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Clinical practice guidelines in Europe.
Title.
Management of low back pain based on scientific evidence.
Background.
Back pain ("common back pain") involves a first magnitude problem for all the industrialized countries due to its frequency, and labor and health care costs.
Usually, physicians do not consider the results of scientific studies when deciding their recommendations to patients. This means that a great number of patients are being subjected to inadequate or not indicated diagnostic procedures and treatments. This also represents a higher and unnecessary health care cost. This problem affects most European countries in the same proportion, although some have already implemented initiatives to rationally solve it.
Objective.
To set up a panel of European experts that would:
1) Analyze the available scientific evidence on the usefulness and indication criteria of each of the diagnostic procedures and treatments for back pain.
2) Identify the procedures that lack the necessary evaluation with sufficient scientific quality, thus defining the priority research areas.
3) Combine the procedures (diagnostic and therapeutic) whose usefulness is based on scientific evidence, establishing an intervention protocol based on scientific principles that would ensure the greatest efficiency (cost/outcome) of resources.
4) Spread and recommend the use of the intervention protocol among physicians and start the previously defined priority research projects.
Methodology.
The European investigators that participate in this study are fully familiar with clinical research methodology and thoroughly experienced in the management of back pain.
This Committee will be responsible for locating, evaluating the scientific quality, summarizing the available scientific studies concerning back pain, and structuring a clinical practice guideline based on quality scientific evidence.
With this objective, the work previously performed by other groups will be used [Cochrane Cooperative Group, Agency for Health Care Policy and Research (USA), Royal College of General Practitioners (UK)] and the scientific database will be updated and increased.
Finally, these guidelines will be widely disseminated in collaboration with the COST organization, dependent on the DGXII of the European Commission.
Participants, jointly with the Kovacs Foundation's Scientific Department.
Experts and specialized institutions in the following countries:
Germany: |
Ambulanz für Schmerzbehandlung Georg-August-University of Gottingen |
Austria: |
Ludwig Boltzmann Institut für Konservative Orthopädie und Abteilung für konservative Orthopädie des |
Belgium: |
Center Hospitalier Universitaire Brull |
Denmark: |
Odense University and Back Clinic Ringe |
Spain: |
Scientific Department |
Finland: |
Department of Physical and Rehabilitation Medicine |
France: |
INSERM Unite U 292 |
Holland: |
Department of Anatomy Spine and Joint Center Erasmus University Rotterdam |
Norway: |
Department of Biological and Medical Psychology University of Bergen |
Sweden: |
Department of Orthopaedics Gothenbourg University |
Switzerland: |
Dept. Maladies Rheumatismales Hôpital Cantonal de Fribourg |
The Spanish part of the project is entirely financed by the Kovacs Foundation. The COST organization, dependent on the DGXII -research- of the European Commission, assumes the international coordination expenses.
Status.
The project has been approved by the DGXII of the European Commission, and has been called the COST B13 project. The Spanish Ministers' Council has appointed the Foundation as the organization to represent Spain in this project.
The European Commission has put this project into effect on 8 September, 1999, and the Action has now begun.