Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #99672

Dana J. Lawrence, DC¹, Bill Meeker, DC, MPH¹, and Marc S. Micozzi, MD, PhD². (1) Palmer Center for Chiropractic Research, 741 Brady Street, Davenport, IA 52803, 563-884-5302, dana.lawrence@palmer.edu, (2) Jefferson-Myrna Brind Center of Integrative Medicine, Thomas Jefferson University Hospital, 1015 Chestnut St, Suite 820, Philadelphia, PA 19107

Objective: To review the literature, and develop evidence-based best practice recommendations for the use of spinal manipulation in the treatment and management of low back pain by chiropractors and CAM practitioners. Methods: A systematic review of the literature was conducted. All papers (over 700) were categorized and all randomized trials, systematic reviews or guidelines were sent to an expert panel for rating. Randomized trials were rated using an instrument developed by Bronfort; guidelines by the AGREE instrument; and systematic reviews by the MOOSE instrument. Cut-off points were developed for a quality rating. A series of 5 consensus seed statements were circulated to a panel of experts, who then offered a consensus rating for each.. Results: Five consensus statements results: (1) Established for patients with chronic low back pain of greater than 6 weeks duration: Rating A (29 trials, 18 rated highly); (2) Established for patients with low back pain of 2-6 weeks duration: Rating A (6 trials, 3 rated highly); (3) Established for patients low back pain of less than 2 weeks duration: Rating A (23 trials, 9 rated highly); (4) Established for patients with low back pain and radiating leg pain, sciatica or radiculopathy: Rating AB (6 trials, 0 rated highly); (5) Established for other specific conditions affecting the low back: Rating C (2 trials, 0 rated highly). Conclusion: This paper reports on the consensus process and conclusions drawn in the development of best practice recommendations for the use of manipulation for low back pain.

Learning Objectives: At the conclusion of the session, the participant in this session will be able to

• Understand the process of developing best practice recommendations; and
• Understand the application of three quality rating tools to types of scientific literature.

Keywords: Chiropractic, Evidence Based Practice

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Recorded presentation