Guest guest Posted July 28, 2004 Report Share Posted July 28, 2004 Dear Colleagues: Have you see this new study: Efficacy of spinal manipulation and mobilization for low back pain and neck pain: a systematic review and best evidence synthesis. Gert Bronfort, PhD, Haas, DC, MA, Roni L. , DC, MS, Lex M. Bouter, PhD. The Spine Journal 4:335-356, 2004 Mitch of course is from WSCC and Goldberg from OHSU the very folks I'm working with to design and complete my cost comparison study, chiropractic vs. medical treatment of common musculoskeletal conditions within the Oregon Worker's Compensation System. This is an important systematic review of the literature that supports chiropractic treatment of neck and lower back pain but most importantly chronic lower back pain with concomitant referred (ridiculer?) pain to the lower extremity. This sub-group very likely represents the single most expensive group in the Worker's Compensation systems world-wide. Those injured workers with disc herniations!...and we get the best results which would be a HUGE savings to the system. Now, Germaine to our discussions on what constitutes reasonable and necessary curative (not wellness-care Willard & ) chiropractic treatment (frequency and most importantly duration of care) and the proposed "over-utilization," (excessive treatment) "under-utilization" (IMEs/DMEs) is the use of evidence based Outcomes management/assessment tools both patient driven (measures of their current pain and disability levels) and doctor driven (physical examination, functional radiology, instrumentation etc., etc., etc.). Ok, with that said guess what the two markers/instruments/tools were that the authors used to determine the results of chiropractic care as having better results for folks with chronic back pain with leg pain? Yep....the Visual Analogue Scale (VAS) and the Revised Oswestry Disability Questionnaire! Both of the above of course are the two "Patient Driven" subjective Outcomes self-reporting tools I keep speaking of and that which is in the proposed OR., Admin. Language. One (VAS) documents the patient current level of pain and the other (Oswestry) their current level of disability (activities intolerances). Again, the entire health care delivery planet is headed (has been for quite sometime) down the Outcomes Management trail....we here in Oregon have the opportunity to lead, follow, or get the hell out of the way! How's about we lead for once??? Me two cents worth on a beautiful Wed, morning! Vern Saboe, DC., DACAN., FICC., DABFP., FACO President Chiropractic Association of Oregon Quote Link to comment Share on other sites More sharing options...
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