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Research Studies is a compilation of published research articles funded by 大象视频or authored by 大象视频researchers.

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1 to 8 of 8 Research Studies Displayed
Fenton JJ, Cipri C, Gosdin M
Standardized patient communication and low-value spinal imaging: a randomized clinical trial.
This randomized clinical trial鈥檚 objective was to evaluate the effect of a standardized patient-delivered intervention on rates of low-value spinal imaging among primary care patients with acute low back pain. Physicians or advanced practice clinicians were recruited from 10 adult primary care or urgent care clinics. The intervention clinician group received 3 simulated office visits, each with a standardized patient instructor (SPI) portraying a patient with acute uncomplicated back pain. Primary outcome was lumbar spinal imaging completion within 90 days of acute low back pain visits, with study clinicians assessed up to 18 months of follow-up. The secondary outcomes were cervical spine imaging completion after acute neck pain visits, any imaging completion after an adult visit, patient experience ratings of clinicians, and use of targeted communication skills during an audio-recorded standardized patient evaluation visit. A total of 53 clinicians were included, with 25 in the intervention group, and 28 in the control group. Patients with acute low back pain who saw intervention and control clinicians during follow-up had similar rates of lumbar imaging. Adjusted follow-up rates of imaging for acute neck pain and overall imaging were not significantly different among patients of intervention and control clinicians. Intervention and control clinicians had similar mean (SD) patient experience ratings during follow-up. During audio-recorded standardized patient visits, intervention clinicians had significantly better ratings than controls on eliciting the patient's perspective and conveying empathy.
AHRQ-funded; HS026415.
Citation: Fenton JJ, Cipri C, Gosdin M . Standardized patient communication and low-value spinal imaging: a randomized clinical trial. https://www.pubmed.ncbi.nlm.nih.gov/39504026.
Keywords: Communication, Imaging, Back Health and Pain, Primary Care, Pain
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
O'Reilly-Jacob M, Perloff J, Buerhaus P
Comparing the rates of low-value back images ordered by physicians and nurse practitioners for Medicare beneficiaries in primary care.
This study measures the rates of low-value back images ordered by primary care physicians and nurse practitioners for Medicare beneficiaries, and there was no detectable difference between the two groups in 2012 and 2013.
AHRQ-funded; HS00062.
Citation: O'Reilly-Jacob M, Perloff J, Buerhaus P . Comparing the rates of low-value back images ordered by physicians and nurse practitioners for Medicare beneficiaries in primary care. Nurs Outlook 2019 Nov - Dec;67(6):713-24. doi: 10.1016/j.outlook.2019.05.005..
Keywords: Imaging, Back Health and Pain, Primary Care, Imaging, Pain
Fritz JM, Kim M, Magel JS
Cost-effectiveness of primary care management with or without early physical therapy for acute low back pain: economic evaluation of a randomized clinical trial.
The objective of this study was to compare costs and cost-effectiveness of usual primary care management for patients with acute low back pain with or without the addition of early physical therapy. The authors suggest that their results support early physical therapy as cost-effective relative to usual primary care after 1 year for patients with acute, nonspecific lower back pain.
AHRQ-funded; HS018672.
Citation: Fritz JM, Kim M, Magel JS . Cost-effectiveness of primary care management with or without early physical therapy for acute low back pain: economic evaluation of a randomized clinical trial. Spine 2017 Mar;42(5):285-90. doi: 10.1097/brs.0000000000001729..
Keywords: Back Health and Pain, Healthcare Costs, Pain, Primary Care
Tan A, Zhou J, Kuo YF
Variation among primary care physicians in the use of imaging for older patients with acute low back pain.
The authors sought to estimate the variation among primary care providers (PCPs) in the use of diagnostic imaging for older patients with non-specific acute low back pain. They used Texas Medicare claims data and tracked whether each patient received lumbar imaging within 4 weeks of the initial visit. They found that the specific physician seen by a patient accounted for 25 % of the variability in whether imaging was performed and that the use of imaging by individual physicians was stable over time.
AHRQ-funded; HS022134.

Citation: Tan A, Zhou J, Kuo YF . Variation among primary care physicians in the use of imaging for older patients with acute low back pain. J Gen Intern Med 2016 Feb;31(2):156-63. doi: 10.1007/s11606-015-3475-3.

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Keywords: Back Health and Pain, Elderly, Imaging, Primary Care, Practice Patterns
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
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

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