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Efficacy and acceptability of pharmacological and non-pharmacological interventions for non-specific chronic low back pain: a protocol for a systematic review and network meta-analysis

Authors
 Trevor Thompson  ;  Sofia Dias  ;  Damian Poulter  ;  Sharon Weldon  ;  Lucy Marsh  ;  Claire Rossato  ;  Jae Il Shin  ;  Joseph Firth  ;  Nicola Veronese  ;  Elena Dragioti  ;  Brendon Stubbs  ;  Marco Solmi  ;  Christopher G Maher  ;  Andrea Cipriani  ;  John P A Ioannidis 
Citation
 SYSTEMATIC REVIEWS, Vol.9(1) : 130, 2020-06 
Journal Title
 SYSTEMATIC REVIEWS 
Issue Date
2020-06
Keywords
Low back pain ; Network meta-analysis ; Protocol ; Randomized controlled trial ; Systematic review
Abstract
Background: Despite the enormous financial and humanistic burden of chronic low back pain (CLBP), there is little consensus on what constitutes the best treatment options from a multitude of competing interventions. The objective of this network meta-analysis (NMA) is to determine the relative efficacy and acceptability of primary care treatments for non-specific CLBP, with the overarching aim of providing a comprehensive evidence base for informing treatment decisions. Methods: We will perform a systematic search to identify randomised controlled trials of interventions endorsed in primary care guidelines for the treatment of non-specific CLBP in adults. Information sources searched will include major bibliographic databases (MEDLINE, Embase, CENTRAL, CINAHL, PsycINFO and LILACS) and clinical trial registries. Our primary outcomes will be patient-reported pain ratings and treatment acceptability (all-cause discontinuation), and secondary outcomes will be functional ability, quality of life and patient/physician ratings of overall improvement. A hierarchical Bayesian class-based NMA will be performed to determine the relative effects of different classes of pharmacological (NSAIDs, opioids, paracetamol, anti-depressants, muscle relaxants) and non-pharmacological (exercise, patient education, manual therapies, psychological therapy, multidisciplinary approaches, massage, acupuncture, mindfulness) interventions and individual treatments within a class (e.g. NSAIDs: diclofenac, ibuprofen, naproxen). We will conduct risk of bias assessments and threshold analysis to assess the robustness of the findings to potential bias. We will compute the effect of different interventions relative to placebo/no treatment for both short- and long-term efficacy and acceptability. Discussion: While many factors are important in selecting an appropriate intervention for an individual patient, evidence for the analgesic effects and acceptability of a treatment are key factors in guiding this selection. Thus, this NMA will provide an important source of evidence to inform treatment decisions and future clinical guidelines. Systematic review registration: PROSPERO registry number: CRD42019138115.
Files in This Item:
T202004762.pdf Download
DOI
10.1186/s13643-020-01398-3
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아과학교실) > 1. Journal Papers
Yonsei Authors
Shin, Jae Il(신재일) ORCID logo https://orcid.org/0000-0003-2326-1820
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/180438
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