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A proposed set of metrics for standardized outcome reporting in the management of low back pain

Clement, R. Carter; Welander, Adina; Stowell, Caleb; Cha, Thomas D.; Chen, John L.; Davies, Michelle; Fairbank, Jeremy C.; Foley, Kevin T.; Gehrchen, Martin and Hagg, Olle, et al. (2015) In Acta Orthopaedica 86(5). p.523-533
Abstract
Background and purpose - Outcome measurement has been shown to improve performance in several fields of healthcare. This understanding has driven a growing interest in value-based healthcare, where value is defined as outcomes achieved per money spent. While low back pain (LBP) constitutes an enormous burden of disease, no universal set of metrics has yet been accepted to measure and compare outcomes. Here, we aim to define such a set. Patients and methods - An international group of 22 specialists in several disciplines of spine care was assembled to review literature and select LBP outcome metrics through a 6-round modified Delphi process. The scope of the outcome set was degenerative lumbar conditions. Results - Patient-reported metrics... (More)
Background and purpose - Outcome measurement has been shown to improve performance in several fields of healthcare. This understanding has driven a growing interest in value-based healthcare, where value is defined as outcomes achieved per money spent. While low back pain (LBP) constitutes an enormous burden of disease, no universal set of metrics has yet been accepted to measure and compare outcomes. Here, we aim to define such a set. Patients and methods - An international group of 22 specialists in several disciplines of spine care was assembled to review literature and select LBP outcome metrics through a 6-round modified Delphi process. The scope of the outcome set was degenerative lumbar conditions. Results - Patient-reported metrics include numerical pain scales, lumbar-related function using the Oswestry disability index, health-related quality of life using the EQ-5D-3L questionnaire, and questions assessing work status and analgesic use. Specific common and serious complications are included. Recommended follow-up intervals include 6, 12, and 24 months after initiating treatment, with optional follow-up at 3 months and 5 years. Metrics for risk stratification are selected based on preexisting tools. Interpretation - The outcome measures recommended here are structured around specific etiologies of LBP, span a patient's entire cycle of care, and allow for risk adjustment. Thus, when implemented, this set can be expected to facilitate meaningful comparisons and ultimately provide a continuous feedback loop, enabling ongoing improvements in quality of care. Much work lies ahead in implementation, revision, and validation of this set, but it is an essential first step toward establishing a community of LBP providers focused on maximizing the value of the care we deliver. (Less)
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Acta Orthopaedica
volume
86
issue
5
pages
523 - 533
publisher
Taylor & Francis
external identifiers
  • wos:000361286600002
  • scopus:84941345633
ISSN
1745-3682
DOI
10.3109/17453674.2015.1036696
language
English
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yes
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11fc288b-213d-4ced-a280-804ac565b77e (old id 8074170)
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2015-11-19 10:40:48
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2017-11-19 03:44:45
@article{11fc288b-213d-4ced-a280-804ac565b77e,
  abstract     = {Background and purpose - Outcome measurement has been shown to improve performance in several fields of healthcare. This understanding has driven a growing interest in value-based healthcare, where value is defined as outcomes achieved per money spent. While low back pain (LBP) constitutes an enormous burden of disease, no universal set of metrics has yet been accepted to measure and compare outcomes. Here, we aim to define such a set. Patients and methods - An international group of 22 specialists in several disciplines of spine care was assembled to review literature and select LBP outcome metrics through a 6-round modified Delphi process. The scope of the outcome set was degenerative lumbar conditions. Results - Patient-reported metrics include numerical pain scales, lumbar-related function using the Oswestry disability index, health-related quality of life using the EQ-5D-3L questionnaire, and questions assessing work status and analgesic use. Specific common and serious complications are included. Recommended follow-up intervals include 6, 12, and 24 months after initiating treatment, with optional follow-up at 3 months and 5 years. Metrics for risk stratification are selected based on preexisting tools. Interpretation - The outcome measures recommended here are structured around specific etiologies of LBP, span a patient's entire cycle of care, and allow for risk adjustment. Thus, when implemented, this set can be expected to facilitate meaningful comparisons and ultimately provide a continuous feedback loop, enabling ongoing improvements in quality of care. Much work lies ahead in implementation, revision, and validation of this set, but it is an essential first step toward establishing a community of LBP providers focused on maximizing the value of the care we deliver.},
  author       = {Clement, R. Carter and Welander, Adina and Stowell, Caleb and Cha, Thomas D. and Chen, John L. and Davies, Michelle and Fairbank, Jeremy C. and Foley, Kevin T. and Gehrchen, Martin and Hagg, Olle and Jacobs, Wilco C. and Kahler, Richard and Khan, Safdar N. and Lieberman, Isador H. and Morisson, Beth and Ohnmeiss, Donna D. and Peul, Wilco C. and Shonnard, Neal H. and Smuck, Matthew W. and Solberg, Tore K. and Strömqvist, Björn and Van Hooff, Miranda L. and Wasan, Ajay D. and Willems, Paul C. and Yeo, William and FRitzell, Peter},
  issn         = {1745-3682},
  language     = {eng},
  number       = {5},
  pages        = {523--533},
  publisher    = {Taylor & Francis},
  series       = {Acta Orthopaedica},
  title        = {A proposed set of metrics for standardized outcome reporting in the management of low back pain},
  url          = {http://dx.doi.org/10.3109/17453674.2015.1036696},
  volume       = {86},
  year         = {2015},
}