INFORMATION FOR THE GENERAL PUBLIC ON THE WEB OF THE BACK
The Web of the Back (indistinctly www.espalda.org
or www.weboftheback.org) is the Reference Center on the back
and its disorders. It contains information aimed at professionals
and the general public, including how the back is structured
and how it works. The Web provides all of the important information
about such topics as prevention, diagnosis, treatment, prognosis,
economic analysis and the comparative effectiveness of different
strategies for patient management.
The disorders to which the Web refers are those known as
the "mechanical pathologies of the spine". They
are the ailments in which the pain varies according to posture,
movement and exertion, and are not due to systemic illnesses
such as cancer or infections. They are the most common cause
of back pain and include such diagnoses as arthrosis, disc
hernia, disc protrusion, muscle contraction, scoliosis, spondylolisthesis,
and spinal stenosis.
This section refers to the information on the Web of the
Back aimed at the general public. Its scientific area, aimed
at health care professionals, is described here.
Background.
Scientific studies show that it is very useful
for patients to have reliable information about their ailment,
to know why and how it appears, the methods available for
diagnosing and treating it and how to prevent it from reappearing
in the future.
However, this information takes a lot of time to explain,
and practicing physicians do not usually have this time. Furthermore,
it is sometimes hard for them to describe medical issues in
an easily comprehensible language, and they usually do not
have the kind of illustrations, graphs or visual aids to help
make themselves clear. Finally, the information communicated
should be up to date and based on the best scientific evidence
possible. When it is not, it could lead the patient to adopt
inappropriate attitudes or make the wrong decisions about
his or her problem and can be counterproductive.
All conscientious physicians would like to provide their
patients the information they need to be able to understand
the nature of their illness, how to treat it, what to expect
from the applied treatments and how to prevent it from reappearing.
But in fact, most doctors lack the time and means necessary
to be able to do so effectively.
In this sense, the Internet can be a tremendously useful
tool. However, to create and maintain an up-to-date Web page
which includes extensive, reliable and understandable information
requires significant work and investment. Mechanisms must
be structured to assure that the information included is true
and be able to detect that which arises as the fruit of scientific
and technical development. Furthermore, it must ensure that
the information is presented in a manner that can be understood
by the general public.
Additionally, it is also important to ensure the impartiality
of the mechanisms of the search, selection, evaluation and
summary of the information. In fact, the immense majority
of Web pages with health information has been developed by
for-profit entities and thus responds to commercial objectives,
and the information they include does not meet the strict
standards which are to be desired.
Objective.
The essential objective of the Information
for the General Public section of the Web of the Back is to
provide the non-medical public the most complete, clearest
and reliable information on the back and its ailments, in
order to be of practical use.
Description.
The Web is bilingual (Spanish/English) and
free of charge for its users. It is divided into a general
information section for the broader, non-technical public
and a scientific section, designed for health professionals.
The main contents of the general information
area of the Web of the Back are based on the results of the
scientific studies which, once evaluated in the Web's scientific
area, are considered of sufficient methodological quality
so as to provide reliable results. These are then summarized
and rewritten in non-technical language to be comprehensible
to the non-professional public. In both the Spanish and English
versions, all of the contents are reviewed by experts in communication,
Spanish editors and native English-speakers.
The main contents of the General Information section of the
Web of the Back are:
-
How the back
and spine are formed and how they function.
-
Description of back anomalies and illnesses.
-
Diagnostic methods: describing what they
consist of, what they are able to detect, what risks they
entail and in what cases the existing scientific evidence
recommends their use.
-
Treatments used: describing in detail
for each, what they consist of, their objective, their
theoretical basis, the available scientific evidence of
their efficacy, their risks and counter-indications, and
in what cases they are recommended by the existing clinical
guidelines.
-
Treatment standards, as recommended by
the available scientific evidence, in which the order
of the different treatments and their indications are
presented.
-
How to avoid back pain: all of the measures
that have been proven effective in preventing back pain,
including the patient's attitude toward pain, the importance
of avoiding or limiting bed rest in the event of a painful
episode in order to shorten its duration and prevent relapses,
and the norms of correct posture that reduce the load
on the back. These norms are classified both by activity
and by specific segments of the population, as for example,
in different sports, jobs or household chores, or among
school children and adolescents, senior citizens or the
general public.
-
Exercises designed for the appropriate
muscle groups: written and illustrated with graphic descriptions
of the appropriate exercises to increase strength, resistance
and flexibility of the muscle groups involved in the functioning
of the back.
-
Glossary of medical terms, aimed at explaining
their meaning to the general public.
In addition to constantly bringing the information
it offers up to date, the Web adds new information that its
users request or that it finds useful to present such as:
-
Brief summary of the basic concepts presented in the
Web that allows the user to get a general and rapid idea
of its contents.
-
User's Guide to the Web, which makes navigation and finding
the exact information one is looking for easier.
-
Specific information for concrete groups, such as pregnant
women, sedentary or overweight people.
It should be stressed that the Web of the Back does not provide
on-line medical consultation. As is repeatedly pointed out
on the Web, physical examination is essential in order to
determine the kind of prevention or the treatments appropriate
to each given person. So it is necessary to consult a competent
professional in person. The Website provides information,
but it can never take the place of a doctor's visit for a
specific case.
The work methods and contents of the General Information
area of the Web of the Back are reviewed by its Editorial
Committee, made up of prestigious experts in specializations
related to the treatment of back problems, such as primary
care physicians, traumatologists and neurosurgeons. An up-to-date
list of the members of the Editorial Committee can be found
in the General Information section of the Web of the Back
(either www.espalda.org or www.weboftheback.org).
Along with the Kovacs Foundation, the following
participate in this project.
-
A multidisciplinary and international team of more than
80 experts in medical documentation, research methodology,
medical translation and clinical specializations related
to ailments of the back, working together through the
Internet
-
The Web of the Back is non-profit and free of charge,
so that it is funded through the contributions of its
sponsors, who as of June 2004 are the Kovacs Foundation,
the Spanish Red Cross, the Spanish National Organization
of the Blind (ONCE), Flex and the Telefónica Foundation
Status.
Between January 2001 and June 2004, the Web of the Back received
more than 5 million visitors from all around the world. The
analysis of the evolution of visits shows a spectacular increase:
the number of visitors to the site has increased at an average
rate of 500% per year.
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