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Assessment and Management of Back Pain

Assessment and Management of Back Pain Letters the need for increased vigilance. While we acknowledge that the intensive care unit (ICU) is, and will always remain, a high- To the Editor We wish to congratulate Mafi and colleagues on intensity monitoring and treatment environment, in our ar- their article “Worsening Trends in the Management and Treat- ticle we explicated that more intensive monitoring and treat- ment of Back Pain.” The assessment and management of back ment is in many cases not associated with better outcome and pain has long been recognized as suboptimal in the United may even do harm. We therefore do not agree with the au- States, with perceived overutilization of health services that thors’ suggestion that any reduction in vigilance, monitor- are not in accordance with recommendations from evidence- ing, and treatment intensity will lead to undesirable clinical based clinical practice guidelines (CPGs) and underutiliza- outcomes because there is simply no evidence to support this. tion of recommended health services. Nevertheless, this ar- For instance, with regard to monitoring, a recent meta- ticle has stimulated additional thought on several issues that analysis confirmed the results found in the observational warrant attention. study we initially referred to by showing that a restrictive chest http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA Internal Medicine American Medical Association

Assessment and Management of Back Pain

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References (7)

Publisher
American Medical Association
Copyright
Copyright 2014 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.
ISSN
2168-6106
eISSN
2168-6114
DOI
10.1001/jamainternmed.2013.13692
pmid
24590092
Publisher site
See Article on Publisher Site

Abstract

Letters the need for increased vigilance. While we acknowledge that the intensive care unit (ICU) is, and will always remain, a high- To the Editor We wish to congratulate Mafi and colleagues on intensity monitoring and treatment environment, in our ar- their article “Worsening Trends in the Management and Treat- ticle we explicated that more intensive monitoring and treat- ment of Back Pain.” The assessment and management of back ment is in many cases not associated with better outcome and pain has long been recognized as suboptimal in the United may even do harm. We therefore do not agree with the au- States, with perceived overutilization of health services that thors’ suggestion that any reduction in vigilance, monitor- are not in accordance with recommendations from evidence- ing, and treatment intensity will lead to undesirable clinical based clinical practice guidelines (CPGs) and underutiliza- outcomes because there is simply no evidence to support this. tion of recommended health services. Nevertheless, this ar- For instance, with regard to monitoring, a recent meta- ticle has stimulated additional thought on several issues that analysis confirmed the results found in the observational warrant attention. study we initially referred to by showing that a restrictive chest

Journal

JAMA Internal MedicineAmerican Medical Association

Published: Mar 1, 2014

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