The DOI matches its Crossref record; 58 of the 58 references it cites were found in a registry or an index; none of the 46 sources its claims cite is checked for support yet.
An Online Self-help CBT Intervention for Chronic Lower Back Pain
Open accessAbstract
OBJECTIVES: Research has shown that cognitive and behavioral therapies can effectively improve quality of life in chronic pain patients. Unfortunately, many patients lack access to cognitive and behavioral therapy treatments. We developed a pilot version of an interactive online intervention to teach self-management skills for chronic lower back pain, a leading cause of disability and work absenteeism. The objective of this randomized, controlled trial was to evaluate its efficacy. METHODS: Individuals with chronic lower back pain were recruited over the Internet, screened by phone, and randomly assigned to receive access to the intervention (Wellness Workbook; WW) either immediately (intervention group) or after a 3-week delay (wait-list control). Participants (n=141, 83% female, 23% minority) were asked to complete the WW over 3 weeks. Self-report measures of pain, disability, disabling attitudes and beliefs, self-efficacy for pain control, and mood regulation were completed at baseline, week 3, and week 6. RESULTS: Controlling for baseline individual differences in the outcome measures, multivariate analysis of covariance revealed that, at week 3, the intervention group scored better than the wait-list control group on all outcomes, including pain severity ratings. At week 6, after both groups had been exposed to the WW, there were no differences between groups. DISCUSSION: Use of this pilot intervention seems to have had positive effects on a number of pain-related outcomes, including disability. Future research will evaluate the effectiveness of the completed intervention, with particular attention to quality of life and disability.
Overview
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Written from the paper’s full text.
TL;DR
This randomized wait-list controlled trial found that a 3-week online self-help CBT program (Wellness Workbook) improved pain-related beliefs, self-efficacy, catastrophizing, fear avoidance, and disability in adults with chronic lower back pain, but did not reduce pain severity. Between-group differences disappeared by Week 6 after the wait-list group also received the intervention.
Key findings
- At Week 3, the intervention group scored significantly better than wait-list controls on most outcomes: multivariate main effect \(F(18,109)=4.88, p<.001\). Univariate effects were significant for all measures except SOPA Medical Cure, FABQ Work, and pain severity ratings.
- Improvements included stronger belief in pain control, less belief in disability/harm from exercise/medication need, better pain self-efficacy and mood regulation self-efficacy, and reduced pain catastrophizing and fear avoidance of physical activity. No significant change was found for pain severity.
- At Week 6, after both groups had used the workbook, groups were functionally equivalent: \(F(15,101)=0.55, p=.909\).
- Usage was high: 81% completed all six chapters; participants viewed an average of 153.9 (SD=48.0) of 189 pages and completed 5.3 (SD=1.7) of 6 chapters. The intervention group used the workbook on more days than the wait-list group (\(M=6.8\) vs. \(5.2\), \(p=.005\)).
Methods
- Design: online randomized wait-list controlled trial. Participants were recruited via Internet bulletin boards and newspaper advertisements, screened by phone, and completed all measures online.
- Sample: 230 screened, 66 ineligible, 164 eligible, and 141 completed baseline measures. Participants were aged 21–74 years (\(M=42.5\), \(SD=10.3\)); 83% were women; 23% were racial/ethnic minorities; they represented 40 states. Midway through recruitment, minimum age was raised to 40.
- Intervention and analysis: the Wellness Workbook was a six-chapter, 189-page online CBT self-help program completed over 3 weeks at two chapters per week. Primary outcome was the Survey of Pain Attitudes (SOPA); other measures included FABQ, Negative Mood Regulation Scale, Pain Catastrophizing Scale, Roland-Morris Disability Questionnaire, adapted Pain Self-efficacy Scale, pain severity, and usability/satisfaction. Hypotheses were tested with MANCOVA controlling for baseline scores, with post-hoc paired t-tests using Bonferroni-corrected alpha of .003.
Limitations
- The paper states that participants were required to complete at least four of six chapters; those who did not were considered dropouts and were not offered later assessments, so reasons for dropout were lost. Differential attrition occurred, with more wait-list participants dropping out, and more men than women left the study; the sample was primarily women, limiting generalizability.
- The paper states that little is known about who benefits most from self-help or Internet-based therapies, and that age may affect willingness to engage online. It also notes that a wait-list control does not control for non-specific treatment effects and that an active control is needed.
- Evident from the text: pain severity was not assessed at Week 6, and follow-up was limited to 6 weeks, so longer-term maintenance of gains was not evaluated.
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Claims the paper makes
27 Own result · 26 Not checked yet · 17 Own method · 11 Own interpretation · 1 No basis given
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“At Week 3, the intervention group (as compared to the waitlist control group) endorsed stronger belief that they could control their pain”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > DISCUSSION
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“No significant changes were noted with regard to pain severity.”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > DISCUSSION
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“such that, on average, the INT group (M = 6.8) used the WW on more days than the WLC group (M = 5.2).”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > RESULTS > Usage data
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Across conditions, 81% of participants completed all six chapters.”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > RESULTS > Usage data
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The omnibus multivariate main effect of condition was significant, F(3, 131) = 2.96, p = .035.”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > RESULTS > Usage data
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“with both groups showing improvements on cognitive and attitude measures as compared to pre-test.”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > DISCUSSION
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“they less strongly believed that they were disabled by pain”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > DISCUSSION
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The multivariate main effect of group assignment was significant, F(18, 109) = 4.88, p < .001.”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > RESULTS > Hypothesis testing
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“that they should avoid exercise”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > DISCUSSION
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Inspection of the univariate tests indicated that the effect was significant for number of days using the WW, F(1, 135) = 8.14, p = .005”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > RESULTS > Usage data
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“As shown in Table 1, follow-up univariate F tests indicated that the effect was significant for all measures, except the Medical Cure subscale of the SOPA, the Work subscale of the FABQ, and the pain severity ratings.”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > RESULTS > Hypothesis testing
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“At six weeks (when both groups had used the WW), between group differences disappeared”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > DISCUSSION
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Within the WLC group, we compared Week 3 scores to Week 6 scores. Similarly, significant improvement was noted for all outcomes except the Medical Cure subscale of the SOPA (p = .100) and the Work subscale of the FABQ (p = .004).”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > RESULTS > Post-hoc tests
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“the intervention group participants, who had immediate access to the workbook, used it more days and viewed more pages overall than the waitlist control group.”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > DISCUSSION
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“that medications were the best treatment.”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > DISCUSSION
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The multivariate main effect of group assignment was not significant, F(15, 101) = 0.55, p = .909”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > RESULTS > Hypothesis testing
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“and that improving dysfunctional beliefs improves pain management outcomes.14,41,42”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > MATERIALS AND METHODS > Measures
What the sources say
- Not checked yetcites [14] Jensen MP Turner JA Romano JM Correlates of improvement in multidisciplinary treatment of chronic pain J Consult Clin Psychol Feb 1994 62 1 172 179 8034820 source
- Not checked yetcites [41] Jensen MP Turner JA Romano JM Changes in beliefs, catastrophizing, and coping are associated with improvement in multidisciplinary pain treatment J Consult Clin Psychol Aug 2001 69 4 655 662 11550731 source
- Not checked yetcites [42] Turner JA Jensen MP Romano JM Do beliefs, coping, and catastrophizing independently predict functioning in patients with chronic pain? Pain Mar 2000 85 1–2 115 125 10692610 source
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“were found by a recent review to be effective treatment for CLBP.11”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > INTRODUCTION
What the sources say
- Not checked yetcites [11] Chou R Qaseem A Snow V Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society Ann Intern Med Oct 2 2007 147 7 478 491 17909209 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“Pre-to post-treatment changes in specific factors targeted by cognitive interventions (e.g., attitudes towards coping, disability beliefs, and catastrophizing) are correlated with improvement in pain severity, disability, and distress.13–19”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > INTRODUCTION
What the sources say
- Not checked yetcites [13] Burns JW Kubilus A Bruehl S Harden RN Lofland K Do changes in cognitive factors influence outcome following multidisciplinary treatment for chronic pain? A cross-lagged panel analysis J Consult Clin Psychol Feb 2003 71 1 81 91 12602428 source
- Not checked yetcites [14] Jensen MP Turner JA Romano JM Correlates of improvement in multidisciplinary treatment of chronic pain J Consult Clin Psychol Feb 1994 62 1 172 179 8034820 source
- Not checked yetcites [15] Jensen MP Turner JA Romano JM Lawler BK Relationship of pain-specific beliefs to chronic pain adjustment Pain Jun 1994 57 3 301 309 7936708 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“there continues to exist evidence that non-pharmacological strategies are under-utilized.8,9”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > INTRODUCTION
What the sources say
- Not checked yetcites [8] Clarke EB French B Bilodeau ML Capasso VC Edwards A Empoliti J Pain management knowledge, attitudes and clinical practice: the impact of nurses’ characteristics and education J Pain Symptom Manage Jan 1996 11 1 18 31 8815146 source
- Not checked yetcites [9] Salantera S Lauri S Salmi TT Helenius H Nurses’ knowledge about pharmacological and nonpharmacological pain management in children J Pain Symptom Manage Oct 1999 18 4 289 299 10534969 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
None of the sources cited for this claim have been checked yet.
In the paper
“shown that the SOPA predicts outcomes of pain management efforts”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > MATERIALS AND METHODS > Measures
What the sources say
- Not checked yetcites [14] Jensen MP Turner JA Romano JM Correlates of improvement in multidisciplinary treatment of chronic pain J Consult Clin Psychol Feb 1994 62 1 172 179 8034820 source
- Not checked yetcites [41] Jensen MP Turner JA Romano JM Changes in beliefs, catastrophizing, and coping are associated with improvement in multidisciplinary pain treatment J Consult Clin Psychol Aug 2001 69 4 655 662 11550731 source
- Not checked yetcites [42] Turner JA Jensen MP Romano JM Do beliefs, coping, and catastrophizing independently predict functioning in patients with chronic pain? Pain Mar 2000 85 1–2 115 125 10692610 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In summary, this study demonstrated the potential efficacy of a web-based, self-help intervention to change maladaptive pain-related thoughts and beliefs in a self-identified CLBP population.”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > DISCUSSION
boostedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Unfortunately, the gender inbalance may further limit the generalizability of the results.”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > DISCUSSION
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“In fact, effect sizes from a 2004 meta-analysis comparing web-based vs. non-web-based interventions showed an increase in knowledge and positive behavior change among chronically ill participants who used web-based approaches.53”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > DISCUSSION
What the sources say
- Not checked yetcites [53] Wantland DJ Portillo CJ Holzemer WL Slaughter R McGhee EM The effectiveness of Web-based vs. non-Web-based interventions: a meta-analysis of behavioral change outcomes J Med Internet Res Nov 10 2004 6 4 e40 15631964 PMC1550624
plaindirect- Asserted: passes — The authors put it forward as true.
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What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Older individuals were more likely to drop out of the study between weeks one and three”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > DISCUSSION
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Independent groups t-tests revealed no significant differences between Week 3 completers and non-completers on any dependent variable.”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > MATERIALS AND METHODS > Data Analytic Approach
plain- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“These results suggest that participating in a brief web-based, self-help intervention can effectively alter individuals’ pain-related beliefs and attitudes”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > DISCUSSION
hedgeddirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Because seeking external causes/treatments for pain can be common in, and problematic for, persons with CLBP, an intervention that enhances self-efficacy is of particular relevance.”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > DISCUSSION
plain- Asserted: passes — The authors put it forward as true.
- Checkable: unclear — It is unclear whether it could be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
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- Rests on an assumption: Seeking external causes/treatments for pain can be common in, and problematic for, persons with CLBP.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“indicating that the groups were functionally equivalent at Week 6 follow-up.”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > RESULTS > Hypothesis testing
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“other studies have demonstrated similar results for self-help interventions involving other chronic pain populations.25”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > DISCUSSION
What the sources say
- Not checked yetcites [25] Buenaver LF McGuire L Haythornthwaite JA Cognitive-Behavioral self-help for chronic pain J Clin Psychol Nov 2006 62 11 1389 1396 16937351 source
boosteddirect- Asserted: passes — The authors put it forward as true.
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What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“There were no other significant differences.”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > MATERIALS AND METHODS > Data Analytic Approach
plainn = 138- Asserted: passes — The authors put it forward as true.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The workbook, however, was effective for both groups.”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > DISCUSSION
plaindirect- Asserted: passes — The authors put it forward as true.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“and may improve functioning.”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > DISCUSSION
hedgedconditional- Asserted: passes — The authors put it forward as true.
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What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Attrition also differed by gender with more men leaving the study than women.”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > DISCUSSION
plaincorrelational- Asserted: passes — The authors put it forward as true.
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- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“There was also differential attrition between the two groups:more participants in the wait-list group dropped out of the study, both between weeks one and three and between weeks three and six.”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > DISCUSSION
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
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A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In summary, results suggest that the WW had significant positive effects on participants’ ability to conceptualize, self-manage, and react to their pain.”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > DISCUSSION
hedgeddirect- Asserted: passes — The authors put it forward as true.
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- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“Change often occurs early in cognitive behavioral therapy before patients have an opportunity to learn and practice the skills that are the putative mechanisms of change55.”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > DISCUSSION
What the sources say
- Not checked yetcites [55] Ilardi SS Craighead WE The role of nonspecific factors in cognitive-behavior therapy for depression Clin Psychol Sci Pract 1994 1 2 138 156
plaindirect- Asserted: passes — The authors put it forward as true.
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- Probably not a substantial claim. 29
- It may state two separate claims as one. 24
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The intervention and wait-list control group had somewhat different patterns of use of the workbook.”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > DISCUSSION
hedgedcorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“There was no difference between conditions in terms of number of unique pages visited or number of chapters completed.”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > RESULTS > Usage data
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
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It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Across conditions, participants viewed an average of 153.9 (SD = 48.0) out of 189 pages and completed 5.3 (SD = 1.7) out of 6 chapters.”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > RESULTS > Usage data
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Sixty-five percent of participants in the INT group returned to the WW after the Week 3 assessment, i.e., after they had already completed the WW.”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > RESULTS > Usage data
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“and the present study did not shed any new light on the issue.”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > DISCUSSION
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Furthermore, the intervention group showed improvement in self-efficacy for pain management and mood regulation”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > DISCUSSION
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Within the INT group, we compared baseline scores to Week 3 scores. Significant improvement (ps < .003) was noted for all outcomes except the Solicitude (p = .085) and Medical Cure (p = .322) subscales of the SOPA and the Work subscale of the FABQ (p = .032).”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > RESULTS > Post-hoc tests
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Percent of participants completing each chapter ranged from 84% (Chapter 5) to 94% (Chapter 1).”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > RESULTS > Usage data
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Although participants used the intervention for only three weeks, we found changes on most cognitive measures and on disability ratings with medium to large effect sizes.”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > DISCUSSION
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Only 1% of participants reported using WW less than 2 hours per week; 59% reported using it at least 6 hours per week, and 28% at least 10 hours per week.”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > RESULTS > Usage data
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“as well as decreased pain catastrophizing and fearful avoidance of physical activity.”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > DISCUSSION
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In general, the WW appears to have been well regarded.”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > RESULTS > Usability and satisfaction
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Turner et al48 reported good psychometric properties for a similarly modified SES, which focused on pain instead of arthritis.”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > MATERIALS AND METHODS > Measures
What the sources say
- Not checked yetcites [48] Turner JA Ersek M Kemp C Self-efficacy for managing pain is associated with disability, depression, and pain coping among retirement community residents with chronic pain J Pain Jul 2005 6 7 471 479 15993826 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“The SOPA-32 is a well-validated 32-item measure with seven subscales that measure strength of endorsement of pain-related beliefs”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > MATERIALS AND METHODS > Measures
What the sources say
- Not matchedcites [38] Klare GR A second look at the validity of readability formulas Journal of Reading Behavior 1976 8 129 152
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not checked yetcites [39] Jensen MP Karoly P Pain-specific beliefs, perceived symptom severity, and adjustment to chronic pain Clin J Pain Jun 1992 8 2 123 130 1633376 source
- Not checked yetcites [40] Jensen MP Turner JA Romano JM Fisher LD Comparative reliability and validity of chronic pain intensity measures Pain Nov 1999 83 2 157 162 10534586 source
boosted- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
- Not matched
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“With regard to the dependent variables, independent groups t-tests revealed no significant differences between the groups on any dependent variable, with the exception of the Emotion subscale of the SOPA, t(139) = −2.15, p = .034.”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > MATERIALS AND METHODS > Data Analytic Approach
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“The authors have demonstrated strong construct validity, internal consistency, and two-week test-retest reliability”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > MATERIALS AND METHODS > Measures
What the sources say
- Not checked yetcites [14] Jensen MP Turner JA Romano JM Correlates of improvement in multidisciplinary treatment of chronic pain J Consult Clin Psychol Feb 1994 62 1 172 179 8034820 source
- Not checked yetcites [41] Jensen MP Turner JA Romano JM Changes in beliefs, catastrophizing, and coping are associated with improvement in multidisciplinary pain treatment J Consult Clin Psychol Aug 2001 69 4 655 662 11550731 source
- Not checked yetcites [42] Turner JA Jensen MP Romano JM Do beliefs, coping, and catastrophizing independently predict functioning in patients with chronic pain? Pain Mar 2000 85 1–2 115 125 10692610 source
boosted- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“two functional contextual approaches have been identified as being important in chronic pain treatment: acceptance and values-based action.20”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > INTRODUCTION
What the sources say
- Not checked yetcites [20] Wicksell RK Ahlqvist J Bring A Melin L Olsson GL Can exposure and acceptance strategies improve functioning and life satisfaction in people with chronic pain and whiplash-associated disorders (WAD)? A randomized controlled trial Cogn Behav Ther 2008 37 3 169 182 18608312 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“A password-protected document linking participant names to user IDs was maintained by the study coordinator, but this was not accessible to individuals involved in analyzing outcome data.”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > MATERIALS AND METHODS > Procedure
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“Cognitive and behavioral therapy (CBT) approaches to pain management have been used with chronic pain patients for many years10”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > INTRODUCTION
What the sources say
- Not checked yetcites [10] Flor H Fydrich T Turk DC Efficacy of multidisciplinary pain treatment centers: a meta- analytic review Pain May 1992 49 2 221 230 1535122 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Vowles and McCracken23 found that improvement in pain acceptance and values-based action predicted improvement in primary outcomes including pain-related anxiety, depression, and disability.”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > INTRODUCTION
What the sources say
- Not checked yetcites [23] Vowles KE McCracken LM Acceptance and values-based action in chronic pain: a study of treatment effectiveness and process J Consult Clin Psychol Jun 2008 76 3 397 407 18540733 source
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
None of the sources cited for this claim have been checked yet.
In the paper
“A review of self-help for chronic pain25 found that self-help delivered via group formats, workbooks, books, audiotapes, minimal contact formats, and telephone delivery systems has been effectively used to reduce pain, pain-related disability, depression, and anxiety in arthritis,26,27 lower backpain,28,29 headache,30–32 and temporomandibular joint disorder.33,34”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > INTRODUCTION
What the sources say
- Not checked yetcites [25] Buenaver LF McGuire L Haythornthwaite JA Cognitive-Behavioral self-help for chronic pain J Clin Psychol Nov 2006 62 11 1389 1396 16937351 source
- Not checked yetcites [26] Lorig K Holman H Arthritis self-management studies: a twelve-year review Health Educ Q Spring 1993 20 1 17 28 8444622 source
- Not checked yetcites [27] Lorig KR Ritter PL Laurent DD Fries JF Long-term randomized controlled trials of tailored-print and small-group arthritis self-management interventions Med Care Apr 2004 42 4 346 354 15076811 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
In the paper
“self-help interventions for chronic diseases such as chronic pain are cost-effective, more easily disseminated than traditional, professional-led interventions and serve to empower patients.24”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > INTRODUCTION
What the sources say
- Not checked yetcites [24] Smith BH Elliott AM Active self-management of chronic pain in the community Pain Feb 2005 113 3 249 250 15661429 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
In the paper
“A meta-analysis of 22 randomized controlled trials concluded that psychological interventions are effective for CLBP, with cognitive-behavioral and self-regulatory (e.g., biofeedback, relaxation) interventions being particularly effective.12”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > INTRODUCTION
What the sources say
- Not checked yetcites [12] Hoffman BM Papas RK Chatkoff DK Kerns RD Meta-analysis of psychological interventions for chronic low back pain Health Psychol Jan 2007 26 1 1 9 17209691 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“The Fear Avoidance Beliefs Questionnaire (FABQ)43 is a reliable and valid 16-item instrument that assesses patients’ beliefs regarding the effects of physical activity and work on their lower back pain”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > MATERIALS AND METHODS > Measures
What the sources say
- Not checked yetcites [43] Waddell G Newton M Henderson I Somerville D Main CJ A Fear-Avoidance Beliefs Questionnaire (FABQ) and the role of fear-avoidance beliefs in chronic low back pain and disability Pain Feb 1993 52 2 157 168 8455963 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Chi-square tests revealed no significant differences between the INT and WLC groups in terms of the proportions of women, racial/ethnic minorities, those completing more than 2 years of post-secondary education, those currently being treated for chronic pain, those currently taking medications, those who had tried opioids, and those whom opioids had helped.”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > MATERIALS AND METHODS > Data Analytic Approach
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Internet-based self-help interventions for chronic pain have been shown to be effective for a number of pain conditions, including headache,35 non-headache chronic pain,36 and rheumatoid arthritis, osteoarthritis, or fibromyalgia.37”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > INTRODUCTION
What the sources say
- Not checked yetcites [35] Devineni T Blanchard EB A randomized controlled trial of an internet-based treatment for chronic headache Behav Res Ther Mar 2005 43 3 277 292 15680926 source
- Not checked yetcites [36] Buhrman M Faltenhag S Strom L Andersson G Controlled trial of Internet-based treatment with telephone support for chronic back pain Pain Oct 2004 111 3 368 377 15363881 source
- Not checked yetcites [37] Lorig KR Ritter PL Laurent DD Plant K The internet-based arthritis self-management program: a one-year randomized trial for patients with arthritis or fibromyalgia Arthritis Rheum Jul 15 2008 59 7 1009 1017 18576310 source
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Because the groups were slightly different at baseline, we elected to use multivariate analysis of covariance (MANCOVA) to test our hypotheses, controlling for baseline individual differences in the dependent measures.”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > MATERIALS AND METHODS > Data Analytic Approach
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Upon completion of the baseline measures, participants were randomized to the intervention (INT) group or to a wait-list control (WLC) group using a random number table.”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > MATERIALS AND METHODS > Procedure
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Independent-groups t-tests revealed no significant differences between the INT and WLC groups in terms of age, average pain rating, or duration of chronic pain.”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > MATERIALS AND METHODS > Data Analytic Approach
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“In sum, CLBP is a significant public health problem.”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > INTRODUCTION
What the sources say
- Not matchedcites [1] CDC N, ed Healthy People 2010: 2 Arthritis, Osteoporosis, and Chronic Back Conditions 12006
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not checked yetcites [2] Hardt J Jacobsen C Goldberg J Nickel R Buchwald D Prevalence of chronic pain in a representative sample in the United States Pain Medicine 2008 9 7 803 812 18346058 source
- Not checked yetcites [3] Lawrence RC Helmick CG Arnett FC Estimates of the prevalence of arthritis and selected musculoskeletal disorders in the United States Arthritis Rheum May 1998 41 5 778 799 9588729 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Not matched
In the paper
“The evidence is perhaps strongest for the treatment of headache, with home-based, self-help interventions resulting in comparable or superior outcomes to clinic-based treatments.31”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > DISCUSSION
What the sources say
- Not checked yetcites [31] Haddock CK Rowan AB Andrasik F Wilson PG Talcott GW Stein RJ Home-based behavioral treatments for chronic benign headache: a meta-analysis of controlled trials Cephalalgia Apr 1997 17 2 113 118 9137849 source
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Furthermore, Buenaver, McGuire, and Haythornthwaite25 have posited this increase in self-efficacy mediates the relationship between self-help interventions and subsequent reductions in pain and disability”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > DISCUSSION
What the sources say
- Not checked yetcites [25] Buenaver LF McGuire L Haythornthwaite JA Cognitive-Behavioral self-help for chronic pain J Clin Psychol Nov 2006 62 11 1389 1396 16937351 source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Chi-square tests revealed that compared to completers, Week 6 non-completers were more likely to be in the WLC group (see Figure 1), χ2(1) = 4.06, p = .044, N = 141; racial/ethnic minorities, χ2(1) = 13.29, p < .001, N = 138.”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > MATERIALS AND METHODS > Data Analytic Approach
plaincorrelationaln = 141 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Chi-square tests revealed no significant differences between Week 3 completers and non-completers with regard to racial/ethnic minority status, educational attainment, or chronic pain treatment, nor did they differ according to group assignment.”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > MATERIALS AND METHODS > Data Analytic Approach
plainn = 141- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Our initial sample was primarily made up of individuals in their twenties and thirties.”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > DISCUSSION
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“This rapid change is perhaps due to the acceptance of an internally consistent and meaningful treatment rationale.”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > DISCUSSION
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it.
In the paper
“we postulate that introducing a mind/body treatment rationale, thus encouraging patients to try new ways to manage their own pain is empowering and enhancesself-efficacy.24”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > DISCUSSION
What the sources say
- Not checked yetcites [24] Smith BH Elliott AM Active self-management of chronic pain in the community Pain Feb 2005 113 3 249 250 15661429 source
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may state two separate claims as one.
- The authors state this as an assumption: To be successful, patients need sufficient motivation to make the time to use the materials on their own and sufficient receptiveness to the mind/body treatment rationale.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Compared to completers, Week 3 non-completers were more likely to be men, χ2(1) = 4.02, p = .045, N = 141; less variable in age, Levene’s F = 4.04, p = .046; older (M = 47.7 vs. 42.0), t(13.2) = 2.60, p = .022; and in lower average pain, t(139) = −2.20, p = .029.”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > MATERIALS AND METHODS > Data Analytic Approach
plaincorrelationaln = 141 ·- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“In several ways self-help interventions delivered via the internet may be ideal for persons living with chronic lower back pain.”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > DISCUSSION
hedgedconditional- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence.
- Rests on an assumption: Multidisciplinary treatment for chronic pain (including non-pharmacological treatment) is considered the gold standard by numerous healthcare organizations.
- Rests on an assumption: Many people may find seeing a psychologist or mental health practitioner stigmatizing.
- Rests on an assumption: Comprehensive or multidisciplinary pain treatment programs may not be accessible for a substantial number of patients, as they tend to be located in large, urban areas and require a high level of commitment.
- Rests on an assumption: Comprehensive or multidisciplinary pain treatment programs are expensive and may not be covered by insurance companies.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Finally, a wait-list control group does not control for non-specific effects of treatment as it is comparing the online treatment to no treatment.”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > DISCUSSION
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“and that these changes can be maintained over long periods of time.”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > DISCUSSION
What the sources say
- Not checked yetcites [25] Buenaver LF McGuire L Haythornthwaite JA Cognitive-Behavioral self-help for chronic pain J Clin Psychol Nov 2006 62 11 1389 1396 16937351 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“this study demonstrates that it can also be an efficient and effective tool for delivering evidence-based interventions.”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > DISCUSSION
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“There were also more female participants in the initial sample, leading to a study sample primarily comprised of women.”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > DISCUSSION
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“Little remains known regarding who benefits most from self-help treatments,25”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > DISCUSSION
What the sources say
- Not checked yetcites [25] Buenaver LF McGuire L Haythornthwaite JA Cognitive-Behavioral self-help for chronic pain J Clin Psychol Nov 2006 62 11 1389 1396 16937351 source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
None of the sources cited for this claim have been checked yet.
In the paper
“Furthermore, web-based self-help interventions have been shown to have notable benefits with a variety of patient populations with pain.49–52”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > DISCUSSION
What the sources say
- Not checked yetcites [49] Allen M Iezzoni LI Huang A Huang L Leveille SG Improving patient-clinician communication about chronic conditions: description of an internet-based nurse E-coach intervention Nurs Res Mar-Apr 2008 57 2 107 112 18347482 source
- Not checked yetcites [50] Brattberg G Internet-based rehabilitation for individuals with chronic pain and burnout: a randomized trial Int J Rehabil Res Sep 2006 29 3 221 227 16900043 source
- Not checked yetcites [51] Brattberg G Internet-based rehabilitation for individuals with chronic pain and burnout II: a long-term follow-up Int J Rehabil Res Sep 2007 30 3 231 234 17762769 source
- Not checked yetcites [52] Sciamanna CN Nicholson RA Lofland JH Manocchia M Mui S Hartman CW Effects of a Website designed to improve the management of migraines Headache Jan 2006 46 1 92 100 16412156 source
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The paper relies on this without support.
Cognitive and behavioral techniques for chronic pain have few if any negative side effects and, once learned, can be used by patients nearly anywhere and anytime.
“These techniques have few if any negative side effects and, once learned, can be used by patients nearly anywhere and anytime.”
The paper relies on this without support.
Therapeutic content of the WW was drawn from established and empirically-supported cognitive and behavioral strategies.
“Therapeutic content was drawn from established and empirically-supported cognitive and behavioral strategies, including cognitive therapy, behavioral activation, acceptance and commitment therapy, and mindfulness-based stress reduction.”
The paper relies on this without support.
The Joint Commission requires that pain management plans include non-pharmacological methods of pain control for patients in both inpatient and outpatient settings.
“The Joint Commission, which accredits and certifies more than 18000 health care organizations and programs in the United States, specifically requires that pain management plans include non-pharmacological methods of pain control for patients in both inpatient and outpatient settings.”
The paper relies on this without support.
Managing chronic pain, including CLBP, often necessitates both pharmacological and non-pharmacological strategies.
“Managing chronic pain, including CLBP, often necessitates both pharmacological and non-pharmacological strategies.”
The paper relies on this without support.
Multidisciplinary treatment for chronic pain (including non-pharmacological treatment) is considered the gold standard by numerous healthcare organizations.
“although multidisciplinary treatment for chronic pain (which includes non-pharmacological treatment) is now considered the “gold standard” by numerous healthcare organizations”
The paper relies on this without support.
Many people may find seeing a psychologist or mental health practitioner stigmatizing.
“many people may find seeing a psychologist or mental health practitioner stigmatizing.”
The paper relies on this without support.
Comprehensive or multidisciplinary pain treatment programs may not be accessible for a substantial number of patients, as they tend to be located in large, urban areas and require a high level of commitment.
“comprehensive or multidisciplinary pain treatment programs may not be accessible for a substantial number of patients, as they tend to be located in large, urban areas and require a high level of commitment (such as daily attendance for several weeks).”
The paper relies on this without support.
Comprehensive or multidisciplinary pain treatment programs are expensive and may not be covered by insurance companies.
“They are also expensive, and may not be covered by insurance companies.”
The paper relies on this without support.
Seeking external causes/treatments for pain can be common in, and problematic for, persons with CLBP.
“Because seeking external causes/treatments for pain can be common in, and problematic for, persons with CLBP”
The authors state this as an assumption.
To be successful, patients need sufficient motivation to make the time to use the materials on their own and sufficient receptiveness to the mind/body treatment rationale.
“Presumably, to be successful, patients need sufficient motivation to make the time to use the materials on their own and sufficient receptiveness to the mind/body treatment rationale.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“The dosage of interventions was also very diverse, ranging from 2 sessions per week for 3 weeks [51] or 5 sessions per week for 4 weeks [46,47] to 12 to 15 weekly sessions [39] or even weekly reminders for 12 months [55].”
From Tailored web-based interventions for pain: Systematic review and meta-analysis (2017) · cites this paper as [51]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Programs based on a CBT approach seem to help reduce distress symptoms and cognitive dysfunctions, improve pain management, and increase well-being [19–21].”
From Connect-ROD – development and qualitative evaluation of a community-based group intervention to support well-being in patients with a rare or orphan disease (2024) · cites this paper as [21]
Experimental — accuracy not yet measuredIn the citing paper
“We found attrition risk of bias in 7 studies that presented a high risk regarding incomplete data [48,51,56-58,60,61].”
From Tailored web-based interventions for pain: Systematic review and meta-analysis (2017) · cites this paper as [51]
In the citing paper
“Internet-based CBT conducted for chronic pain has been on the rise [15-18].”
Statistics recomputed
Every reported test result, recomputed from its test statistic and degrees of freedom. A result shows as not adding up only once an independent check has confirmed it.
- Consistentt(139) = -2.15reported p = .034 · recomputed p = .033
“t(139) = −2.15, p = .034”
- Consistentχ²(1) = 4.02reported p = .045 · recomputed p = .045
“χ2(1) = 4.02, p = .045”
- Consistentt(13.2) = 2.6reported p = .022 · recomputed p = .022
“t(13.2) = 2.60, p = .022”
- Consistentt(139) = -2.2reported p = .029 · recomputed p = .029
“t(139) = −2.20, p = .029”
- Consistentχ²(1) = 4.06reported p = .044 · recomputed p = .044
“χ2(1) = 4.06, p = .044”
- Consistentχ²(1) = 13.29reported p < .001 · recomputed p < .001
“χ2(1) = 13.29, p < .001”
- ConsistentF(3, 131) = 2.96reported p = .035 · recomputed p = .035
“F(3, 131) = 2.96, p = .035”
- ConsistentF(1, 135) = 8.14reported p = .005 · recomputed p = .005
“F(1, 135) = 8.14, p = .005”
- ConsistentF(18, 109) = 4.88reported p < .001 · recomputed p < .001
“F(18, 109) = 4.88, p < .001”
- ConsistentF(15, 101) = 0.55reported p = .909 · recomputed p = .905
“F(15, 101) = 0.55, p = .909”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > MATERIALS AND METHODS > Measures
“Each item is rated on a 5-point scale (1=”strongly disagree”; 5= “strongly disagree”); higher scores reflect stronger self-efficacy for mood regulation.”
§ An Online Self-Help CBT Intervention for Chronic Lower Back Pain > MATERIALS AND METHODS > Measures
““When I’m upset, I believe that I can usually find a way to cheer myself up””
Citations
Cites
The Pain Catastrophizing Scale: Development and validation.
Sullivan, M. J. L., Bishop, S. R., & Pivik, J. (1995) · Psychological Assessment · doi:10.1037//1040-3590.7.4.524 · Cited by 8,227
Acceptance and commitment therapy: model, processes and outcomes
Hayes, S. C., Luoma, J. B., Bond, F. W., Masuda, A., & Lillis, J. (2006) · Behaviour Research and Therapy · doi:10.1016/j.brat.2005.06.006 · Cited by 6,587 · cited 1×
“Values-based action refers to the aligning of actions with desired, personally meaningful purposes rather than with the elimination of unwanted experiences.(21,22) Integrating functional contextual interventions into their multidisciplinary pain program, Vowles and McCracken(23) found that improvement Copyright r 2011…”
Background(1999) · Cited by 5,934
A Study of the Natural History of Back Pain: Part I
ROLAND, M., & MORRIS, R. (1983) · Spine · doi:10.1097/00007632-198303000-00004 · Cited by 3,395
Waddell, G., Newton, M., Henderson, I., Somerville, D., & Main, C. J. (1993) · Pain · doi:10.1016/0304-3959(93)90127-b · Cited by 3,167
Chou, R., Qaseem, A., Snow, V., Casey, D., Cross, J. T., Shekelle, P., Owens, D. K., & for the Clinical Efficacy Assessment Subcommittee of the American College of Physicians and the American College of Physicians/American Pain Society Low Back Pain Guidelines Panel* (2007) · Annals of Internal Medicine · doi:10.7326/0003-4819-147-7-200710020-00006 · Cited by 2,718
Development and evaluation of a scale to measure perceived self‐efficacy in people with arthritis
Lorig, K., Chastain, R. L., Ung, E., Shoor, S., & Holman, H. R. (1989) · Arthritis & Rheumatism · doi:10.1002/anr.1780320107 · Cited by 1,590
Comparative reliability and validity of chronic pain intensity measures.
Jensen, M. P., Turner, J. A., Romano, J. M., & Fisher, L. D. (1999) · Pain · doi:10.1016/s0304-3959(99)00101-3 · Cited by 1,247
Efficacy of multidisciplinary pain treatment centers: a meta-analytic review.
Flor, H., Fydrich, T., & Turk, D. C. (1992) · Pain · doi:10.1016/0304-3959(92)90145-2 · Cited by 1,227
Wantland, D. J., Portillo, C. J., Holzemer, W. L., Slaughter, R., & McGhee, E. M. (2004) · Journal of Medical Internet Research · doi:10.2196/jmir.6.4.e40 · Cited by 966 · cited 1×
“In fact, effect sizes from a 2004 meta-analysis comparing web-based versus nonweb-based interventions showed an increase in knowledge and positive behavior change among chronically ill participants who used web-based approaches.(53) Although there is still much work to be done with regard to the development of compreh…”
Background
Cited by
Sorted by citations
Hedman, E., Ljótsson, B., & Lindefors, N. (2012) · Expert Review of Pharmacoeconomics & Outcomes Research · doi:10.1586/erp.12.67 · Cited by 672
Acceptance and Commitment Therapy (ACT) for Chronic Pain: A Systematic Review and Meta-Analyses
Hughes, L. S., Clark, J., Colclough, J. A., Dale, E., & McMillan, D. (2017) · The Clinical Journal of Pain · doi:10.1097/ajp.0000000000000425 · Cited by 611
Randomized controlled trial of a 12-week digital care program in improving low back pain
Shebib, R., Bailey, J. F., Smittenaar, P., Perez, D. A., Mecklenburg, G., & Hunter, S. (2019) · npj Digital Medicine · doi:10.1038/s41746-018-0076-7 · Cited by 341
Buhrman, M., Skoglund, A., Husell, J., Bergström, K., Gordh, T., Hursti, T., Bendelin, N., Furmark, T., & Andersson, G. (2013) · Behaviour Research and Therapy · doi:10.1016/j.brat.2013.02.010 · Cited by 285
Psychological therapies (Internet-delivered) for the management of chronic pain in adults
Eccleston, C., Fisher, E., Craig, L., Duggan, G. B., Rosser, B. A., & Keogh, E. (2014) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd010152.pub2 · Cited by 271
Metadata
- Authors
- Carpenter, K. M., Stoner, S. A., Mundt, J. M., & Stoelb, B.
- Affiliations
- Talaria (United States) (US)
- Venue
- The Clinical Journal of Pain
- Published
- 2012-01
- Volume
- 28
- Issue
- 1
- Pages
- 14-22
- ISSN
- 0749-8047 (ISSN-L)
- PMC
- PMC3184315
- OpenAlex
- W2066657052
- Semantic Scholar
- 3418bdb9f67d17755cee144eecf73b24862fad90
- Cited by
- 157
- References
- 56
- Citations by year
- 2026: 3 · 2025: 7 · 2024: 9 · 2023: 13 · 2022: 11 · 2021: 12 · 2020: 9 · 2019: 13 · 2018: 11 · 2017: 13 · 2016: 11 · 2015: 11 · 2014: 15 · 2013: 12 · 2012: 6
- FWCI
- 7.97
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Clinical Journal of Pain (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (R43AR052569)
- Topics
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Musculoskeletal pain and rehabilitation
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Treatment
- Keywords
- chronic low back pain, cognitive behavioral therapy, online self-help intervention, self-management skills, pain-related disability, pain intensity, self-efficacy, mood regulation, digital health interventions
- MeSH terms
- Adult, Aged, Chronic Disease, Disability Evaluation, Female, Follow-Up Studies, Humans, Male, Middle Aged, Online Systems, Pain Measurement, Time Factors, Cognitive Behavioral Therapy, Multivariate Analysis, Treatment Outcome, Low Back Pain, Young Adult, Self Report
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-10-09, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-10-09 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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