  • Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Clinical practice guidelines implementation
Keywords
chronic non-specific low back pain, methodological quality, conservative treatment, quality of evidence, contradictory evidence
MeSH terms
Adolescent, Adult, Aged, Chronic Disease, Humans, Middle Aged, Low Back Pain

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