TY - JOUR
T1 - Network meta-analysis for comparative effectiveness of treatments for chronic low back pain disorders
T2 - Systematic review protocol
AU - Belavy, Daniel L.
AU - Diwan, Ashish D.
AU - Ford, Jon
AU - Miller, Clint T.
AU - Hahne, Andrew J.
AU - Mundell, Niamh
AU - Tagliaferri, Scott
AU - Bowe, Steven
AU - Pedder, Hugo
AU - Saueressig, Tobias
AU - Zhao, Xiaohui
AU - Chen, Xiaolong
AU - Balasundaram, Arun Prasad
AU - Arora, Nitin Kumar
AU - Owen, Patrick J.
N1 - Publisher Copyright:
© 2021 Author(s) (or their employer(s)). Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2021/11/29
Y1 - 2021/11/29
N2 - Introduction Chronic low back pain disorders (CLBDs) present a substantial societal burden; however, optimal treatment remains debated. To date, pairwise and network meta-analyses have evaluated individual treatment modes, yet a comparison of a wide range of common treatments is required to evaluate their relative effectiveness. Using network meta-analysis, we aim to evaluate the effectiveness of treatments (acupuncture, education or advice, electrophysical agents, exercise, manual therapies/manipulation, massage, the McKenzie method, pharmacotherapy, psychological therapies, surgery, epidural injections, percutaneous treatments, traction, physical therapy, multidisciplinary pain management, placebo, â € usual care' and/or no treatment) on pain intensity, disability and/or mental health in patients with CLBDs. Methods and analysis Six electronic databases and reference lists of 285 prior systematic reviews were searched. Eligible studies will be randomised controlled/clinical trials (including cross-over and cluster designs) that examine individual treatments or treatment combinations in adult patients with CLBDs. Studies must be published in English, German or Chinese as a full-journal publication in a peer-reviewed journal. A narrative approach will be used to synthesise and report qualitative and quantitative data, and, where feasible, network meta-analyses will be performed. Reporting of the review will be informed by Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidance, including the network meta-analysis extension (PRISMA-NMA). The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach for network meta-analysis will be implemented for assessing the quality of the findings. Ethics and dissemination Ethical approval is not required for this systematic review of the published data. Findings will be disseminated via peer-reviewed publication.
AB - Introduction Chronic low back pain disorders (CLBDs) present a substantial societal burden; however, optimal treatment remains debated. To date, pairwise and network meta-analyses have evaluated individual treatment modes, yet a comparison of a wide range of common treatments is required to evaluate their relative effectiveness. Using network meta-analysis, we aim to evaluate the effectiveness of treatments (acupuncture, education or advice, electrophysical agents, exercise, manual therapies/manipulation, massage, the McKenzie method, pharmacotherapy, psychological therapies, surgery, epidural injections, percutaneous treatments, traction, physical therapy, multidisciplinary pain management, placebo, â € usual care' and/or no treatment) on pain intensity, disability and/or mental health in patients with CLBDs. Methods and analysis Six electronic databases and reference lists of 285 prior systematic reviews were searched. Eligible studies will be randomised controlled/clinical trials (including cross-over and cluster designs) that examine individual treatments or treatment combinations in adult patients with CLBDs. Studies must be published in English, German or Chinese as a full-journal publication in a peer-reviewed journal. A narrative approach will be used to synthesise and report qualitative and quantitative data, and, where feasible, network meta-analyses will be performed. Reporting of the review will be informed by Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidance, including the network meta-analysis extension (PRISMA-NMA). The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach for network meta-analysis will be implemented for assessing the quality of the findings. Ethics and dissemination Ethical approval is not required for this systematic review of the published data. Findings will be disseminated via peer-reviewed publication.
KW - back pain
KW - pain management
KW - rehabilitation medicine
KW - spine
UR - http://www.scopus.com/inward/record.url?scp=85121031433&partnerID=8YFLogxK
U2 - 10.1136/bmjopen-2021-057112
DO - 10.1136/bmjopen-2021-057112
M3 - Review Article
C2 - 34845083
AN - SCOPUS:85121031433
SN - 2044-6055
VL - 11
JO - BMJ Open
JF - BMJ Open
IS - 11
M1 - e057112
ER -
