Index to Chiropractic Literature
Index to Chiropractic Literature
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ID 25347
Title Cost-effectiveness of spinal manipulation, exercise, and self-management for spinal pain using an individual participant data meta-analysis approach: A study protocol [randomized controlled trial]
URL https://chiromt.biomedcentral.com/articles/10.1186/s12998-018-0216-9
Journal Chiropr & Manual Ther. 2018 ;26(46):Online access only 8 p
Author(s)
Subject(s)
Peer Review Yes
Publication Type Randomized Controlled Trial
Abstract/Notes

Background: Spinal pain is a common and disabling condition with considerable socioeconomic burden. Spine pain management in the United States has gathered increased scrutiny amidst concerns of overutilization of costly and potentially harmful interventions and diagnostic tests. Conservative interventions such as spinal manipulation, exercise and self-management may provide value for the care of spinal pain, but little is known regarding the cost-effectiveness of these interventions in the U.S. Our primary objective for this project is to estimate the incremental cost-effectiveness of spinal manipulation, exercise therapy, and self-management for spinal pain using an individual patient data meta-analysis approach.

Methods/design: We will estimate the incremental cost-effectiveness of spinal manipulation, exercise therapy, and self-management using cost and clinical outcome data collected in eight randomized clinical trials performed in the U.S. Cost-effectiveness will be assessed from both societal and healthcare perspectives using QALYs, pain intensity, and disability as effectiveness measures. The eight randomized clinical trials used similar methods and included different combinations of spinal manipulation, exercise therapy, or self-management for spinal pain. They also collected similar clinical outcome, healthcare utilization, and work productivity data. A two-stage approach to individual patient data meta-analysis will be conducted.

Discussion: This project capitalizes on a unique opportunity to combine clinical and economic data collected in a several clinical trials that used similar methods. The findings will provide important information on the value of spinal manipulation, exercise therapy, and self-management for spinal pain management in the U.S.

Author keywords: Cost effectiveness — Back pain — Neck pain — Exercise — Spinal manipulation — Self-care — Randomized clinical trial

Author affiliations: BL, GB, RE: Integrative Health & Wellbeing Research Program, Earl E. Bakken Center for Spirituality & Healing, University of Minnesota, Minneapolis, USA; JH: Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, USA; KK, JAN: Department of Health Policy and Management, University of Minnesota, Minneapolis, USA

This abstract is reproduced with the permission of the publisher; click on the above link for free full text. PubMed Record


 

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