Re: 2007 Clinical Guidelines for Low Back Pain [2 Attachments]

[Guest guest]

Better yet Jamey go to the brand new Oregon State Evidence-based Low Back Pain Guidelines (attached) we used the Chou guidelines you cite as a starting point…following key evidence-based input to the downside of all the listed medications by the OCA (attached) and highlighting the fact the algorithm on page 482 of the original Chou guidelines dead-end into surgery or other invasive procedures with no provision for continued non-surgical (e.g. flexion-distraction, SMT) interventions…..Oregon with the help of the Oregon Chiropractic Association’s input built a better mouse trap check out the algorithm in the new guides. The “Health Evidence Review Commission” which I serve on approved and adopted these new guidelines five months ago and we now have a draft “Coverage Guidance” document also attached. Doctors reading this feel free to use all or part of the “response” paper I wrote remove my name put yours on it whatever you believe will help move the profession along in the eyes of your local medical community do it! What the Oregon Chiropractic Association was able to accomplish with these guidelines combined with the non-discrimination law language we achieved with our coalition of other health care providers continues to move our wonderful profession towards that “level playing field” in healthcare and cultural authority…..doctors reading this are you a member of the OCA? Come join us it’s going to be great we indeed are going to reach that mountain top…together! We need your financial support call the OCA office tomorrow morning and join call ……To The Continued Good Fight! !! Vern Saboe questions call my cell at ….. From: oregondcs [mailto:oregondcs ] On Behalf Of Jamey DysonSent: Sunday, May 20, 2012 2:04 PMTo: Oregon DC'sSubject: 2007 Clinical Guidelines for Low Back Pain [2 Attachments] [Attachment(s) from Jamey Dyson included below] I came across these guidelines today on the web and thought it was very interesting. Here is a chart from the guidelines showing that spinal manipulation is the only non-pharma therapy recommended for both acute and chronic low back pain. How many MDs know about these guidelines and the options available to them? It's usually meds for the first 4 weeks, then physical therapy. If they do go outside that box, it might be acupuncture or massage but rarely spinal manipulation in my experience. Looks like we all need to do a better job of educating our local MDs on their own clinical guidelines. Full guidelines are attached. Maybe we could print these out and mail them to our local MDs with a cordial introduction letter that lets them know we are nearby and accepting referrals. If we could actually get out and meet them face-to-face and introduce ourselves so they know we are not kooks, that would be even better. Jamey Dyson, DC

3 of 3 File(s)

OCA Response to Oregon (Draft) Low Back Pain Guidelines, May 2011.docx

OCA Coverage Guide LBPNon-Pharm.pdf

OCA Oregon State Evidence based Low Back Pain Guidelines, Adopted Dec., 2011.pdf

[Guest guest]

Thanks Verne for connecting the dots for me in regards to the new Oregon guidelines being a better, more thorough document. This is the document we need to get out to our local MDs. Thanks for everything you and the OCA are doing for chiropractic in Oregon. Proud to be a bonafide dues-paying member!One question I have has to do with Table A. Why does it say the strength of the recommendation is "Weak" for Non-pharmacologic Therapy, yet the evidence grade is "Moderate-quality"?All the other sections come with a "Strong" recommendation with "Moderate-quality" evidence grade. What's the reason for this?Thanks,Jamey Dyson, DCBetter yet Jamey go to the brand new Oregon State Evidence-based Low Back Pain Guidelines (attached) we used the Chou guidelines you cite as a starting point…following key evidence-based input to the downside of all the listed medications by the OCA (attached) and highlighting the fact the algorithm on page 482 of the original Chou guidelines dead-end into surgery or other invasive procedures with no provision for continued non-surgical (e.g. flexion-distraction, SMT) interventions…..Oregon with the help of the Oregon Chiropractic Association’s input built a better mouse trap check out the algorithm in the new guides. The “Health Evidence Review Commission” which I serve on approved and adopted these new guidelines five months ago and we now have a draft “Coverage Guidance” document also attached. Doctors reading this feel free to use all or part of the “response” paper I wrote remove my name put yours on it whatever you believe will help move the profession along in the eyes of your local medical community do it! What the Oregon Chiropractic Association was able to accomplish with these guidelines combined with the non-discrimination law language we achieved with our coalition of other health care providers continues to move our wonderful profession towards that “level playing field” in healthcare and cultural authority…..doctors reading this are you a member of the OCA? Come join us it’s going to be great we indeed are going to reach that mountain top…together! We need your financial support call the OCA office tomorrow morning and join call ……To The Continued Good Fight! !! Vern Saboe questions call my cell at ….. From: oregondcs [mailto:oregondcs ] On Behalf Of Jamey DysonSent: Sunday, May 20, 2012 2:04 PMTo: Oregon DC'sSubject: 2007 Clinical Guidelines for Low Back Pain [2 Attachments] [Attachment(s) from Jamey Dyson included below]I came across these guidelines today on the web and thought it was very interesting. Here is a chart from the guidelines showing that spinal manipulation is the only non-pharma therapy recommended for both acute and chronic low back pain. How many MDs know about these guidelines and the options available to them? It's usually meds for the first 4 weeks, then physical therapy. If they do go outside that box, it might be acupuncture or massage but rarely spinal manipulation in my experience. Looks like we all need to do a better job of educating our local MDs on their own clinical guidelines. Full guidelines are attached. Maybe we could print these out and mail them to our local MDs with a cordial introduction letter that lets them know we are nearby and accepting referrals. If we could actually get out and meet them face-to-face and introduce ourselves so they know we are not kooks, that would be even better. Jamey Dyson, DC<OCA Oregon State Evidence based Low Back Pain Guidelines, Adopted Dec., 2011.pdf><OCA Response to Oregon (Draft) Low Back Pain Guidelines, May 2011.docx><OCA Coverage Guide LBPNon-Pharm.pdf>

[Guest guest]

“Weak” refers to the number of studies (as in a paucity of) which measured up quality-wise, the Grade refers to the studies included were of moderate quality. I would recommend to all that you read the initial critic of the first draft of the guidelines the OCA submitted in May of 2011…point being which had limited effect (we have but one vote on the Commission) the adverse events/side effects or risk vs. benefit ratio of all the medications were smoothed over and not really address…though the OCA shouted long and loud. However, as per medically trained folks on the Commission (the majority) if all you have in your tool box for treating low back pain are drugs…well how would you vote??? At least we are finally in the game and have a voice A VERY LOUD VOICE THAT ISN’T GOING AWAY! Cheers, Vern Saboe PS: Thank you Dr. Dyson for being a proud member of the OCA….. From: Jamey Dyson Sent: Sunday, May 20, 2012 9:04 PMTo: vsaboeCc: 'Oregon DC's'; 'Dan Beeson'; rongrice@...; 'Sunny Kierstyn'; '* Dr. Matt Freedman *'; ' M. s, D.C.'; 'Charlie Caughlin'; 'Judith Boothby'; 'david corl'; 'anthony saboe'; ' Seitz'; 'LARRY HANBERG'; 'Brad Rethwill'; 'ed hacmac'; 'Dan 'Subject: Re: 2007 Clinical Guidelines for Low Back Pain [2 Attachments] Thanks Verne for connecting the dots for me in regards to the new Oregon guidelines being a better, more thorough document. This is the document we need to get out to our local MDs. Thanks for everything you and the OCA are doing for chiropractic in Oregon. Proud to be a bonafide dues-paying member! One question I have has to do with Table A. Why does it say the strength of the recommendation is " Weak " for Non-pharmacologic Therapy, yet the evidence grade is " Moderate-quality " ?All the other sections come with a " Strong " recommendation with " Moderate-quality " evidence grade. What's the reason for this?Thanks, Jamey Dyson, DC Better yet Jamey go to the brand new Oregon State Evidence-based Low Back Pain Guidelines (attached) we used the Chou guidelines you cite as a starting point…following key evidence-based input to the downside of all the listed medications by the OCA (attached) and highlighting the fact the algorithm on page 482 of the original Chou guidelines dead-end into surgery or other invasive procedures with no provision for continued non-surgical (e.g. flexion-distraction, SMT) interventions…..Oregon with the help of the Oregon Chiropractic Association’s input built a better mouse trap check out the algorithm in the new guides. The “Health Evidence Review Commission” which I serve on approved and adopted these new guidelines five months ago and we now have a draft “Coverage Guidance” document also attached. Doctors reading this feel free to use all or part of the “response” paper I wrote remove my name put yours on it whatever you believe will help move the profession along in the eyes of your local medical community do it! What the Oregon Chiropractic Association was able to accomplish with these guidelines combined with the non-discrimination law language we achieved with our coalition of other health care providers continues to move our wonderful profession towards that “level playing field” in healthcare and cultural authority…..doctors reading this are you a member of the OCA? Come join us it’s going to be great we indeed are going to reach that mountain top…together! We need your financial support call the OCA office tomorrow morning and join call ……To The Continued Good Fight! !! Vern Saboe questions call my cell at ….. From: oregondcs [mailto:oregondcs ] On Behalf Of Jamey DysonSent: Sunday, May 20, 2012 2:04 PMTo: Oregon DC'sSubject: 2007 Clinical Guidelines for Low Back Pain [2 Attachments] [Attachment(s) from Jamey Dyson included below]I came across these guidelines today on the web and thought it was very interesting. Here is a chart from the guidelines showing that spinal manipulation is the only non-pharma therapy recommended for both acute and chronic low back pain. How many MDs know about these guidelines and the options available to them? It's usually meds for the first 4 weeks, then physical therapy. If they do go outside that box, it might be acupuncture or massage but rarely spinal manipulation in my experience. Looks like we all need to do a better job of educating our local MDs on their own clinical guidelines. Full guidelines are attached. Maybe we could print these out and mail them to our local MDs with a cordial introduction letter that lets them know we are nearby and accepting referrals. If we could actually get out and meet them face-to-face and introduce ourselves so they know we are not kooks, that would be even better. Jamey Dyson, DC<OCA Oregon State Evidence based Low Back Pain Guidelines, Adopted Dec., 2011.pdf><OCA Response to Oregon (Draft) Low Back Pain Guidelines, May 2011.docx><OCA Coverage Guide LBPNon-Pharm.pdf>