Health Services Research/Cost Effectiveness
Secondary Topic: Manual medicine/body work (including chiropractic and massage)
Tertiary Topic: Research Methodology
Study protocol: Estimating the cost-effectiveness of spinal manipulation, exercise, or self-management for neck or back pain in the United States using an individual participant data meta-analysis approach.
Brent Leininger, DC; Gert Bronfort, DC, PhD, , Minneapolis, MN, United States; Roni Evans, DC, MS, PhD, University of Minnesota, Minneapolis, MN, United States; Jim Hodges, PhD; Pamela Jo Johnson, MPH, PhD; Karen Kuntz, ScD; John Nyman, PhD, , Minneapolis, MN, United States
Late Breaker: No
Spinal pain is a common and disabling condition with considerable socioeconomic burden. The management of spinal pain in the United States has gathered increased scrutiny amidst concerns of overutilization of costly and potentially harmful interventions and diagnostic tests. Complimentary and integrative healthcare interventions such as spinal manipulation may provide value for the care of spinal pain, but little is known regarding the cost-effectiveness of these interventions within the U.S. Our primary objective for this project is to estimate the incremental cost-effectiveness of spinal manipulation, exercise therapy, and self-management for spinal pain using an individual patient data meta-analysis approach.
We will estimate the incremental cost-effectiveness of spinal manipulation, exercise therapy, and self-management for spinal pain using cost and clinical outcome data collected alongside eight randomized clinical trials performed in the U.S. Cost-effectiveness will be assessed from both societal and healthcare perspectives using QALYs, pain intensity, and disability as effectiveness measures. The eight randomized clinical trials were selected because they used similar methods, collected similar clinical outcome, healthcare utilization, and work productivity data, and included different combinations of SMT, exercise therapy, or self-management for spinal pain. A two-stage approach to individual patient data meta-analysis will be conducted.
This project represents a unique opportunity to combine clinical and economic data collected alongside a number of clinical trials with similar methodologies. The findings will provide important information on the value of spinal manipulation, exercise therapy, and self-management for spinal pain in the U.S.