Low back pain and associated disorders are a major social, political, economic, and medical problem in the United States. Approximately 80% of adults will suffer a memorable episode of low back pain, 14% of adults will have episodes lasting more than two weeks in any given year, and back pain is the 5th most common reason for presentation to a physician. Furthermore, low back pain is the major cause of compensable disability in North America. Treatment of persistent low back pain is problematic from a medical perspective. Although several treatment modalities have demonstrated efficacy for the treatment of radiculopathy, neurogenic claudication, and spinal deformity, numerous operative and non-operative measures are widely employed without evidence for a significant impact on outcome. Funding is sought to support a scientific meeting focused on mechanisms for evaluating the effectiveness of various treatments for low back disorders, primarily in the Medicare population. The specific issues to be addressed at this conference include the establishment of coding homogeneity between participating centers and practitioners from different backgrounds;the establishment of consistent diagnostic criteria for justification of the clinical codes used;the establishment of valid, responsive, reliable, and relevant outcomes measures to be used across the low back pain population as well as secondary outcomes measures to be used in selected subsets;the establishment of a user friendly yet secure and HIPAA compliant database management system;and the establishment of a reporting mechanism for communication of results. It is hoped that the proceedings of this meeting will serve as a template for the development of prospective registry based outcomes measures which will provide information as to the comparative effectiveness of different treatment modalities for low back disorders.
Lower back pain and related disorders are a major medical and societal problem in the United States. Establishing the relative efficacy of various treatments for lower back disorders has been impossible due to differences in diagnostic definitions, outcomes measures, and patient populations. We intend to establish a mechanism by which physicians of many specialties can contribute to a prospective database in order to allow for the comparison of outcomes following different treatments for similar disorders. The first step in this process is to agree upon the definitions, outcomes measures, and reporting mechanisms to be used. The proposed conference will be an important step in gathering relevant stakeholders together to work out the components of such a database. This is the first attempt to coordinate input from multiple medical societies, the insurance industry, and government overseers.
