G2TT
来源类型Report
规范类型报告
DOIhttps://doi.org/10.7249/RR2476
来源IDRR-2476-NCCIH
Determining the Appropriateness of Spinal Manipulation and Mobilization for Chronic Neck Pain: Indications and Ratings by a Multidisciplinary Expert Panel
Ian D. Coulter; Margaret D. Whitley; Howard Vernon; Eric Hurwitz; Paul G. Shekelle; Patricia M. Herman
发表日期2018-07-24
出版年2018
页码70
语种英语
结论

The methodology involved a literature review and panel assessments.

  • To determine the appropriateness of manipulation and mobilization for chronic neck pain, we convened a nine-member modified-Delphi panel of clinicians.
  • The initial ratings of appropriateness were made individually and without group discussion.
  • The second-round ratings followed a structured face-to-face method that was based on procedures often used to bring people closer to consensus or agreement.
  • The project staff compiled the initial indications list using a literature review, the advice of chiropractors and an internist, and a list of indications created for an earlier study on manipulation for neck pain.

The panel rated 186 indications to assess the appropriateness of manipulation and mobilization for chronic neck pain.

  • There was agreement among the panelists for 13.3 percent to 37.0 percent of indications.
  • The average median appropriateness ratings ranged from 3.9 to 4.7 on a nine-point scale, and 8.6 percent to 20.4 percent of indications were rated appropriate.
  • Appropriateness ratings for mobilization were higher than the ratings for manipulation.
  • Panelists agreed on the ratings for between 33.9 percent and 44.1 percent of the indications.
  • Rates of agreement increased after panelists met to discuss the issues.
摘要

The approach developed by researchers at the RAND Corporation for assessing the appropriateness of health care makes it feasible to take the best of what is known from research and apply it — using the expertise of experienced clinicians — over the wide range of patients and health problems seen in real-world clinical practice. The major limitation of the RAND approach is that it utilizes a limited definition of appropriateness that that relies heavily on safety, efficacy, and effectiveness. This report, which focuses on appropriateness of indications for spinal manipulation and mobilization for chronic neck pain, presents results from one part of a broader study designed to develop a methodology to integrate patient-reported outcomes, patient preferences, and cost into the appropriateness panel process. It describes the results and methodology of convened panels of neck pain experts who met to discuss and rate appropriateness of 186 indications for spinal manipulation and mobilization for chronic neck pain, and serves four objectives: (1) Describe the methodology of the process of obtaining appropriateness ratings that can be used later to calculate rates of appropriate care and can be replicated by other studies; (2) provide the list of actual indications used in this study so that future studies can use them or adapt them without going through the extensive and costly process we did; (3) provide further data on the modified Delphi process for generating consensus by exploring whether ratings of appropriateness changed between rounds and whether agreement or disagreement went up after panelists met face to face; and (4) present final ratings of the appropriateness of manipulation and mobilization for neck pain for 186 indications.

目录
  • Chapter One

    Introduction

  • Chapter Two

    Methods

  • Chapter Three

    Results

  • Chapter Four

    Discussion

  • Appendix A

    Definitions Provided to Panelists

  • Appendix B

    Final Panel Ratings of Indications, by Chapter

主题Chronic Diseases and Conditions ; Evidence Based Health Practice ; Measuring Health Care Costs ; Pain Management
URLhttps://www.rand.org/pubs/research_reports/RR2476.html
来源智库RAND Corporation (United States)
引用统计
资源类型智库出版物
条目标识符http://119.78.100.153/handle/2XGU8XDN/523592
推荐引用方式
GB/T 7714
Ian D. Coulter,Margaret D. Whitley,Howard Vernon,et al. Determining the Appropriateness of Spinal Manipulation and Mobilization for Chronic Neck Pain: Indications and Ratings by a Multidisciplinary Expert Panel. 2018.
条目包含的文件
文件名称/大小 资源类型 版本类型 开放类型 使用许可
RAND_RR2476.pdf(1188KB)智库出版物 限制开放CC BY-NC-SA浏览
x1532433880115.jpg.p(2KB)智库出版物 限制开放CC BY-NC-SA浏览
个性服务
推荐该条目
保存到收藏夹
导出为Endnote文件
谷歌学术
谷歌学术中相似的文章
[Ian D. Coulter]的文章
[Margaret D. Whitley]的文章
[Howard Vernon]的文章
百度学术
百度学术中相似的文章
[Ian D. Coulter]的文章
[Margaret D. Whitley]的文章
[Howard Vernon]的文章
必应学术
必应学术中相似的文章
[Ian D. Coulter]的文章
[Margaret D. Whitley]的文章
[Howard Vernon]的文章
相关权益政策
暂无数据
收藏/分享
文件名: RAND_RR2476.pdf
格式: Adobe PDF
文件名: x1532433880115.jpg.pagespeed.ic.vccNqYIqK5.jpg
格式: JPEG

除非特别说明,本系统中所有内容都受版权保护,并保留所有权利。