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Implementing Stratified Primary Care Management for Low Back Pain

Overview of attention for article published in Spine, March 2015
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About this Attention Score

  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (92nd percentile)
  • High Attention Score compared to outputs of the same age and source (94th percentile)

Mentioned by

policy
1 policy source
twitter
24 tweeters
facebook
2 Facebook pages

Citations

dimensions_citation
15 Dimensions

Readers on

mendeley
32 Mendeley
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Title
Implementing Stratified Primary Care Management for Low Back Pain
Published in
Spine, March 2015
DOI 10.1097/brs.0000000000000770
Pubmed ID
Authors

David G. T. Whitehurst, Stirling Bryan, Martyn Lewis, Elaine M. Hay, Ricky Mullis, Nadine E. Foster

Abstract

Study Design. Within-study cost-utility analysis.Objectives. To explore the cost-utility of implementing stratified care for low back pain (LBP) in general practice, compared with usual care, within risk-defined patient subgroups (that is, patients at low, medium and high risk of persistent disabling pain).Summary of Background Data. Individual-level data collected alongside a prospective, sequential comparison of separate patient cohorts with six-month follow-up.Methods. Adopting a cost-utility framework, the base case analysis estimated the incremental LBP-related healthcare cost per additional quality-adjusted life year (QALY) by risk subgroup. QALYs were constructed from responses to the three-level EQ-5D, a preference-based health-related quality of life instrument. Uncertainty was explored with cost-utility planes and acceptability curves. Sensitivity analyses examined alternative methodological approaches, including a complete case analysis, the incorporation of non-back pain-related healthcare use and estimation of societal costs relating to work absence.Results. Stratified care was a dominant treatment strategy compared with usual care for patients at high risk, with mean healthcare cost savings of £124 and an incremental QALY estimate of 0.023. The likelihood that stratified care provides a cost-effective use of resources for patients at low and medium risk is no greater than 60% irrespective of a decision makers' willingness-to-pay for additional QALYs. Patients at medium and high risk of persistent disability in paid employment at six-month follow-up reported, on average, six fewer days of LBP-related work absence in the stratified care cohort compared with usual care (associated societal cost savings per employed patient of £736 and £652, respectively).Conclusions. At the observed level of adherence to screening tool recommendations for matched treatments, stratified care for LBP is cost-effective for patients at high risk of persistent disabling LBP only.

Twitter Demographics

The data shown below were collected from the profiles of 24 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 32 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Australia 1 3%
United Kingdom 1 3%
Unknown 30 94%

Demographic breakdown

Readers by professional status Count As %
Student > Master 8 25%
Student > Ph. D. Student 5 16%
Researcher 5 16%
Other 3 9%
Student > Doctoral Student 3 9%
Other 8 25%
Readers by discipline Count As %
Medicine and Dentistry 8 25%
Unspecified 7 22%
Nursing and Health Professions 7 22%
Psychology 3 9%
Social Sciences 2 6%
Other 5 16%

Attention Score in Context

This research output has an Altmetric Attention Score of 17. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 10 September 2017.
All research outputs
#777,335
of 12,372,326 outputs
Outputs from Spine
#265
of 6,634 outputs
Outputs of similar age
#20,800
of 265,930 outputs
Outputs of similar age from Spine
#7
of 127 outputs
Altmetric has tracked 12,372,326 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 93rd percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 6,634 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 5.7. This one has done particularly well, scoring higher than 96% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 265,930 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 92% of its contemporaries.
We're also able to compare this research output to 127 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 94% of its contemporaries.