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AHRQ Research Studies Date
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 20 of 20 Research Studies DisplayedRumble DD, O'Neal K, Overstreet DS
Sleep and neighborhood socioeconomic status: a micro longitudinal study of chronic low-back pain and pain-free individuals.
This study compared associations between neighborhood-level socioeconomic status (SES), pain-status (chronic low back pain vs. pain-free), and daily sleep metrics in 117 adults. With neighborhood-level SES gathered from Neighborhood Atlas, and with individuals completing home sleep monitoring for 7 consecutive days/nights, analyses revealed neighborhood-level SES and neighborhood-level SES pain-status interaction significantly impacted objective sleep quality.
AHRQ-funded; HS013852.
Citation: Rumble DD, O'Neal K, Overstreet DS .
Sleep and neighborhood socioeconomic status: a micro longitudinal study of chronic low-back pain and pain-free individuals.
J Behav Med 2021 Dec;44(6):811-21. doi: 10.1007/s10865-021-00234-w..
Keywords: Sleep Problems, Back Health and Pain, Chronic Conditions, Pain
Greenberg JK, Olsen MA, Poe J
Administrative data are unreliable for ranking hospital performance based on serious complications after spine fusion.
The authors evaluated the extent to which a metric of serious complications determined from administrative data can reliably profile hospital performance in spine fusion surgery. They found that a metric of serious complications was unreliable for benchmarking cervical fusion outcomes and only modestly reliable for thoracolumbar fusion. They concluded that, when assessed using administrative datasets, these measures appeared to be inappropriate for high-stakes applications, such as public reporting or pay-for-performance.
AHRQ-funded; HS027075; HS019455.
Citation: Greenberg JK, Olsen MA, Poe J .
Administrative data are unreliable for ranking hospital performance based on serious complications after spine fusion.
Spine 2021 Sep 1;46(17):1181-90. doi: 10.1097/brs.0000000000004017..
Keywords: Surgery, Provider Performance, Hospitals, Adverse Events, Back Health and Pain
Overstreet DS, Michl AN, Penn TM
Temporal summation of mechanical pain prospectively predicts movement-evoked pain severity in adults with chronic low back pain.
The objective of this study was to determine whether quantitative sensory tests of endogenous pain inhibition and facilitation prospectively predict movement-evoked pain and chronic low back pain severity self-reported on a validated questionnaire. Through surveys using the Brief Pain Inventory-Short Form, findings suggested that a pro-nociceptive pain modulatory balance characterized by enhanced pain facilitation may be an important driver of movement-evoked pain severity and poor physical function in individuals with chronic low back pain.
AHRQ-funded; HS013852.
Citation: Overstreet DS, Michl AN, Penn TM .
Temporal summation of mechanical pain prospectively predicts movement-evoked pain severity in adults with chronic low back pain.
BMC Musculoskelet Disord 2021 May 10;22(1):429. doi: 10.1186/s12891-021-04306-5..
Keywords: Back Health and Pain, Pain, Chronic Conditions, Diagnostic Safety and Quality
Kim HS, Ciolino JD, Lancki N
A prospective observational study of emergency department-initiated physical therapy for acute low back pain.
The purpose of this study was to compare patient-reported outcomes in patients receiving emergency department-initiated physical therapy and patients receiving usual care for acute low back pain. Findings showed that emergency department-initiated physical therapy for low back pain was associated with greater improvement in functioning and lower use of high-risk medications over 3 months.
AHRQ-funded; HS023011.
Citation: Kim HS, Ciolino JD, Lancki N .
A prospective observational study of emergency department-initiated physical therapy for acute low back pain.
Phys Ther 2021 Mar 3;101(3). doi: 10.1093/ptj/pzaa219..
Keywords: Emergency Department, Back Health and Pain, Pain, Chronic Conditions
Fenton JJ, Jerant A, Franks P
Watchful waiting as a strategy to reduce low-value spinal imaging: study protocol for a randomized trial.
This paper describes the protocol that will be used for an upcoming randomized control trial to determine the effectiveness of teaching clinicians how to advise watchful waiting when patients request low-value spinal imaging for acute low back pain. The authors will recruit 8-10 primary care and urgent care clinics in Sacramento, California. The study will last 3-6 months and during this time clinicians in the intervention group with receive 3 visits with standardized patient instructors (SPIs) portraying patients with acute back pain. The SPIs will instruct clinicians in a 3-step model emphasizing trust, empathic communication, and negotiation of a watchful waiting approach. The primary outcome looked for will a decreased post-intervention rate of spinal imaging among actual patients with acute back pain compared to the rate of imaging during the baseline period. Secondary outcomes will include use of targeted communication techniques during a follow-up visit with an SP.
AHRQ-funded; HS026415.
Citation: Fenton JJ, Jerant A, Franks P .
Watchful waiting as a strategy to reduce low-value spinal imaging: study protocol for a randomized trial.
Trials 2021 Feb 27;22(1):167. doi: 10.1186/s13063-021-05106-x..
Keywords: Back Health and Pain, Pain, Chronic Conditions, Imaging, Diagnostic Safety and Quality, Clinician-Patient Communication, Communication
Fritz JM, Lane E, McFadden M
Physical therapy referral from primary care for acute back pain with sciatica: a randomized controlled trial.
This study examined whether early physical therapy (EPT) use in sciatica patients of less than 90 days duration reduces disability compared to usual care (UC) alone. A cohort of 220 adult sciatica patients ages 18 to 60 at two healthcare systems in Salt Lake City, Utah were randomly assigned to the control or EPT. Half (110) were given EPT, 1 education session, and then referred to 4 weeks of physical therapy including exercise and manual therapy. The other 110 were provided usual care. Outcomes were measured using the Oswestry Disability Index (OSW) after 6 months. Secondary outcomes were pain intensity, patient-reported treatment success, health care use or missed workdays. The EPT group were more likely to self-report less back pain after 5 weeks as well as treatment success after 1 year than the UC care group. There were no significant differences in health care use or missed workdays with the 2 groups.
AHRQ-funded; HS022641.
Citation: Fritz JM, Lane E, McFadden M .
Physical therapy referral from primary care for acute back pain with sciatica: a randomized controlled trial.
Ann Intern Med 2021 Jan;174(1):8-17. doi: 10.7326/m20-4187..
Keywords: Back Health and Pain, Pain, Primary Care
Turner JA, Comstock BA, Standaert CJ
Can patient characteristics predict benefit from epidural corticosteroid injections for lumbar spinal stenosis symptoms?
The study’s aim was to identify patient characteristics associated with benefits from epidural injections of corticosteroid with lidocaine versus epidural injections of lidocaine only for lumbar spinal stenosis symptoms. It found that among 21 baseline patient characteristics examined, none, including clinician rated spinal stenosis severity, were consistent predictors of benefit from epidural injections of lidocain corticosteroid versus lidocaine only.
AHRQ-funded; HS019222; HS022972.
Citation: Turner JA, Comstock BA, Standaert CJ .
Can patient characteristics predict benefit from epidural corticosteroid injections for lumbar spinal stenosis symptoms?
Spine J 2015 Nov;15(11):2319-31. doi: 10.1016/j.spinee.2015.06.050..
Keywords: Patient-Centered Outcomes Research, Decision Making, Medication, Back Health and Pain, Chronic Conditions
Jarvik JG, Comstock BA, James KT
Lumbar Imaging with Reporting of Epidemiology (LIRE)--protocol for a pragmatic cluster randomized trial.
The researchers will conduct a pragmatic cluster randomized clinical trial to test the hypothesis that inserting data on the prevalence of incidental imaging findings into lumbar spine imaging reports for studies ordered by primary care providers will reduce subsequent spine-related interventions. Their primary outcome will be spine-related intervention intensity based on Relative Value Units (RVUs) during the following year.
AHRQ-funded; HS022982.
Citation: Jarvik JG, Comstock BA, James KT .
Lumbar Imaging with Reporting of Epidemiology (LIRE)--protocol for a pragmatic cluster randomized trial.
Contemp Clin Trials 2015 Nov;45(Pt B):157-63. doi: 10.1016/j.cct.2015.10.003.
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Keywords: Imaging, Back Health and Pain, Patient-Centered Outcomes Research
Fritz JM, Magel JS, McFadden M
Early physical therapy vs usual care in patients with recent-onset low back pain: a randomized clinical trial.
This study evaluated whether early physical therapy (manipulation and exercise) is more effective than usual care in improving disability for patients with LBP fitting a decision rule. It concluded that among adults with recent-onset LBP, early physical therapy resulted in statistically significant improvement in disability, but the improvement was modest and did not achieve the minimum clinically important difference compared with usual care.
AHRQ-funded; HS018672.
Citation: Fritz JM, Magel JS, McFadden M .
Early physical therapy vs usual care in patients with recent-onset low back pain: a randomized clinical trial.
JAMA 2015 Oct 13;314(14):1459-67. doi: 10.1001/jama.2015.11648..
Keywords: Back Health and Pain, Comparative Effectiveness, Outcomes, Patient-Centered Outcomes Research
Chou R, Hashimoto R, Friedly J
Epidural corticosteroid injections for radiculopathy and spinal stenosis: a systematic review and meta-analysis.
The researchers reviewed evidence on the benefits and harms of epidural corticosteroid injections in adults with radicular low back pain or spinal stenosis of any duration. They concluded that epidural corticosteroid injections for radiculopathy were associated with immediate reductions in pain and function. However, benefits were small and not sustained, and there was no effect on long-term surgery risk.
AHRQ-funded; 290201200014I.
Citation: Chou R, Hashimoto R, Friedly J .
Epidural corticosteroid injections for radiculopathy and spinal stenosis: a systematic review and meta-analysis.
Ann Intern Med 2015 Sep 1;163(5):373-81. doi: 10.7326/m15-0934.
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Keywords: Medication, Back Health and Pain, Chronic Conditions, Comparative Effectiveness, Evidence-Based Practice
Suri P, Pashova H, Heagerty PJ
Short-term improvements in disability mediate patient satisfaction after epidural corticosteroid injections for symptomatic lumbar spinal stenosis.
The researchers sought to identify mediators of the effect of lumbar epidural injections of corticosteroid plus lidocaine on patient satisfaction at 6 weeks postinjection in patients with lumbar spinal stenosis. Three-week change in disability was a significant mediator of the effects of lumbar epidural corticosteroid injections on patient satisfaction at 6 weeks, explaining 48 percent to 60 percent of the treatment effect on satisfaction.
AHRQ-funded; HS019222; HS022972.
Citation: Suri P, Pashova H, Heagerty PJ .
Short-term improvements in disability mediate patient satisfaction after epidural corticosteroid injections for symptomatic lumbar spinal stenosis.
Spine 2015 Sep 01;40(17):1363-70. doi: 10.1097/brs.0000000000001000.
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Keywords: Medication, Patient-Centered Outcomes Research, Back Health and Pain, Patient Experience
Deyo RA, Bryan M, Comstock BA
Trajectories of symptoms and function in older adults with low back disorders.
The researchers sought to determine whether there are distinct trajectories of back pain and function among older adults and to identify characteristics that distinguish among patients with substantially different prognoses. They found that, although most patients remained relatively stable over a year, latent class analysis identified small groups with major improvement in pain, function, or both.
AHRQ-funded; HS019222.
Citation: Deyo RA, Bryan M, Comstock BA .
Trajectories of symptoms and function in older adults with low back disorders.
Spine 2015 Sep 1;40(17):1352-62. doi: 10.1097/brs.0000000000000975.
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Keywords: Data, Elderly, Back Health and Pain, Chronic Conditions, Outcomes
Rundell SD, Gellhorn AC, Comstock BA
Clinical outcomes of early and later physical therapist services for older adults with back pain.
The purpose of this study was to compare clinical outcomes of patients receiving early or later PT services with those not receiving PT among older adults presenting to primary care for a new visit for back pain. It found that among older adults early referral to PT resulted in no or minimal differences in pain, function, or health-related quality at 3, 6, or 12 months compared with a matched group that did not receive early PT.
AHRQ-funded; HS019222.
Citation: Rundell SD, Gellhorn AC, Comstock BA .
Clinical outcomes of early and later physical therapist services for older adults with back pain.
Spine J 2015 Aug;15(8):1744-55. doi: 10.1016/j.spinee.2015.04.001..
Keywords: Back Health and Pain, Elderly, Primary Care, Comparative Effectiveness, Patient-Centered Outcomes Research
Skolasky RL, Maggard AM, Li D
Health behavior change counseling in surgery for degenerative lumbar spinal stenosis. Part I: improvement in rehabilitation engagement and functional outcomes.
This study examined whether a brief motivational interviewing-based health behavior change counseling (HBCC) intervention increased patient participation in physical therapy and/or home exercise programs (HEPs), reduced disability, and improved health status after surgery for degenerative lumbar spinal stenosis. It found that HBCC can improve outcomes after spine surgery through improved rehabilitation participation.
AHRQ-funded; HS017990.
Citation: Skolasky RL, Maggard AM, Li D .
Health behavior change counseling in surgery for degenerative lumbar spinal stenosis. Part I: improvement in rehabilitation engagement and functional outcomes.
Arch Phys Med Rehabil 2015 Jul;96(7):1200-7. doi: 10.1016/j.apmr.2015.03.009..
Keywords: Back Health and Pain, Surgery, Patient Adherence/Compliance
Skolasky RL, Maggard AM, Li D
Health behavior change counseling in surgery for degenerative lumbar spinal stenosis. Part II: Patient activation mediates the effects of health behavior change counseling on rehabilitation engagement.
This study sought to determine the effect of health behavior change counseling (HBCC) on patient activation and the influence of patient activation on rehabilitation engagement, and to identify common barriers to engagement among individuals undergoing surgery for degenerative lumbar spinal stenosis. It found that the influence of HBCC on rehabilitation engagement was mediated by patient activation. Despite improvements in patient activation, one-third of patients reported low rehabilitation engagement.
AHRQ-funded; HS017990.
Citation: Skolasky RL, Maggard AM, Li D .
Health behavior change counseling in surgery for degenerative lumbar spinal stenosis. Part II: Patient activation mediates the effects of health behavior change counseling on rehabilitation engagement.
Arch Phys Med Rehabil 2015 Jul;96(7):1208-14. doi: 10.1016/j.apmr.2015.02.031..
Keywords: Back Health and Pain, Surgery, Patient Adherence/Compliance
Edwards TC, Lavallee DC, Bauer Z
Problem areas identified as important to older adults with lumbar spinal stenosis.
The purpose of this study was to determine what outcomes are most important to older adults with spinal stenosis and how well frequently used patient-reported outcomes reflect what is most important to them. It found that older adults with spinal stenosis rated problems related to pain and physical function as the most important outcomes to them.
AHRQ-funded; HS022972.
Citation: Edwards TC, Lavallee DC, Bauer Z .
Problem areas identified as important to older adults with lumbar spinal stenosis.
Spine J 2015 Jul;15(7):1636-44. doi: 10.1016/j.spinee.2015.03.008..
Keywords: Elderly, Back Health and Pain, Patient-Centered Outcomes Research
Makris UE, Higashi RT, Marks EG
Ageism, negative attitudes, and competing co-morbidities--why older adults may not seek care for restricting back pain: a qualitative study.
The objective of this study was to understand older adults’ beliefs and perspectives regarding care-seeking for restricting back pain (back pain that restricts activity). Using data from a diverse sample of 93 older adults who reported restricting back pain, it found that illness perceptions (including pain-related beliefs), and interactions with providers may influence older adults’ willingness to seek care for restricting back pain.
AHRQ-funded; HS020648.
Citation: Makris UE, Higashi RT, Marks EG .
Ageism, negative attitudes, and competing co-morbidities--why older adults may not seek care for restricting back pain: a qualitative study.
BMC Geriatr 2015 Apr 8;15:39. doi: 10.1186/s12877-015-0042-z..
Keywords: Elderly, Back Health and Pain, Chronic Conditions
Jarvik JG, Gold LS, Comstock BA
Association of early imaging for back pain with clinical outcomes in older adults.
This study compared function and pain at the 12-month follow-up visit among older adults who received early imaging with those who did not receive early imaging after a new primary care visit for back pain without radiculopathy. It found that early imaging was not associated with better 1-year outcomes. The researchers concluded that the value of early diagnostic imaging in older adults for back pain with radiculopathy is uncertain.
AHRQ-funded; HS019222, HS022972
Citation: Jarvik JG, Gold LS, Comstock BA .
Association of early imaging for back pain with clinical outcomes in older adults.
JAMA. 2015 Mar 17;313(11):1143-53. doi: 10.1001/jama.2015.1871..
Keywords: Back Health and Pain, Elderly, Primary Care, Outcomes, Diagnostic Safety and Quality, Imaging
Rundell SD, Sherman KJ, Heagerty PJ
The clinical course of pain and function in older adults with a new primary care visit for back pain.
This study reports the clinical course of older adults presenting for a new primary care visit for back pain, with no healthcare visit for back pain within the prior 6 months, by describing pain intensity, disability, pain interference, and resolution of back pain over 12 months. It found that improvements in disability and interference with activity over 12 months differed according to age, duration of back pain, symptoms of depression and anxiety, and expectation for recovery.
AHRQ-funded; HS019222.
Citation: Rundell SD, Sherman KJ, Heagerty PJ .
The clinical course of pain and function in older adults with a new primary care visit for back pain.
J Am Geriatr Soc 2015 Mar;63(3):524-30. doi: 10.1111/jgs.13241..
Keywords: Elderly, Primary Care, Back Health and Pain, Comparative Effectiveness, Outcomes
Rundell SD, Sherman KJ, Heagerty PJ
Patient-reported outcomes associated with use of physical therapist services by older adults with a new visit for back pain.
The researchers conducted an observational comparative effectiveness research study to investigate the association between types or amounts of physical therapist services and outcomes, such as disability and pain intensity, among older adults. Higher amounts of active physical therapy were associated with decreased back and leg pain and increased odds of clinically meaningful improvements in back and leg pain relative to results obtained with no active physical therapy.
AHRQ-funded; HS019222.
Citation: Rundell SD, Sherman KJ, Heagerty PJ .
Patient-reported outcomes associated with use of physical therapist services by older adults with a new visit for back pain.
Phys Ther 2015 Feb;95(2):190-201. doi: 10.2522/ptj.20140132..
Keywords: Back Health and Pain, Patient-Centered Outcomes Research, Comparative Effectiveness, Treatments, Elderly