EFFECTIVENESS OF TREATMENT STRATEGIES FOR LOW BACK PAIN

这项建议是为了建立和延长工作的低回 疼痛患者结局研究小组（PORT）。 本发明的目的在于提供 更明确的信息，用于完善和实施临床 关于腰椎手术及其替代方案的指南。 这个项目 将设在卫生服务部在大学 华盛顿，在医学院的广泛参与下， 普吉特海湾团体健康合作社和缅因州医疗评估 基金会 该项目的具体目标是：（1） 坐骨神经痛或椎管狭窄，比较长期的功能和工作- 替代手术和非手术治疗的相关结局;以及 (2)评估背痛指南和医疗改革的影响 在区域和国家背部手术率趋势方面所做的努力， 再手术率、融合率和非手术住院率。 为了实现这些目标，我们建议继续长期跟踪 超过600名手术和非手术治疗的患者， 缅因州社区队列研究。 此外，我们建议每年分析 来自华盛顿州医院出院登记处的最新数据， 国家医院出院调查和医疗保险索赔，以评估 对与港口有关的活动的反应，新的指导方针， 国家卫生保健改革工作。 这些分析将采用 案例选择和协方差调整的有效分析方法 由港口开发，可以相对有效地完成， 便宜地。

This proposal is intended to build on and extend the work of the low back pain Patient Outcome Research Team (PORT). It is intended to provide more definitive information for refining and implementing clinical guidelines about lumbar spine surgery and its alternatives. This project will be based in the Department of Health Services at the University of Washington, with extensive involvement by the School of Medicine, the Group Health Cooperative of Puget Sound, and the Maine Medical Assessment Foundation. Specific aims of the project are: (1) for patients with sciatica or spinal stenosis, to compare long-term functional and work- related outcomes of alternative surgical and nonsurgical treatments; and (2) to assess the impact of back pain guidelines and health care reform efforts on regional and national trends in back surgery rates, reoperation rates, fusion rates, and nonsurgical hospitalization rates. To accomplish these aims, we propose continued long-term follow-up of over 600 surgically and nonsurgically treated patients in the ongoing Maine community-based cohort study. Also, we propose to analyze annually updated data from Washington State's hospital discharge registry, the National Hospital Discharge Survey, and Medicare claims, to assess responses to PORT-related activities, new guidelines, and state and national health care reform efforts. These analyses will employ validated analytic methods for case selection and comorbidity adjustment developed by the PORT, and can be accomplished relatively efficiently and inexpensively.