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2. Causally-interpretable meta-analysis: clearly-defined causal effects and two case studies

Author

Rott, Kollin W., Bronfort, Gert, Chu, Haitao, Huling, Jared D., Leininger, Brent, Murad, Mohammad Hassan, Wang, Zhen, and Hodges, James S.

Subjects
Statistics - Methodology, Statistics - Applications
Abstract

Meta-analysis is commonly used to combine results from multiple clinical trials, but traditional meta-analysis methods do not refer explicitly to a population of individuals to whom the results apply and it is not clear how to use their results to assess a treatment's effect for a population of interest. We describe recently-introduced causally-interpretable meta-analysis methods and apply their treatment effect estimators to two individual-participant data sets. These estimators transport estimated treatment effects from studies in the meta-analysis to a specified target population using individuals' potentially effect-modifying covariates. We consider different regression and weighting methods within this approach and compare the results to traditional aggregated-data meta-analysis methods. In our applications, certain versions of the causally-interpretable methods performed somewhat better than the traditional methods, but the latter generally did well. The causally-interpretable methods offer the most promise when covariates modify treatment effects and our results suggest that traditional methods work well when there is little effect heterogeneity. The causally-interpretable approach gives meta-analysis an appealing theoretical framework by relating an estimator directly to a specific population and lays a solid foundation for future developments., Comment: 31 pages, 2 figures Submitted to Research Synthesis Methods

Published
2023

3. Effectiveness of spinal manipulation and biopsychosocial self-management compared to medical care for low back pain: a randomized trial study protocol

Author

Bronfort, Gert, Delitto, Anthony, Schneider, Michael, Heagerty, Patrick J., Chou, Roger, Connett, John, Evans, Roni, George, Steven, Glick, Ronald M., Greco, Carol, Hanson, Linda, Keefe, Francis, Leininger, Brent, Licciardone, John, McFarland, Christine, Meier, Eric, Schulz, Craig, and Turk, Dennis

Published
2023
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5. Telehealth Mindfulness-Based Interventions for Chronic Pain: The LAMP Randomized Clinical Trial.

Author

Burgess, Diana J., Calvert, Collin, Hagel Campbell, Emily M., Allen, Kelli D., Bangerter, Ann, Behrens, Kimberly, Branson, Mariah, Bronfort, Gert, Cross, Lee J. S., Evans, Roni, Ferguson, John E., Friedman, Jessica K., Haley, Alexander C., Leininger, Brent, Mahaffey, Mallory, Matthias, Marianne S., Meis, Laura A., Polusny, Melissa A., Serpa, J. Greg, and Taylor, Stephanie L.

Published
2024
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9. Causally interpretable meta‐analysis: Clearly defined causal effects and two case studies.

Author

Rott, Kollin W., Bronfort, Gert, Chu, Haitao, Huling, Jared D., Leininger, Brent, Murad, Mohammad Hassan, Wang, Zhen, and Hodges, James S.

Subjects
TREATMENT effectiveness, CLINICAL trials
Abstract

Meta‐analysis is commonly used to combine results from multiple clinical trials, but traditional meta‐analysis methods do not refer explicitly to a population of individuals to whom the results apply and it is not clear how to use their results to assess a treatment's effect for a population of interest. We describe recently‐introduced causally interpretable meta‐analysis methods and apply their treatment effect estimators to two individual‐participant data sets. These estimators transport estimated treatment effects from studies in the meta‐analysis to a specified target population using the individuals' potentially effect‐modifying covariates. We consider different regression and weighting methods within this approach and compare the results to traditional aggregated‐data meta‐analysis methods. In our applications, certain versions of the causally interpretable methods performed somewhat better than the traditional methods, but the latter generally did well. The causally interpretable methods offer the most promise when covariates modify treatment effects and our results suggest that traditional methods work well when there is little effect heterogeneity. The causally interpretable approach gives meta‐analysis an appealing theoretical framework by relating an estimator directly to a specific population and lays a solid foundation for future developments. [ABSTRACT FROM AUTHOR]

Published
2024
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10. Effectiveness of Spinal Manipulation and Biopsychosocial Self-Management compared to Medical Care for Low Back Pain: A Randomized Trial Study Protocol

Author

Bronfort, Gert, primary, Delitto, Anthony, additional, Schneider, Michael, additional, Heagerty, Patrick, additional, Chou, Roger, additional, Connett, John, additional, Evans, Roni, additional, George, Steven, additional, Glick, Ronald, additional, Greco, Carol, additional, Hanson, Linda, additional, Keefe, Francis, additional, Leininger, Brent, additional, Licciardone, John, additional, McFarland, Christine, additional, Meier, Eric, additional, Schulz, Craig, additional, and Turk, Dennis, additional

Published
2023
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24. A united statement of the global chiropractic research community against the pseudoscientific claim that chiropractic care boosts immunity

Author

Côté, Pierre, Bussières, André, Cassidy, J. David, Hartvigsen, Jan, Kawchuk, Greg N., Leboeuf-Yde, Charlotte, Mior, Silvano, Schneider, Michael, Aillet, Luc, Ammendolia, Carlo, Arnbak, Bodil, Axen, Iben, Baechler, Mirjam, Barbier-Cazorla, Florian, Barbier, Gaëtan, Bergstrøm, Cecilia, Beynon, Amber, Blanchette, Marc André, Bolton, Philip S., Breen, Alan, Brinch, Johanne, Bronfort, Gert, Brown, Benjamin, Bruno, Paul, Konner, Mikkel Brunsgaard, Burrell, Christopher, Busse, Jason W., Byfield, David, Campello, Marco, Cancelliere, Carol, Carroll, Linda, Cedraschi, Christine, Chéron, Charlène, Chow, Ngai, Christensen, Henrik Wulff, Claussen, Stine, Corso, Melissa, Davis, Matthew A., Demortier, Marine, De Carvalho, Diana, De Luca, Katie, De Zoete, Annemarie, Doktor, Klaus, Downie, Aron, Du Rose, Alister, Eklund, Andreas, Engel, Roger, Erwin, Mark, Eubanks, James E., Evans, Roni, Evans, Will, Fernandez, Matthew, Field, Jonathan, Fournier, Gilles, French, Simon, Fuglkjaer, Signe, Gagey, Olivier, Giuriato, Rosemary, Gliedt, Jordan A., Goertz, Christine, Goncalves, Guillaume, Grondin, Diane, Gurden, Mark, Haas, Mitchell, Haldeman, Scott, Harsted, Steen, Hartvigsen, Lisbeth, Hayden, Jill, Hincapié, Cesar, Hébert, Jeffrey J., Hesby, Bue, Hestbæk, Lise, Hogg-Johnson, Sheilah, Hondras, Maria A., Honoré, Margaux, Howarth, Samuel, Injeyan, H. Stephen, Innes, Stanley, Irgens, Pernille Marie, Jacobs, Craig, Jenkins, Hazel, Jenks, Alan, Jensen, Tue Secher, Johhansson, Melker, Kongsted, Alice, Kopansky-Giles, Deborah, Kryger, Rikke, Lardon, Arnaud, Lauridsen, Henrik Hein, Leininger, Brent, Lemeunier, Nadège, Le Scanff, Christine, Lewis, Eugene A., Linaker, Kathleen, Lothe, Lise, Marchand, Andrée Anne, McNaughton, David, Meyer, Anne Laure, Miller, Peter, Mølgaard, Anne, Moore, Craig, Murphy, Donald R., Myburgh, Corrie, Myhrvold, Birgitte, Newell, Dave, Newton, Genevieve, Nim, Casper, Nordin, Margareta, Nyiro, Luana, O'Neill, Søren, Øverås, Cecilie, Pagé, Isabelle, Pasquier, Mégane, Penza, Charles W., Perle, Stephen M., Picchiottino, Mathieu, Piché, Mathieu, Poulsen, Erik, Quon, Jeffrey, Raven, Tim, Rezai, Mana, Roseen, Eric J., Rubinstein, Sidney, Salmi, Louis Rachid, Schweinhardt, Petra, Shearer, Heather M., Sirucek, Laura, Sorondo, Delphine, Stern, Paula J., Stevans, Joel, Stochkendahl, Mette Jensen, Stuber, Kent, Stupar, Maja, Srbely, John, Swain, Michael, Teodorczyk-Injeyan, Julita, Théroux, Jean, Thiel, Haymo, Uhrenholt, Lars, Verbeek, Anneke, Verville, Leslie, Vincent, Karl, Dan Wang, Andrew L., Weber, Kenneth A., Whedon, James M., Wong, Jessica, Wuytack, Francesca, Young, James, Yu, Hainan, Ziegler, Dorte, Kinesiology, Health Economics and Health Technology Assessment, APH - Methodology, APH - Societal Participation & Health, Amsterdam Movement Sciences, APH - Health Behaviors & Chronic Diseases, and AMS - Musculoskeletal Health

Subjects
lcsh:Diseases of the musculoskeletal system, Physical Therapy, Sports Therapy and Rehabilitation, Scientific evidence, 03 medical and health sciences, Politics, SDG 17 - Partnerships for the Goals, 0302 clinical medicine, SDG 3 - Good Health and Well-being, Pandemic, Credibility, Medicine, Humans, 030212 general & internal medicine, Chiropractic manipulation, Students, health care economics and organizations, business.industry, Publications, Pseudoscience, Immunity, lcsh:Chiropractic, Public relations, Chiropractic, Research Personnel, Coronavirus, Complementary and alternative medicine, Action (philosophy), lcsh:RZ201-275, Commentary, Spinal manipulation, Chiropractics, lcsh:RC925-935, business, 030217 neurology & neurosurgery
Abstract

Background In the midst of the coronavirus pandemic, the International Chiropractors Association (ICA) posted reports claiming that chiropractic care can impact the immune system. These claims clash with recommendations from the World Health Organization and World Federation of Chiropractic. We discuss the scientific validity of the claims made in these ICA reports. Main body We reviewed the two reports posted by the ICA on their website on March 20 and March 28, 2020. We explored the method used to develop the claim that chiropractic adjustments impact the immune system and discuss the scientific merit of that claim. We provide a response to the ICA reports and explain why this claim lacks scientific credibility and is dangerous to the public. More than 150 researchers from 11 countries reviewed and endorsed our response. Conclusion In their reports, the ICA provided no valid clinical scientific evidence that chiropractic care can impact the immune system. We call on regulatory authorities and professional leaders to take robust political and regulatory action against those claiming that chiropractic adjustments have a clinical impact on the immune system.

Published
2020

31. World Congress Integrative Medicine & Health 2017: Part one

Author

Brinkhaus, Benno, Falkenberg, Torkel, Haramati, Aviad, Willich, Stefan N, Briggs, Josephine P, Willcox, Merlin, Linde, Klaus, Theorell, Töres, Wong, Lisa M, Dusek, Jeffrey, Wu, Darong, Eisenberg, David, Berger, Bettina, Kemper, Kathi, Schröer, Beate, Klein, Hedda, Ferreri, Rosaria, Kaplan, Gary, Matthes, Harald, Rotter, Gabriele, Schiff, Elad, Arnon, Zahi, Hahn, Eckhard, Luberto, Christina M, Martin, David, Schwarz, Silke, Tauschel, Diethard, Flower, Andrew, Gramminger, Harsha, Gupta, Hedwig H, Gupta, S. N, Kerckhoff, Annette, Kessler, Christian S, Michalsen, Andreas, Kim, Eun S, Jang, Eun H, Kim, Rana, Jan, Sae B, Mittwede, Martin, Mohme, Wiebke, Arye, Eran, Bonucci, Massimo, Saad, Bashar, Breitkreuz, Thomas, Rossi, Elio, Kebudi, Rejin, Daher, Michel, Razaq, Samaher, Gafer, Nahla, Nimri, Omar, Hablas, Mohamed, Kienle, Gunver S, Samuels, Noah, Silbermann, Michael, Bandelin, Lena, Lang, Anna-Lena, Wartner, Eva, Holtermann, Christoph, Binstock, Maxwell, Riebau, Robert, Mujkanovic, Edin, Cramer, Holger, Lauche, Romy, Michalsen, Andres, Ward, Lesley, Irnich, Dominik, Stör, Wolfram, Burnstock, Geoffrey, Schaible, Hans-Georg, Ots, Thomas, Langhorst, Jost, Sundberg, Tobias, Amarell, Catherina, Anheyer, Melanie, Eckert, Marion, Ogal, Mercedes, Schönauer, Annette, Reisenberger, Birgit, Brand, Bernhard, Anheyer, Dennis, Dobos, Gustav, Kroez, Matthias, Ammendola, Aldo, Mao, Jun J, Witt, Claudia, Yang, Yufei, Oritz, Miriam, Horneber, Markus, Voiß, Petra, Rosenstiel, Alexandra, Amarell, Catharina, Schad, Friedemann, Schläppi, Marc, Kröz, Matthias, Büssing, Arndt, Sela, Gil, Avshalomov, David, Attias, Samuel, Cotton, Sian, Jong, Miek, Jong, Mats, Scheffer, Christian, Edelhäuser, Friedrich, AlBedah, Abdullah, Lee, Myeong S, Khalil, Mohamed, Ogawa, Keiko, Motoo, Yoshiharu, Arimitsu, Junsuke, Ogawa, Masao, Shimizu, Genki, Stange, Rainer, Kraft, Karin, Kuchta, Kenny, Watanabe, Kenji, Bonin, D, Gruber, Harald, Koch, Sabine, Pohlmann, Urs, Caldwell, Christine, Krantz, Barbara, Kortum, Ria, Martin, Lily, Wieland, Lisa S, Kligler, Ben, Fogerite, Susan, Zhang, Yuqing, Riva, John J, Lumpkin, Michael, Ratner, Emily, Ping, Liu, Jian, Pei, Hamme, Gesa-Meyer, Mao, Xiaosong, Chouping, Han, Schröder, Sven, Hummelsberger, Josef, Wullinger, Michael, Brodzky, Marc, Zalpour, Christoff, Langley, Julia, Weber, Wendy, Mudd, Lanay M, Wayne, Peter, Witt, Clauda, Weidenhammer, Wolfgang, Fønnebø, Vinjar, Boon, Heather, Steel, Amie, Bugarcic, Andrea, Rangitakatu, Melisa, Adams, Jon, Sibbritt, David, Wardle, Jon, Leach, Matthew, Schloss, Janet, Dieze, Helene, Ijaz, Nadine, Heinrich, Michael, Lewith, George, Graz, Bertrand, Adam, Daniela, Grabenhenrich, Linus, Ortiz, Miriam, Binting, Sylvia, Reinhold, Thomas, Andermo, Susanne, Nordberg, Johanna H, Arman, Maria, Bhasin, Manoj, Fan, Xueyi, Libermann, Towia, Fricchione, Gregory, Denninger, John, Benson, Herbert, Martin, David D, Boers, Inge, Vlieger, Arine, Teut, Michael, Ullmann, Alexander, Lotz, Fabian, Roll, Stephanie, Canella, Claudia, Mikolasek, Michael, Rostock, Matthias, Beyer, Jörg, Guckenberger, Matthias, Jenewein, Josef, Linka, Esther, Six, Claudia, Stoll, Sarah, Stupp, Roger, Witt, Claudia M, Chuang, Elisabeth, McKee, Melissa D, Klose, Petra, Lange, Silke, Chung, Vincent C H, Wong, Hoi L C, Wu, Xin Y, Wen, Grace Y G, Ho, Robin S T, Ching, Jessica Y L, Wu, Justin C Y, Coakley, Amanda, Flanagan, Jane, Annese, Christine, Empoliti, Joanne, Gao, Zishan, Liu, Xugang, Yu, Shuguang, Yan, Xianzhong, Liang, Fanrong, Hohmann, Christoph D, Steckhan, Nico, Ostermann, Thomas, Paetow, Arion, Hoff, Evelyn, Hu, Xiao-Yang, Wu, Ruo-Han, Logue, Martin, Blonde, Clara, Lai, Lily Y, Stuart, Beth, Fei, Yu-Tong, Moore, Michael, Liu, Jian-Ping, Jeitler, Michael, Zillgen, Hannah, Högl, Manuel, Stöckigt, Barbara, Seifert, Georg, Kessler, Christian, Khadivzadeh, Talat, Bashtian, Maryam H, Aval, Shapour B, Esmaily, Habibollah, Kim, Jihye, Kim, Keun H, Klocke, Carina, Joos, Stefanie, Koshak, Abdulrahman, Wie, Li, Koshak, Emad, Wali, Siraj, Alamoudi, Omer, Demerdash, Abdulrahman, Qutub, Majdy, Pushparaj, Peter, Kruse, Sigrid, Fischer, Isabell, Tremel, Nadine, Rosenecker, Joseph, Leung, Brenda, Takeda, Wendy, Liang, Ning, Feng, Xue, Liu, Jian-ping, Cao, Hui-juan, Shinday, Nina, Philpotts, Lisa, Park, Elyse, Fricchione, Gregory L, Yeh, Gloria, Munk, Niki, Zakeresfahani, Arash, Foote, Trevor R, Ralston, Rick, Boulanger, Karen, Özbe, Dominik, Gräßel, Elmar, Luttenberger, Katharina, Pendergrass, Anna, Pach, Daniel, Strobl, Judit, Chang, Yinhui, Pasura, Laura, Liu, Bin, Jäger, Sven F, Loerch, Ronny, Jin, Li, Icke, Katja, Shi, Xuemin, Paul, Friedemann, Rütz, Michaela, Lynen, Andreas, Schömitz, Meike, Vahle, Maik, Salomon, Nir, Lang, Alon, Lahat, Adi, Kopylov, Uri, Horin, Shomron, Noi, Ofir, Avidan, Benjamin, Elyakim, Rami, Gamus, Dorit, NG, Siew, Chang, Jessica, Wu, Justin, Kaimiklotis, John, Schumann, Dania, Buttó, Ludovica, Haller, Dirk, Smith, Caroline, Lacey, Sheryl, Chapman, Michael, Ratcliffe, Julie, Johnson, Neil, Lyttleton, Jane, Boothroyd, Clare, Fahey, Paul, Tjaden, Bram, Vliet, Marja, Wietmarschen, Herman, Tröger, Wilfried, Vuolanto, Pia, Aarva, Paulina, Sorsa, Minna, Helin, Kaija, Wenzel, Claudia, Zoderer, Iris, Pammer, Patricia, Simon, Patrick, Tucek, Gerhard, Wode, Kathrin, Henriksson, Roger, Sharp, Lena, Stoltenberg, Anna, ying, Yang, Wang, Li-qiong, Li, Jin-gen, Wang, Ying, Balneaves, Lynda, Capler, Rielle, Bocci, Chiara, Guffi, Marta, Paolini, Marina, Meaglia, Ilaria, Porcu, Patrizia, Ivaldi, Giovanni B, Dragan, Simona, Bucuras, Petru, Pah, Ana M, Petrescu, Marius, Buleu, Florina, Stoichescu, Gheorghe, Christodorescu, Ruxandra, Kao, Lan, Cho, Yumin, Klafke, Nadja, Mahler, Cornelia, von Hagens, Cornelia, Uhlmann, Lorenz, Bentner, Martina, Schneeweiß, Andreas, Mueller, Andreas, Szecsenyi, Joachim, Neri, Isabella, Schnabel, Katharina, Cree, Margit, Suhr, Ralf, Baccetti, Sonia, Firenzuoli, Fabio, Monechi, Maria V, Stefano, Mariella, Amunni, Gianni, Wong, Wendy, Chen, Bingzhong, Amri, Hakima, Kotlyanskaya, Lucy, Anderson, Belinda, Evans, Roni, Marantz, Paul, Bradley, Ryan, LaForce, Cathryn, Zwickey, Heather, Kligler, Benjamin, Brooks, Audrey, Kreitzer, Mary J, Lebensohn, Patricia, Goldblatt, Elisabeth, Esmel, Neus, Herrera, Maria, Jocham, Alexandra, Berberat, Pascal O, Schneider, Antonius, Masetti, Morgana, Murakozy, Henriette, Agdal, Rita, Atarzadeh, Fatemeh, Jaladat, Amir M, Hoseini, Leila, Amini, Fatemeh, Bai, Chen, Liu, Tiegang, Zheng, Zian, Wan, Yuxiang, Xu, Jingnan, Wang, Xuan, Yu, He, Gu, Xiaohong, Daneshfard, Babak, Nimrouzi, Majid, Tafazoli, Vahid, Alorizi, Seyed M E, Saghebi, Seyed A, Fattahi, Mohammad R, Salehi, Alireza, Rezaeizadeh, Hossein, Zarshenas, Mohammad M, Fox, Kealoha, Hughes, John, Kostanjsek, Nenad, Espinosa, Stéphane, Fisher, Peter, Latif, Abdul, Lefeber, Donald, Paske, William, Öztürk, Ali Ö, Öztürk, Gizemnur, Tissing, Wim, Naafs, Marianne, Busch, Martine, Sanaye, Mohammad R, Dräger, Kilian, Leininger, Brent, Shafto, Kate, Breen, Jenny, Wüst, Ana P, Puigmartí, Carolina, Dongen, Martien, Dagnelie, Pieter, Thijs, Carel, White, Shelley, Wiesener, Solveig, Salamonsen, Anita, Stub, Trine, Abanades, Sergio, Blanco, Mar, Masllorens, Laia, Sala, Roser, Ahnoumy, Shafekah, Han, Dongwoon, He, Luzhu, Kim, Ha Y, Choi, Da, Alræk, Terje, Kristoffersen, Agnete, Sceidt, Christel, Bruset, Stig, Musial, Frauke, Saha, Felix J, Haller, Heidemarie, Azizi, Hoda, Khadem, Nayereh, Hassanzadeh, Malihe, Estiri, Nazanin, Azizi, Hamideh, Tavassoli, Fatemeh, Lotfalizadeh, Marzieh, Zabihi, Reza, Shabestari, Mahmoud M, Paeizi, Reza, Azari, Masoumeh A, Taghanaki, Hamidreza, Baars, Erik, Bruin, Anja, Ponstein, Anne, Segantini, Sergio, Voller, Fabio, Barth, Jürgen, Kern, Alexandra, Lüthi, Sebastian, Zieger, Anja, Otto, Fabius, Beccia, Ariel, Dunlap, Corina, Courneene, Brendan, Bedregal, Paula, Passi, Alvaro, Rodríguez, Alfredo, Chang, Mayling, Gutiérrez, Soledad, Beissner, Florian, Preibisch, Christine, Arau, Annemarie, Popovici, Roxana, Meissner, Karin, Beljanski, Sylvie, Belland, Laura, Reyes, Laura, Hwang, Ula, Sethe, Dominik, Hilgard, Dörte, Heusser, Peter, Bishop, Felicity, Abbadey, Miznah, Bradbury, Katherine, Carnes, Dawn, Dimitrov, Borislav, Fawkes, Carol, Foster, Jo, MacPherson, Hugh, Roberts, Lisa, Yardley, Lucy, Holmes, Michelle, Little, Paul, Cooper, Cyrus, Bogani, Patrizia, Maggini, Valentina, Gallo, Eugenia, Miceli, Elisangela, Biffi, Sauro, Mengoni, Alessio, Fani, Renato, Guendling, Nadine, Guendling, Peter W, Bronfort, Gert, Haas, Mitch, Schulz, Craig, Bu, Xiangwei, Wang, J., Fang, T., Shen, Z., He, Y., Zhang, X., Zhang, Zhengju, Wang, Dali, Meng, Fengxian, Baumann, Klaus, Frick, Eckhard, Jacobs, Christoph, Grünther, Ralph-Achim, Lötzke, Désirée, Jung, Sonny, Recchia, Daniela R, Robens, Sibylle, Stankewitz, Josephin, Jeitler, Mika, Cheon, Chunhoo, Jang, Bo H, Ko, Seong G, Huang, Ching W, Sasaki, Yui, Ko, Youme, Cheshire, Anna, Ridge, Damien, Peters, David, Panagioti, Maria, Simon, Chantal, Cho, Hyun J, Choi, Soo J, Jung, Young S, Im, Hyea B, Cooley, Kieran, Simmons, Laura, Wasson, Rachel, Kraemer, Kristen, Sears, Richard, Hueber, Carly, Derk, Gwendolyn, Lill, JR, An, Ruopeng, Steinberg, Lois, Rodriguez, Lourdes D, Fuente, Francisca G, Vega, Miguel, Román, Keyla, Ruiz, Jonatan, Villanueva, Irene, Fuente, Francisca, Guerrero, Fanny, Castillo, Noelia, Saez, Gualberto, Jimenez, José I, Gomez, Olga, Muñoz, Luis, Diez, Camino, Dicen, Demijon, Diezel, Helene, Frawley, Jane, Broom, Alex, Dong, Fei, Ma, Xueyan, Yan, Liyi, Wu, Liqun, Ma, Jiaju, Zhen, Jianhua, Dubois, Julie, Rodondi, Pierre-Yves, Schwartze, Sophia, Trapp, Barbara, Cysarz, Dirk, Brinkhaus, Benno, Falkenberg, Torkel, Haramati, Aviad, Willich, Stefan N, Briggs, Josephine P, Willcox, Merlin, Linde, Klaus, Theorell, Töres, Wong, Lisa M, Dusek, Jeffrey, Wu, Darong, Eisenberg, David, Berger, Bettina, Kemper, Kathi, Schröer, Beate, Klein, Hedda, Ferreri, Rosaria, Kaplan, Gary, Matthes, Harald, Rotter, Gabriele, Schiff, Elad, Arnon, Zahi, Hahn, Eckhard, Luberto, Christina M, Martin, David, Schwarz, Silke, Tauschel, Diethard, Flower, Andrew, Gramminger, Harsha, Gupta, Hedwig H, Gupta, S. N, Kerckhoff, Annette, Kessler, Christian S, Michalsen, Andreas, Kim, Eun S, Jang, Eun H, Kim, Rana, Jan, Sae B, Mittwede, Martin, Mohme, Wiebke, Arye, Eran, Bonucci, Massimo, Saad, Bashar, Breitkreuz, Thomas, Rossi, Elio, Kebudi, Rejin, Daher, Michel, Razaq, Samaher, Gafer, Nahla, Nimri, Omar, Hablas, Mohamed, Kienle, Gunver S, Samuels, Noah, Silbermann, Michael, Bandelin, Lena, Lang, Anna-Lena, Wartner, Eva, Holtermann, Christoph, Binstock, Maxwell, Riebau, Robert, Mujkanovic, Edin, Cramer, Holger, Lauche, Romy, Michalsen, Andres, Ward, Lesley, Irnich, Dominik, Stör, Wolfram, Burnstock, Geoffrey, Schaible, Hans-Georg, Ots, Thomas, Langhorst, Jost, Sundberg, Tobias, Amarell, Catherina, Anheyer, Melanie, Eckert, Marion, Ogal, Mercedes, Schönauer, Annette, Reisenberger, Birgit, Brand, Bernhard, Anheyer, Dennis, Dobos, Gustav, Kroez, Matthias, Ammendola, Aldo, Mao, Jun J, Witt, Claudia, Yang, Yufei, Oritz, Miriam, Horneber, Markus, Voiß, Petra, Rosenstiel, Alexandra, Amarell, Catharina, Schad, Friedemann, Schläppi, Marc, Kröz, Matthias, Büssing, Arndt, Sela, Gil, Avshalomov, David, Attias, Samuel, Cotton, Sian, Jong, Miek, Jong, Mats, Scheffer, Christian, Edelhäuser, Friedrich, AlBedah, Abdullah, Lee, Myeong S, Khalil, Mohamed, Ogawa, Keiko, Motoo, Yoshiharu, Arimitsu, Junsuke, Ogawa, Masao, Shimizu, Genki, Stange, Rainer, Kraft, Karin, Kuchta, Kenny, Watanabe, Kenji, Bonin, D, Gruber, Harald, Koch, Sabine, Pohlmann, Urs, Caldwell, Christine, Krantz, Barbara, Kortum, Ria, Martin, Lily, Wieland, Lisa S, Kligler, Ben, Fogerite, Susan, Zhang, Yuqing, Riva, John J, Lumpkin, Michael, Ratner, Emily, Ping, Liu, Jian, Pei, Hamme, Gesa-Meyer, Mao, Xiaosong, Chouping, Han, Schröder, Sven, Hummelsberger, Josef, Wullinger, Michael, Brodzky, Marc, Zalpour, Christoff, Langley, Julia, Weber, Wendy, Mudd, Lanay M, Wayne, Peter, Witt, Clauda, Weidenhammer, Wolfgang, Fønnebø, Vinjar, Boon, Heather, Steel, Amie, Bugarcic, Andrea, Rangitakatu, Melisa, Adams, Jon, Sibbritt, David, Wardle, Jon, Leach, Matthew, Schloss, Janet, Dieze, Helene, Ijaz, Nadine, Heinrich, Michael, Lewith, George, Graz, Bertrand, Adam, Daniela, Grabenhenrich, Linus, Ortiz, Miriam, Binting, Sylvia, Reinhold, Thomas, Andermo, Susanne, Nordberg, Johanna H, Arman, Maria, Bhasin, Manoj, Fan, Xueyi, Libermann, Towia, Fricchione, Gregory, Denninger, John, Benson, Herbert, Martin, David D, Boers, Inge, Vlieger, Arine, Teut, Michael, Ullmann, Alexander, Lotz, Fabian, Roll, Stephanie, Canella, Claudia, Mikolasek, Michael, Rostock, Matthias, Beyer, Jörg, Guckenberger, Matthias, Jenewein, Josef, Linka, Esther, Six, Claudia, Stoll, Sarah, Stupp, Roger, Witt, Claudia M, Chuang, Elisabeth, McKee, Melissa D, Klose, Petra, Lange, Silke, Chung, Vincent C H, Wong, Hoi L C, Wu, Xin Y, Wen, Grace Y G, Ho, Robin S T, Ching, Jessica Y L, Wu, Justin C Y, Coakley, Amanda, Flanagan, Jane, Annese, Christine, Empoliti, Joanne, Gao, Zishan, Liu, Xugang, Yu, Shuguang, Yan, Xianzhong, Liang, Fanrong, Hohmann, Christoph D, Steckhan, Nico, Ostermann, Thomas, Paetow, Arion, Hoff, Evelyn, Hu, Xiao-Yang, Wu, Ruo-Han, Logue, Martin, Blonde, Clara, Lai, Lily Y, Stuart, Beth, Fei, Yu-Tong, Moore, Michael, Liu, Jian-Ping, Jeitler, Michael, Zillgen, Hannah, Högl, Manuel, Stöckigt, Barbara, Seifert, Georg, Kessler, Christian, Khadivzadeh, Talat, Bashtian, Maryam H, Aval, Shapour B, Esmaily, Habibollah, Kim, Jihye, Kim, Keun H, Klocke, Carina, Joos, Stefanie, Koshak, Abdulrahman, Wie, Li, Koshak, Emad, Wali, Siraj, Alamoudi, Omer, Demerdash, Abdulrahman, Qutub, Majdy, Pushparaj, Peter, Kruse, Sigrid, Fischer, Isabell, Tremel, Nadine, Rosenecker, Joseph, Leung, Brenda, Takeda, Wendy, Liang, Ning, Feng, Xue, Liu, Jian-ping, Cao, Hui-juan, Shinday, Nina, Philpotts, Lisa, Park, Elyse, Fricchione, Gregory L, Yeh, Gloria, Munk, Niki, Zakeresfahani, Arash, Foote, Trevor R, Ralston, Rick, Boulanger, Karen, Özbe, Dominik, Gräßel, Elmar, Luttenberger, Katharina, Pendergrass, Anna, Pach, Daniel, Strobl, Judit, Chang, Yinhui, Pasura, Laura, Liu, Bin, Jäger, Sven F, Loerch, Ronny, Jin, Li, Icke, Katja, Shi, Xuemin, Paul, Friedemann, Rütz, Michaela, Lynen, Andreas, Schömitz, Meike, Vahle, Maik, Salomon, Nir, Lang, Alon, Lahat, Adi, Kopylov, Uri, Horin, Shomron, Noi, Ofir, Avidan, Benjamin, Elyakim, Rami, Gamus, Dorit, NG, Siew, Chang, Jessica, Wu, Justin, Kaimiklotis, John, Schumann, Dania, Buttó, Ludovica, Haller, Dirk, Smith, Caroline, Lacey, Sheryl, Chapman, Michael, Ratcliffe, Julie, Johnson, Neil, Lyttleton, Jane, Boothroyd, Clare, Fahey, Paul, Tjaden, Bram, Vliet, Marja, Wietmarschen, Herman, Tröger, Wilfried, Vuolanto, Pia, Aarva, Paulina, Sorsa, Minna, Helin, Kaija, Wenzel, Claudia, Zoderer, Iris, Pammer, Patricia, Simon, Patrick, Tucek, Gerhard, Wode, Kathrin, Henriksson, Roger, Sharp, Lena, Stoltenberg, Anna, ying, Yang, Wang, Li-qiong, Li, Jin-gen, Wang, Ying, Balneaves, Lynda, Capler, Rielle, Bocci, Chiara, Guffi, Marta, Paolini, Marina, Meaglia, Ilaria, Porcu, Patrizia, Ivaldi, Giovanni B, Dragan, Simona, Bucuras, Petru, Pah, Ana M, Petrescu, Marius, Buleu, Florina, Stoichescu, Gheorghe, Christodorescu, Ruxandra, Kao, Lan, Cho, Yumin, Klafke, Nadja, Mahler, Cornelia, von Hagens, Cornelia, Uhlmann, Lorenz, Bentner, Martina, Schneeweiß, Andreas, Mueller, Andreas, Szecsenyi, Joachim, Neri, Isabella, Schnabel, Katharina, Cree, Margit, Suhr, Ralf, Baccetti, Sonia, Firenzuoli, Fabio, Monechi, Maria V, Stefano, Mariella, Amunni, Gianni, Wong, Wendy, Chen, Bingzhong, Amri, Hakima, Kotlyanskaya, Lucy, Anderson, Belinda, Evans, Roni, Marantz, Paul, Bradley, Ryan, LaForce, Cathryn, Zwickey, Heather, Kligler, Benjamin, Brooks, Audrey, Kreitzer, Mary J, Lebensohn, Patricia, Goldblatt, Elisabeth, Esmel, Neus, Herrera, Maria, Jocham, Alexandra, Berberat, Pascal O, Schneider, Antonius, Masetti, Morgana, Murakozy, Henriette, Agdal, Rita, Atarzadeh, Fatemeh, Jaladat, Amir M, Hoseini, Leila, Amini, Fatemeh, Bai, Chen, Liu, Tiegang, Zheng, Zian, Wan, Yuxiang, Xu, Jingnan, Wang, Xuan, Yu, He, Gu, Xiaohong, Daneshfard, Babak, Nimrouzi, Majid, Tafazoli, Vahid, Alorizi, Seyed M E, Saghebi, Seyed A, Fattahi, Mohammad R, Salehi, Alireza, Rezaeizadeh, Hossein, Zarshenas, Mohammad M, Fox, Kealoha, Hughes, John, Kostanjsek, Nenad, Espinosa, Stéphane, Fisher, Peter, Latif, Abdul, Lefeber, Donald, Paske, William, Öztürk, Ali Ö, Öztürk, Gizemnur, Tissing, Wim, Naafs, Marianne, Busch, Martine, Sanaye, Mohammad R, Dräger, Kilian, Leininger, Brent, Shafto, Kate, Breen, Jenny, Wüst, Ana P, Puigmartí, Carolina, Dongen, Martien, Dagnelie, Pieter, Thijs, Carel, White, Shelley, Wiesener, Solveig, Salamonsen, Anita, Stub, Trine, Abanades, Sergio, Blanco, Mar, Masllorens, Laia, Sala, Roser, Ahnoumy, Shafekah, Han, Dongwoon, He, Luzhu, Kim, Ha Y, Choi, Da, Alræk, Terje, Kristoffersen, Agnete, Sceidt, Christel, Bruset, Stig, Musial, Frauke, Saha, Felix J, Haller, Heidemarie, Azizi, Hoda, Khadem, Nayereh, Hassanzadeh, Malihe, Estiri, Nazanin, Azizi, Hamideh, Tavassoli, Fatemeh, Lotfalizadeh, Marzieh, Zabihi, Reza, Shabestari, Mahmoud M, Paeizi, Reza, Azari, Masoumeh A, Taghanaki, Hamidreza, Baars, Erik, Bruin, Anja, Ponstein, Anne, Segantini, Sergio, Voller, Fabio, Barth, Jürgen, Kern, Alexandra, Lüthi, Sebastian, Zieger, Anja, Otto, Fabius, Beccia, Ariel, Dunlap, Corina, Courneene, Brendan, Bedregal, Paula, Passi, Alvaro, Rodríguez, Alfredo, Chang, Mayling, Gutiérrez, Soledad, Beissner, Florian, Preibisch, Christine, Arau, Annemarie, Popovici, Roxana, Meissner, Karin, Beljanski, Sylvie, Belland, Laura, Reyes, Laura, Hwang, Ula, Sethe, Dominik, Hilgard, Dörte, Heusser, Peter, Bishop, Felicity, Abbadey, Miznah, Bradbury, Katherine, Carnes, Dawn, Dimitrov, Borislav, Fawkes, Carol, Foster, Jo, MacPherson, Hugh, Roberts, Lisa, Yardley, Lucy, Holmes, Michelle, Little, Paul, Cooper, Cyrus, Bogani, Patrizia, Maggini, Valentina, Gallo, Eugenia, Miceli, Elisangela, Biffi, Sauro, Mengoni, Alessio, Fani, Renato, Guendling, Nadine, Guendling, Peter W, Bronfort, Gert, Haas, Mitch, Schulz, Craig, Bu, Xiangwei, Wang, J., Fang, T., Shen, Z., He, Y., Zhang, X., Zhang, Zhengju, Wang, Dali, Meng, Fengxian, Baumann, Klaus, Frick, Eckhard, Jacobs, Christoph, Grünther, Ralph-Achim, Lötzke, Désirée, Jung, Sonny, Recchia, Daniela R, Robens, Sibylle, Stankewitz, Josephin, Jeitler, Mika, Cheon, Chunhoo, Jang, Bo H, Ko, Seong G, Huang, Ching W, Sasaki, Yui, Ko, Youme, Cheshire, Anna, Ridge, Damien, Peters, David, Panagioti, Maria, Simon, Chantal, Cho, Hyun J, Choi, Soo J, Jung, Young S, Im, Hyea B, Cooley, Kieran, Simmons, Laura, Wasson, Rachel, Kraemer, Kristen, Sears, Richard, Hueber, Carly, Derk, Gwendolyn, Lill, JR, An, Ruopeng, Steinberg, Lois, Rodriguez, Lourdes D, Fuente, Francisca G, Vega, Miguel, Román, Keyla, Ruiz, Jonatan, Villanueva, Irene, Fuente, Francisca, Guerrero, Fanny, Castillo, Noelia, Saez, Gualberto, Jimenez, José I, Gomez, Olga, Muñoz, Luis, Diez, Camino, Dicen, Demijon, Diezel, Helene, Frawley, Jane, Broom, Alex, Dong, Fei, Ma, Xueyan, Yan, Liyi, Wu, Liqun, Ma, Jiaju, Zhen, Jianhua, Dubois, Julie, Rodondi, Pierre-Yves, Schwartze, Sophia, Trapp, Barbara, and Cysarz, Dirk

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2017
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35. World Congress Integrative Medicine & Health 2017: Part one

Author

Brinkhaus, Benno, primary, Falkenberg, Torkel, additional, Haramati, Aviad, additional, Willich, Stefan N., additional, Briggs, Josephine P., additional, Willcox, Merlin, additional, Linde, Klaus, additional, Theorell, Töres, additional, Wong, Lisa M., additional, Dusek, Jeffrey, additional, Wu, Darong, additional, Eisenberg, David, additional, Berger, Bettina, additional, Kemper, Kathi, additional, Stock-Schröer, Beate, additional, Sützl-Klein, Hedda, additional, Ferreri, Rosaria, additional, Kaplan, Gary, additional, Matthes, Harald, additional, Rotter, Gabriele, additional, Schiff, Elad, additional, Arnon, Zahi, additional, Hahn, Eckhard, additional, Luberto, Christina M., additional, Martin, David, additional, Schwarz, Silke, additional, Tauschel, Diethard, additional, Flower, Andrew, additional, Gramminger, Harsha, additional, Gupta, Hedwig H., additional, Gupta, S. N., additional, Kerckhoff, Annette, additional, Kessler, Christian S., additional, Michalsen, Andreas, additional, Kim, Eun S., additional, Jang, Eun H., additional, Kim, Rana, additional, Jan, Sae B., additional, Mittwede, Martin, additional, Mohme, Wiebke, additional, Ben-Arye, Eran, additional, Bonucci, Massimo, additional, Saad, Bashar, additional, Breitkreuz, Thomas, additional, Rossi, Elio, additional, Kebudi, Rejin, additional, Daher, Michel, additional, Razaq, Samaher, additional, Gafer, Nahla, additional, Nimri, Omar, additional, Hablas, Mohamed, additional, Kienle, Gunver Sophia, additional, Samuels, Noah, additional, Silbermann, Michael, additional, Bandelin, Lena, additional, Lang, Anna-Lena, additional, Wartner, Eva, additional, Holtermann, Christoph, additional, Binstock, Maxwell, additional, Riebau, Robert, additional, Mujkanovic, Edin, additional, Cramer, Holger, additional, Lauche, Romy, additional, Michalsen, Andres, additional, Ward, Lesley, additional, Irnich, Dominik, additional, Stör, Wolfram, additional, Burnstock, Geoffrey, additional, Schaible, Hans-Georg, additional, Ots, Thomas, additional, Langhorst, Jost, additional, Sundberg, Tobias, additional, Amarell, Catherina, additional, Anheyer, Melanie, additional, Eckert, Marion, additional, Ogal, Mercedes, additional, Schönauer, Annette, additional, Reisenberger, Birgit, additional, Brand, Bernhard, additional, Anheyer, Dennis, additional, Dobos, Gustav, additional, Kroez, Matthias, additional, Ammendola, Aldo, additional, Mao, Jun J., additional, Witt, Claudia, additional, Yang, Yufei, additional, Oritz, Miriam, additional, Horneber, Markus, additional, Voiß, Petra, additional, von Rosenstiel, Alexandra, additional, Amarell, Catharina, additional, Schad, Friedemann, additional, Schläppi, Marc, additional, Kröz, Matthias, additional, Büssing, Arndt, additional, Bar-Sela, Gil, additional, Avshalomov, David, additional, Attias, Samuel, additional, Brinkhaus, Benno, additional, Cotton, Sian, additional, Jong, Miek, additional, Jong, Mats, additional, Scheffer, Christian, additional, Edelhäuser, Friedrich, additional, AlBedah, Abdullah, additional, Lee, Myeong Soo, additional, Khalil, Mohamed, additional, Ogawa, Keiko, additional, Motoo, Yoshiharu, additional, Arimitsu, Junsuke, additional, Ogawa, Masao, additional, Shimizu, Genki, additional, Stange, Rainer, additional, Kraft, Karin, additional, Kuchta, Kenny, additional, Watanabe, Kenji, additional, Bonin, D, additional, Gruber, Harald, additional, Koch, Sabine, additional, Pohlmann, Urs, additional, Caldwell, Christine, additional, Krantz, Barbara, additional, Kortum, Ria, additional, Martin, Lily, additional, Wieland, Lisa S., additional, Kligler, Ben, additional, Gould-Fogerite, Susan, additional, Zhang, Yuqing, additional, Riva, John J., additional, Lumpkin, Michael, additional, Ratner, Emily, additional, Ping, Liu, additional, Jian, Pei, additional, Hamme, Gesa-Meyer, additional, Mao, Xiaosong, additional, Chouping, Han, additional, Schröder, Sven, additional, Hummelsberger, Josef, additional, Wullinger, Michael, additional, Brodzky, Marc, additional, Zalpour, Christoff, additional, Langley, Julia, additional, Weber, Wendy, additional, Mudd, Lanay M., additional, Wayne, Peter, additional, Witt, Clauda, additional, Weidenhammer, Wolfgang, additional, Fønnebø, Vinjar, additional, Boon, Heather, additional, Steel, Amie, additional, Bugarcic, Andrea, additional, Rangitakatu, Melisa, additional, Adams, Jon, additional, Sibbritt, David, additional, Wardle, Jon, additional, Leach, Matthew, additional, Schloss, Janet, additional, Dieze, Helene, additional, Ijaz, Nadine, additional, Heinrich, Michael, additional, Lewith, George, additional, Graz, Bertrand, additional, Adam, Daniela, additional, Grabenhenrich, Linus, additional, Ortiz, Miriam, additional, Binting, Sylvia, additional, Reinhold, Thomas, additional, Andermo, Susanne, additional, Nordberg, Johanna Hök, additional, Arman, Maria, additional, Bhasin, Manoj, additional, Fan, Xueyi, additional, Libermann, Towia, additional, Fricchione, Gregory, additional, Denninger, John, additional, Benson, Herbert, additional, Martin, David D., additional, Boers, Inge, additional, Vlieger, Arine, additional, Teut, Michael, additional, Ullmann, Alexander, additional, Lotz, Fabian, additional, Roll, Stephanie, additional, Canella, Claudia, additional, Mikolasek, Michael, additional, Rostock, Matthias, additional, Beyer, Jörg, additional, Guckenberger, Matthias, additional, Jenewein, Josef, additional, Linka, Esther, additional, Six, Claudia, additional, Stoll, Sarah, additional, Stupp, Roger, additional, Witt, Claudia M., additional, Chuang, Elisabeth, additional, McKee, Melissa D., additional, Klose, Petra, additional, Lange, Silke, additional, Chung, Vincent C. H., additional, Wong, Hoi L. C., additional, Wu, Xin Y., additional, Wen, Grace Y. G., additional, Ho, Robin S. T., additional, Ching, Jessica Y. L., additional, Wu, Justin C. Y., additional, Coakley, Amanda, additional, Flanagan, Jane, additional, Annese, Christine, additional, Empoliti, Joanne, additional, Gao, Zishan, additional, Liu, Xugang, additional, Yu, Shuguang, additional, Yan, Xianzhong, additional, Liang, Fanrong, additional, Hohmann, Christoph D., additional, Steckhan, Nico, additional, Ostermann, Thomas, additional, Paetow, Arion, additional, Hoff, Evelyn, additional, Hu, Xiao-Yang, additional, Wu, Ruo-Han, additional, Logue, Martin, additional, Blonde, Clara, additional, Lai, Lily Y., additional, Stuart, Beth, additional, Fei, Yu-Tong, additional, Moore, Michael, additional, Liu, Jian-Ping, additional, Jeitler, Michael, additional, Zillgen, Hannah, additional, Högl, Manuel, additional, Stöckigt, Barbara, additional, Seifert, Georg, additional, Kessler, Christian, additional, Khadivzadeh, Talat, additional, Bashtian, Maryam Hassanzadeh, additional, Aval, Shapour Badiee, additional, Esmaily, Habibollah, additional, Kim, Jihye, additional, Kim, Keun H., additional, Klocke, Carina, additional, Joos, Stefanie, additional, Koshak, Abdulrahman, additional, Wie, Li, additional, Koshak, Emad, additional, Wali, Siraj, additional, Alamoudi, Omer, additional, Demerdash, Abdulrahman, additional, Qutub, Majdy, additional, Pushparaj, Peter, additional, Kruse, Sigrid, additional, Fischer, Isabell, additional, Tremel, Nadine, additional, Rosenecker, Joseph, additional, Leung, Brenda, additional, Takeda, Wendy, additional, Liang, Ning, additional, Feng, Xue, additional, Liu, Jian-ping, additional, Cao, Hui-juan, additional, Shinday, Nina, additional, Philpotts, Lisa, additional, Park, Elyse, additional, Fricchione, Gregory L., additional, Yeh, Gloria, additional, Munk, Niki, additional, Zakeresfahani, Arash, additional, Foote, Trevor R., additional, Ralston, Rick, additional, Boulanger, Karen, additional, Özbe, Dominik, additional, Gräßel, Elmar, additional, Luttenberger, Katharina, additional, Pendergrass, Anna, additional, Pach, Daniel, additional, Bellmann-Strobl, Judit, additional, Chang, Yinhui, additional, Pasura, Laura, additional, Liu, Bin, additional, Jäger, Sven F., additional, Loerch, Ronny, additional, Jin, Li, additional, Icke, Katja, additional, Shi, Xuemin, additional, Paul, Friedemann, additional, Rütz, Michaela, additional, Lynen, Andreas, additional, Schömitz, Meike, additional, Vahle, Maik, additional, Salomon, Nir, additional, Lang, Alon, additional, Lahat, Adi, additional, Kopylov, Uri, additional, Ben-Horin, Shomron, additional, Har-Noi, Ofir, additional, Avidan, Benjamin, additional, Elyakim, Rami, additional, Gamus, Dorit, additional, NG, Siew, additional, Chang, Jessica, additional, Wu, Justin, additional, Kaimiklotis, John, additional, Schumann, Dania, additional, Buttó, Ludovica, additional, Haller, Dirk, additional, Smith, Caroline, additional, de Lacey, Sheryl, additional, Chapman, Michael, additional, Ratcliffe, Julie, additional, Johnson, Neil, additional, Lyttleton, Jane, additional, Boothroyd, Clare, additional, Fahey, Paul, additional, Tjaden, Bram, additional, van Vliet, Marja, additional, van Wietmarschen, Herman, additional, Tröger, Wilfried, additional, Vuolanto, Pia, additional, Aarva, Paulina, additional, Sorsa, Minna, additional, Helin, Kaija, additional, Wenzel, Claudia, additional, Zoderer, Iris, additional, Pammer, Patricia, additional, Simon, Patrick, additional, Tucek, Gerhard, additional, Wode, Kathrin, additional, Henriksson, Roger, additional, Sharp, Lena, additional, Stoltenberg, Anna, additional, Xiao-ying, Yang, additional, Wang, Li-qiong, additional, Li, Jin-gen, additional, Wang, Ying, additional, Balneaves, Lynda, additional, Capler, Rielle, additional, Bocci, Chiara, additional, Guffi, Marta, additional, Paolini, Marina, additional, Meaglia, Ilaria, additional, Porcu, Patrizia, additional, Ivaldi, Giovanni B., additional, Dragan, Simona, additional, Bucuras, Petru, additional, Pah, Ana M., additional, Badalica-Petrescu, Marius, additional, Buleu, Florina, additional, Hogea-Stoichescu, Gheorghe, additional, Christodorescu, Ruxandra, additional, Kao, Lan, additional, Cho, Yumin, additional, Klafke, Nadja, additional, Mahler, Cornelia, additional, von Hagens, Cornelia, additional, Uhlmann, Lorenz, additional, Bentner, Martina, additional, Schneeweiss, Andreas, additional, Mueller, Andreas, additional, Szecsenyi, Joachim, additional, Neri, Isabella, additional, Schnabel, Katharina, additional, Cree, Margit, additional, Suhr, Ralf, additional, Baccetti, Sonia, additional, Firenzuoli, Fabio, additional, Monechi, Maria V., additional, Di Stefano, Mariella, additional, Amunni, Gianni, additional, Wong, Wendy, additional, Chen, Bingzhong, additional, Amri, Hakima, additional, Kotlyanskaya, Lucy, additional, Anderson, Belinda, additional, Evans, Roni, additional, Marantz, Paul, additional, Bradley, Ryan, additional, Booth-LaForce, Cathryn, additional, Zwickey, Heather, additional, Kligler, Benjamin, additional, Brooks, Audrey, additional, Kreitzer, Mary J., additional, Lebensohn, Patricia, additional, Goldblatt, Elisabeth, additional, Esmel-Esmel, Neus, additional, Jiménez-Herrera, Maria, additional, Jocham, Alexandra, additional, Berberat, Pascal O., additional, Schneider, Antonius, additional, Masetti, Morgana, additional, Murakozy, Henriette, additional, Van Vliet, Marja, additional, Agdal, Rita, additional, Atarzadeh, Fatemeh, additional, Jaladat, Amir M., additional, Hoseini, Leila, additional, Amini, Fatemeh, additional, Bai, Chen, additional, Liu, Tiegang, additional, Zheng, Zian, additional, Wan, Yuxiang, additional, Xu, Jingnan, additional, Wang, Xuan, additional, Yu, He, additional, Gu, Xiaohong, additional, Daneshfard, Babak, additional, Nimrouzi, Majid, additional, Tafazoli, Vahid, additional, Alorizi, Seyed M. Emami, additional, Saghebi, Seyed A., additional, Fattahi, Mohammad R., additional, Salehi, Alireza, additional, Rezaeizadeh, Hossein, additional, Zarshenas, Mohammad M., additional, Fox, Kealoha, additional, Hughes, John, additional, Kostanjsek, Nenad, additional, Espinosa, Stéphane, additional, Fisher, Peter, additional, Latif, Abdul, additional, Lefeber, Donald, additional, Paske, William, additional, Öztürk, Ali Ö., additional, Öztürk, Gizemnur, additional, Tissing, Wim, additional, Naafs, Marianne, additional, Busch, Martine, additional, Sanaye, Mohammad R., additional, Dräger, Kilian, additional, Leininger, Brent, additional, Shafto, Kate, additional, Breen, Jenny, additional, Simões-Wüst, Ana P., additional, Moltó-Puigmartí, Carolina, additional, van Dongen, Martien, additional, Dagnelie, Pieter, additional, Thijs, Carel, additional, White, Shelley, additional, Wiesener, Solveig, additional, Salamonsen, Anita, additional, Stub, Trine, additional, Abanades, Sergio, additional, Blanco, Mar, additional, Masllorens, Laia, additional, Sala, Roser, additional, Al-Ahnoumy, Shafekah, additional, Han, Dongwoon, additional, He, Luzhu, additional, Kim, Ha Yun, additional, In Choi, Da, additional, Alræk, Terje, additional, Kristoffersen, Agnete, additional, von Sceidt, Christel, additional, Bruset, Stig, additional, Musial, Frauke, additional, Saha, Felix J., additional, Haller, Heidemarie, additional, Azizi, Hoda, additional, Khadem, Nayereh, additional, Hassanzadeh, Malihe, additional, Estiri, Nazanin, additional, Azizi, Hamideh, additional, Tavassoli, Fatemeh, additional, Lotfalizadeh, Marzieh, additional, Zabihi, Reza, additional, Shabestari, Mahmoud Mohammadzadeh, additional, Paeizi, Reza, additional, Azari, Masoumeh Alvandi, additional, Bahrami-Taghanaki, Hamidreza, additional, Baars, Erik, additional, De Bruin, Anja, additional, Ponstein, Anne, additional, Segantini, Sergio, additional, Monechi, Maria Valeria, additional, Voller, Fabio, additional, Barth, Jürgen, additional, Kern, Alexandra, additional, Lüthi, Sebastian, additional, Zieger, Anja, additional, Otto, Fabius, additional, Beccia, Ariel, additional, Dunlap, Corina, additional, Courneene, Brendan, additional, Bedregal, Paula, additional, Passi, Alvaro, additional, Rodríguez, Alfredo, additional, Chang, Mayling, additional, Gutiérrez, Soledad, additional, Beissner, Florian, additional, Preibisch, Christine, additional, Schweizer-Arau, Annemarie, additional, Popovici, Roxana, additional, Meissner, Karin, additional, Beljanski, Sylvie, additional, Belland, Laura, additional, Rivera-Reyes, Laura, additional, Hwang, Ula, additional, Sethe, Dominik, additional, Hilgard, Dörte, additional, Heusser, Peter, additional, Bishop, Felicity, additional, Al-Abbadey, Miznah, additional, Bradbury, Katherine, additional, Carnes, Dawn, additional, Dimitrov, Borislav, additional, Fawkes, Carol, additional, Foster, Jo, additional, MacPherson, Hugh, additional, Roberts, Lisa, additional, Yardley, Lucy, additional, Holmes, Michelle, additional, Little, Paul, additional, Cooper, Cyrus, additional, Bogani, Patrizia, additional, Maggini, Valentina, additional, Gallo, Eugenia, additional, Miceli, Elisangela, additional, Biffi, Sauro, additional, Mengoni, Alessio, additional, Fani, Renato, additional, Brands-Guendling, Nadine, additional, Guendling, Peter W., additional, Bronfort, Gert, additional, Haas, Mitch, additional, Schulz, Craig, additional, Bu, Xiangwei, additional, Wang, J., additional, Fang, T., additional, Shen, Z., additional, He, Y., additional, Zhang, X., additional, Zhang, Zhengju, additional, Wang, Dali, additional, Meng, Fengxian, additional, Baumann, Klaus, additional, Frick, Eckhard, additional, Jacobs, Christoph, additional, Grünther, Ralph-Achim, additional, Lötzke, Désirée, additional, Jung, Sonny, additional, Recchia, Daniela R., additional, Robens, Sibylle, additional, Stankewitz, Josephin, additional, Jeitler, Mika, additional, Cheon, Chunhoo, additional, Jang, Bo H., additional, Ko, Seong G., additional, Huang, Ching W., additional, Sasaki, Yui, additional, Ko, Youme, additional, Cheshire, Anna, additional, Ridge, Damien, additional, Peters, David, additional, Panagioti, Maria, additional, Simon, Chantal, additional, Cho, Hyun J., additional, Choi, Soo J., additional, Jung, Young S., additional, Im, Hyea B, additional, Cooley, Kieran, additional, Tummon-Simmons, Laura, additional, Wasson, Rachel, additional, Kraemer, Kristen, additional, Sears, Richard, additional, Hueber, Carly, additional, Derk, Gwendolyn, additional, Lill, JR, additional, An, Ruopeng, additional, Steinberg, Lois, additional, Rodriguez, Lourdes Diaz, additional, la Fuente, Francisca García-de, additional, De la Vega, Miguel, additional, Vargas-Román, Keyla, additional, Fernández-Ruiz, Jonatan, additional, Cantarero-Villanueva, Irene, additional, García-De la Fuente, Francisca, additional, Jiménez-Guerrero, Fanny, additional, Galiano-Castillo, Noelia, additional, Diaz-Saez, Gualberto, additional, Torres-Jimenez, José I., additional, Garcia-Gomez, Olga, additional, Hortal-Muñoz, Luis, additional, Diaz-Diez, Camino, additional, Dicen, Demijon, additional, Diezel, Helene, additional, Frawley, Jane, additional, Broom, Alex, additional, Dong, Fei, additional, Ma, Xueyan, additional, Yan, Liyi, additional, Wu, Liqun, additional, Ma, Jiaju, additional, Zhen, Jianhua, additional, Dubois, Julie, additional, Rodondi, Pierre-Yves, additional, Schwartze, Sophia, additional, Trapp, Barbara, additional, and Cysarz, Dirk, additional

Published
2017
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41. Cost-effectiveness of spinal manipulation therapy for neck or back pain

Author

Leininger, Brent

Subjects
Back pain, Cost-effectiveness, Decision model, Neck pain
Abstract

Chronic pain is a major public health problem, affecting more adults in the United States than heart disease, diabetes, and cancer combined. Low back and neck pain are the most common chronic pain conditions and are two of the most disabling and costly conditions in the U.S. Approximately 4% of all healthcare spending in the U.S. is directed towards the management of back and neck pain, more than any other condition. Spine pain management has gathered increased scrutiny amidst concerns about overutilization of costly and potentially harmful interventions such as opioids, injections, and surgeries. Complementary and integrative interventions may reduce the clinical and cost burden of spine pain and are now recommended by clinical guidelines, but their use remains limited.This dissertation addresses the cost-effectiveness of spinal manipulation therapy and other complementary and integrative therapies for neck or back pain. First, we used individual patient data from eight randomized trials to conduct standardized cost-effectiveness analyses of spinal manipulation therapy (SMT), one of the most common complementary and integrative interventions, compared to home exercise or supervised exercise approaches. We found the cost-effectiveness of SMT varied by population and comparison. When compared to or added to home exercise, cost-effectiveness findings were favorable for acute neck pain, chronic neck pain in older adults, and chronic back-related leg pain; however, SMT was not likely cost-effective for chronic back pain. When compared to or added to supervised exercise, cost-effectiveness findings were favorable for chronic back pain in multiple age groups (adolescents, adults, older adults) and older adults with chronic neck pain. For adults with chronic neck pain, findings were mixed where SMT was not likely cost-effective relative to supervised exercise, but maybe cost-effective when added to supervised exercise. Next, we assessed the generalizability of the randomized clinical trial populations by comparing socio-demographic characteristics and clinical features to representative samples of US adults with chronic spine pain using data from the National Health Interview and Medical Expenditure Panel Surveys. We found the clinical trials had an under-representation of individuals from underserved communities with lower percentages of racial and ethnic minorities, less educated, and unemployed adults relative to the U.S. population with spine pain. While the odds of chiropractic use in the U.S. were lower for individuals from underserved communities, the trial populations also under-represented these populations relative to U.S. adults with chronic spine pain who visit a chiropractor. Finally, we estimated the cost-effectiveness of spinal manipulation and other complementary and integrative approaches for spine pain using a decision analysis model incorporating multiple sources of evidence. We found that yoga resulted in the lowest costs and largest health benefits relative to all other treatments across multiple populations. Other complementary and integrative approaches such as massage, mindfulness-based stress reduction, cognitive behavioral therapy, and SMT were also shown to be cost-effective options relative to home exercise and advice for chronic spine pain across different populations. Findings for these treatments were not sensitive to changes in key model parameters impacting costs or effectiveness. In summary, our work contributes to the understanding of the cost-effectiveness of complementary and integrative approaches including spinal manipulation in U.S. healthcare settings. We used both clinical trial-based and decision model analyses to assess cost-effectiveness and found general consistency of findings across the two approaches. There is a need to better understand the impact of these approaches in populations most severely impacted who are often under-represented in clinical trials.

Published
2023

44. World Congress Integrative Medicine & Health 2017: Part one : Berlin, Germany. 3-5 May 2017

Author

Brinkhaus, Benno, Falkenberg, Torkel, Haramati, Aviad, Willich, Stefan N., Briggs, Josephine P., Willcox, Merlin, Linde, Klaus, Theorell, Töres, Wong, Lisa M., Dusek, Jeffrey, Wu, Darong, Eisenberg, David, Berger, Bettina, Kemper, Kathi, Stock-Schröer, Beate, Sützl-Klein, Hedda, Ferreri, Rosaria, Kaplan, Gary, Matthes, Harald, Rotter, Gabriele, Schiff, Elad, Arnon, Zahi, Hahn, Eckhard, Luberto, Christina M., Martin, David, Schwarz, Silke, Tauschel, Diethard, Flower, Andrew, Gramminger, Harsha, Gupta, Hedwig H., Gupta, S. N., Kerckhoff, Annette, Kessler, Christian S., Michalsen, Andreas, Kim, Eun S., Jang, Eun H., Kim, Rana, Jan, Sae B., Mittwede, Martin, Mohme, Wiebke, Ben-Arye, Eran, Bonucci, Massimo, Saad, Bashar, Breitkreuz, Thomas, Rossi, Elio, Kebudi, Rejin, Daher, Michel, Razaq, Samaher, Gafer, Nahla, Nimri, Omar, Hablas, Mohamed, Kienle, Gunver Sophia, Samuels, Noah, Silbermann, Michael, B, Elin, Lena, Lang, Anna-Lena, Wartner, Eva, Holtermann, Christoph, Binstock, Maxwell, Riebau, Robert, Mujkanovic, Edin, Cramer, Holger, Lauche, Romy, Michalsen, Andres, Ward, Lesley, Irnich, Dominik, Stör, Wolfram, Burnstock, Geoffrey, Schaible, Hans-Georg, Ots, Thomas, Langhorst, Jost, Sundberg, Tobias, Amarell, Catherina, Anheyer, Melanie, Eckert, Marion, Ogal, Mercedes, Schönauer, Annette, Reisenberger, Birgit, Bernhard, Dennis Anheyer, Dobos, Gustav, Kroez, Matthias, Ammendola, Aldo, Mao, Jun J., Witt, Claudia, Yang, Yufei, Oritz, Miriam, Horneber, Markus, Voiß, Petra, Rosenstiel, Alex, Amarell, Catharina, Schad, Friedemann, Schläppi, Marc, Kröz, Matthias, Büssing, Arndt, Bar-Sela, Gil, Avshalomov, David, Attias, Samuel, Cotton, Sian, Jong, Miek, Jong, Mats, Scheffer, Christian, Edelhäuser, Friedrich, Albedah, Abdullah, Lee, Myeong Soo, Khalil, Mohamed, Ogawa, Keiko, Motoo, Yoshiharu, Arimitsu, Junsuke, Ogawa, Masao, Shimizu, Genki, Stange, Rainer, Kraft, Karin, Kuchta, Kenny, Watanabe, Kenji, Bonin, D., Gruber, Harald, Koch, Sabine, Pohlmann, Urs, Caldwell, Christine, Krantz, Barbara, Kortum, Ria, Martin, Lily, Wiel, Lisa S., Kligler, Ben, Gould-Fogerite, Susan, Zhang, Yuqing, Riva, John J., Lumpkin, Michael, Ratner, Emily, Ping, Liu, Jian, Pei, Hamme, Gesa-Meyer, Mao, Xiaosong, Chouping, Han, Schröder, Sven, Hummelsberger, Josef, Wullinger, Michael, Brodzky, Marc, Zalpour, Christoff, Langley, Julia, Weber, Wendy, Mudd, Lanay M., Wayne, Peter, Witt, Clauda, Weidenhammer, Wolfgang, Fønnebø, Vinjar, Boon, Heather, Steel, Amie, Bugarcic, Andrea, Rangitakatu, Melisa, Adams, Jon, Sibbritt, David, Wardle, Jon, Leach, Matthew, Schloss, Janet, Dieze, Helene, Ijaz, Nadine, Heinrich, Michael, Lewith, George, Graz, Bertr, Adam, Daniela, Grabenhenrich, Linus, Ortiz, Miriam, Binting, Sylvia, Reinhold, Thomas, Andermo, Susanne, Nordberg, Johanna Hök, Arman, Maria, Bhasin, Manoj, Fan, Xueyi, Libermann, Towia, Fricchione, Gregory, Denninger, John, Benson, Herbert, Martin, David D., Boers, Inge, Vlieger, Arine, Teut, Michael, Ullmann, Alex, Lotz, Fabian, Roll, Stephanie, Canella, Claudia, Mikolasek, Michael, Rostock, Matthias, Beyer, Jörg, Guckenberger, Matthias, Jenewein, Josef, Linka, Esther, Six, Claudia, Stoll, Sarah, Stupp, Roger, Witt, Claudia M., Chuang, Elisabeth, Mckee, Melissa D., Klose, Petra, Lange, Silke, Chung, Vincent C. H., Wong, Hoi L. C., Wu, Xin Y., Wen, Grace Y. G., Ho, Robin S. T., Ching, Jessica Y. L., Wu, Justin C. Y., Coakley, Am, a, Flanagan, Jane, Annese, Christine, Empoliti, Joanne, Gao, Zishan, Liu, Xugang, Yu, Shuguang, Yan, Xianzhong, Liang, Fanrong, Hohmann, Christoph D., Steckhan, Nico, Ostermann, Thomas, Paetow, Arion, Hoff, Evelyn, Hu, Xiao-Yang, Wu, Ruo-Han, Logue, Martin, Blonde, Clara, Lai, Lily Y., Stuart, Beth, Fei, Yu-Tong, Moore, Michael, Liu, Jian-Ping, Jeitler, Michael, Zillgen, Hannah, Högl, Manuel, Stöckigt, Barbara, Seifert, Georg, Kessler, Christian, Khadivzadeh, Talat, Bashtian, Maryam Hassanzadeh, Aval, Shapour Badiee, Esmaily, Habibollah, Kim, Jihye, Kim, Keun H., Klocke, Carina, Joos, Stefanie, Koshak, Abdulrahman, Wie, Li, Koshak, Emad, Wali, Siraj, Alamoudi, Omer, Demerdash, Abdulrahman, Qutub, Majdy, Pushparaj, Peter, Kruse, Sigrid, Fischer, Isabell, Tremel, Nadine, Rosenecker, Joseph, Leung, Brenda, Takeda, Wendy, Liang, Ning, Feng, Xue, Cao, Hui-Juan, Shinday, Nina, Philpotts, Lisa, Park, Elyse, Fricchione, Gregory L., Yeh, Gloria, Munk, Niki, Zakeresfahani, Arash, Foote, Trevor R., Ralston, Rick, Boulanger, Karen, Özbe, Dominik, Gräßel, Elmar, Luttenberger, Katharina, Pendergrass, Anna, Pach, Daniel, Bellmann-Strobl, Judit, Chang, Yinhui, Pasura, Laura, Liu, Bin, Jäger, Sven F., Loerch, Ronny, Jin, Li, Icke, Katja, Shi, Xuemin, Paul, Friedemann, Rütz, Michaela, Lynen, Andreas, Schömitz, Meike, Vahle, Maik, Salomon, Nir, Lang, Alon, Lahat, Adi, Kopylov, Uri, Ben-Horin, Shomron, Har-Noi, Ofir, Avidan, Benjamin, Elyakim, Rami, Gamus, Dorit, Ng, Siew, Chang, Jessica, Wu, Justin, Kaimiklotis, John, Schumann, Dania, Buttó, Ludovica, Haller, Dirk, Smith, Caroline, Lacey, Sheryl, Chapman, Michael, Ratcliffe, Julie, Johnson, Neil, Lyttleton, Jane, Boothroyd, Clare, Fahey, Paul, Tjaden, Bram, Vliet, Marja, Wietmarschen, Herman, Tröger, Wilfried, Vuolanto, Pia, Aarva, Paulina, Sorsa, Minna, Helin, Kaija, Wenzel, Claudia, Zoderer, Iris, Pammer, Patricia, Simon, Patrick, Tucek, Gerhard, Wode, Kathrin, Henriksson, Roger, Sharp, Lena, Stoltenberg, Anna, Xiao-Ying, Yang, Wang, Li-Qiong, Li, Jin-Gen, Wang, Ying, Balneaves, Lynda, Capler, Rielle, Bocci, Chiara, Guffi, Marta, Paolini, Marina, Meaglia, Ilaria, Porcu, Patrizia, Ivaldi, Giovanni B., Dragan, Simona, Bucuras, Petru, Pah, Ana M., Badalica-Petrescu, Marius, Buleu, Florina, Hogea-Stoichescu, Gheorghe, Christodorescu, Rux, Kao, Lan, Cho, Yumin, Klafke, Nadja, Mahler, Cornelia, Hagens, Cornelia, Uhlmann, Lorenz, Bentner, Martina, Schneeweiss, Andreas, Mueller, Andreas, Szecsenyi, Joachim, Neri, Isabella, Schnabel, Katharina, Cree, Margit, Suhr, Ralf, Baccetti, Sonia, Firenzuoli, Fabio, Monechi, Maria V., Di Stefano, Mariella, Amunni, Gianni, Wong, Wendy, Chen, Bingzhong, Amri, Hakima, Kotlyanskaya, Lucy, Anderson, Belinda, Evans, Roni, Marantz, Paul, Bradley, Ryan, Booth-Laforce, Cathryn, Zwickey, Heather, Kligler, Benjamin, Brooks, Audrey, Kreitzer, Mary J., Lebensohn, Patricia, Goldblatt, Elisabeth, Esmel-Esmel, Neus, Jiménez-Herrera, Maria, Jocham, Alex, Berberat, Pascal O., Schneider, Antonius, Masetti, Morgana, Murakozy, Henriette, Agdal, Rita, Atarzadeh, Fatemeh, Jaladat, Amir M., Hoseini, Leila, Amini, Fatemeh, Bai, Chen, Liu, Tiegang, Zheng, Zian, Wan, Yuxiang, Xu, Jingnan, Wang, Xuan, Yu, He, Gu, Xiaohong, Daneshfard, Babak, Nimrouzi, Majid, Tafazoli, Vahid, Alorizi, Seyed M. Emami, Saghebi, Seyed A., Fattahi, Mohammad R., Salehi, Alireza, Rezaeizadeh, Hossein, Zarshenas, Mohammad M., Fox, Kealoha, Hughes, John, Kostanjsek, Nenad, Espinosa, Stéphane, Fisher, Peter, Latif, Abdul, Lefeber, Donald, Paske, William, Öztürk, Ali Ö, Öztürk, Gizemnur, Tissing, Wim, Naafs, Marianne, Busch, Martine, Sanaye, Mohammad R., Dräger, Kilian, Leininger, Brent, Shafto, Kate, Breen, Jenny, Simões-Wüst, Ana P., Moltó-Puigmartí, Carolina, Dongen, Martien, Dagnelie, Pieter, Thijs, Carel, White, Shelley, Wiesener, Solveig, Salamonsen, Anita, Stub, Trine, Abanades, Sergio, Blanco, Mar, Masllorens, Laia, Sala, Roser, Al-Ahnoumy, Shafekah, Han, Dongwoon, He, Luzhu, Kim, Ha Yun, In Choi, Da, Alræk, Terje, Kristoffersen, Agnete, Sceidt, Christel, Bruset, Stig, Musial, Frauke, Anheyer, Dennis, Saha, Felix J., Haller, Heidemarie, Azizi, Hoda, Khadem, Nayereh, Hassanzadeh, Malihe, Estiri, Nazanin, Azizi, Hamideh, Tavassoli, Fatemeh, Lotfalizadeh, Marzieh, Zabihi, Reza, Shabestari, Mahmoud Mohammadzadeh, Paeizi, Reza, Azari, Masoumeh Alv, i, Bahrami-Taghanaki, Hamidreza, Baars, Erik, Bruin, Anja, Ponstein, Anne, Segantini, Sergio, Monechi, Maria Valeria, Voller, Fabio, Barth, Jürgen, Kern, Alex, Lüthi, Sebastian, Zieger, Anja, Otto, Fabius, Beccia, Ariel, Dunlap, Corina, Courneene, Brendan, Bedregal, Paula, Passi, Alvaro, Rodríguez, Alfredo, Chang, Mayling, Gutiérrez, Soledad, Beissner, Florian, Preibisch, Christine, Schweizer-Arau, Annemarie, Popovici, Roxana, Meissner, Karin, Beljanski, Sylvie, Bell, Laura, Rivera-Reyes, Laura, Hwang, Ula, Sethe, Dominik, Hilgard, Dörte, Heusser, Peter, Bishop, Felicity, Al-Abbadey, Miznah, Bradbury, Katherine, Carnes, Dawn, Dimitrov, Borislav, Fawkes, Carol, Foster, Jo, Macpherson, Hugh, Roberts, Lisa, Yardley, Lucy, Holmes, Michelle, Little, Paul, Cooper, Cyrus, Bogani, Patrizia, Maggini, Valentina, Gallo, Eugenia, Miceli, Elisangela, Biffi, Sauro, Mengoni, Alessio, Fani, Renato, S-Guendling, Nadine, Guendling, Peter W., Bronfort, Gert, Haas, Mitch, Schulz, Craig, Bu, Xiangwei, Wang, J., Fang, T., Shen, Z., He, Y., Zhang, X., Zhang, Zhengju, Wang, Dali, Meng, Fengxian, Baumann, Klaus, Frick, Eckhard, Jacobs, Christoph, Grünther, Ralph-Achim, Lötzke, Désirée, Jung, Sonny, Recchia, Daniela R., Robens, Sibylle, Stankewitz, Josephin, Jeitler, Mika, Cheon, Chunhoo, Jang, Bo H., Ko, Seong G., Huang, Ching W., Sasaki, Yui, Ko, Youme, Cheshire, Anna, Ridge, Damien, Peters, David, Panagioti, Maria, Simon, Chantal, Cho, Hyun J., Choi, Soo J., Jung, Young S., Im, Hyea B., Cooley, Kieran, Tummon-Simmons, Laura, Wasson, Rachel, Kraemer, Kristen, Sears, Richard, Hueber, Carly, Derk, Gwendolyn, Lill, Jr, An, Ruopeng, Steinberg, Lois, Rodriguez, Lourdes Diaz, La Fuente, Francisca García-De, La Vega, Miguel, Vargas-Román, Keyla, Fernández-Ruiz, Jonatan, Cantarero-Villanueva, Irene, García-De La Fuente, Francisca, Jiménez-Guerrero, Fanny, Galiano-Castillo, Noelia, Diaz-Saez, Gualberto, Torres-Jimenez, José I., Garcia-Gomez, Olga, Hortal-Muñoz, Luis, Diaz-Diez, Camino, Dicen, Demijon, Diezel, Helene, Frawley, Jane, Broom, Alex, Dong, Fei, Ma, Xueyan, Yan, Liyi, Wu, Liqun, Ma, Jiaju, Zhen, Jianhua, Dubois, Julie, Rodondi, Pierre-Yves, Schwartze, Sophia, Trapp, Barbara, and Cysarz, Dirk

Subjects
0106 biological sciences, 0301 basic medicine, medicine.medical_specialty, business.industry, Alternative medicine, General Medicine, 01 natural sciences, 03 medical and health sciences, 030104 developmental biology, Complementary and alternative medicine, Family medicine, medicine, Integrative medicine, business, 010606 plant biology & botany

45. Measurement properties of quality-adjusted life year (QALY) measures among older adults with chronic neck pain

Author

Leininger, Brent

Subjects
EQ-5D, Neck pain, Older adults, Quality-adjusted life years, SF-6D
Abstract

Background Quality-adjusted life year (QALY) measures are an important outcome for assessing the cost-effectiveness of healthcare interventions. Ideally, the choice of QALY measures will be informed by the measurement properties within the population of interest. Currently, the EQ-5D and SF-6D are the most commonly used QALY measures within cost-effectiveness analyses for spine pain. A number of studies have assessed the measurement properties of QALY measures for individuals with spine pain, but primarily within surgical populations. The psychometric properties of QALY measures may vary substantially within non-surgical populations. The primary aim of this thesis is to assess the psychometric properties (reliability, validity, and responsiveness) of commonly used QALY measures (SF-6D, EQ-5D, EQ Visual Analog Scale) among older U.S. adults with chronic mechanical neck pain managed non-surgically. The secondary aim of the thesis is to assess differences in the psychometric properties of QALY measures derived from the same instrument (SF-6D), but using different valuation methods. Methods Data for the study was collected within a randomized clinical trial comparing different combinations of non-invasive interventions (home exercise and advice, supervised exercise therapy, spinal manipulation) for the management of chronic neck pain in older adults. Quality-adjusted life years (QALYs) were measured with the 1) SF-6D, 2) EQ-5D, and 3) Euroqol visual analogue scale (EQ VAS) using U.S. population values for the primary aim. Test-retest reliability was determined using intraclass correlation coefficients (ICCs). The Bland-Altman method for limits of agreement and the smallest detectable change (SDC) were used to assess agreement. The longitudinal known-group validity and responsiveness of QALY measures was estimated using four external criteria: 1) global perceived change in health; 2) global improvement in neck symptoms; 3) neck pain; and 4) neck disability. Known-group validity was assessed by calculating mean QALY changes for each category of global perceived change in health and neck symptoms in addition to quintiles of neck pain and disability improvement. The relative responsiveness of QALY changes was estimated using correlation and area under the receiver operating characteristic (ROC) curve analyses. Results The SF-6D demonstrated better test-retest reliability (ICC = 0.81; 95% CI 0.77 to 0.85) relative to the EQ-5D (ICC = 0.44; 95% CI 0.33 to 0.53) and EQ VAS (ICC = 0.68; 95% CI 0.61 to 0.75). In addition, the smallest detectable change was lowest for the SF-6D (0.16; 95% CI 0.14 to 0.17), followed by the EQ-5D (0.18; 95% CI 0.16 to 0.20), and EQ VAS (0.22; 95% CI 0.20 to 0.25). Differences in QALYs during the one-week baseline period were evenly spread over the range of mean QALYs for the SF-6D, but not the EQ-5D or EQ VAS. The SF-6D and EQ VAS demonstrated better longitudinal known-group validity relative to the EQ-5D. Mean SF-6D and EQ VAS QALY changes were monotonically decreasing across levels of improvement for three of the four external criteria. All three QALY measures demonstrated similar responsiveness to change. Correlations between QALY measures and three of the external criteria were similar and very low to low in strength (-0.233 to -0.391). Correlations with neck disability were low to moderate in strength with the SF-6D demonstrating the strongest association (-0.596; p-values for differences with EQ-5D and EQ VAS = 0.01). There were no significant differences among the QALY measures when measuring responsiveness with area under the ROC curve. SF-6D based QALY measures had similar reliability, agreement, validity, and responsiveness. Conclusions There were minor differences between U.S. QALY measures in terms of responsiveness; however, the SF-6D was more reliable and demonstrated less measurement error relative to the EQ-5D and EQ VAS, in addition to better known-group validity relative to the EQ-5D. The different methods for obtaining QALY values from the same instrument (SF-6D) had little to no impact on the psychometric properties.

Published
2016

46. Effectiveness of Spinal Manipulation and Biopsychosocial Self-Management compared to Medical Care for Low Back Pain: A Randomized Trial Study Protocol.

Author

Bronfort G, Delitto A, Schneider M, Heagerty P, Chou R, Connett J, Evans R, George S, Glick R, Greco C, Hanson L, Keefe F, Leininger B, Licciardone J, McFarland C, Meier E, Schulz C, and Turk D

Abstract

Background Chronic low back pain (cLBP) is widespread, costly, and burdensome to patients and health systems. Little is known about non-pharmacological treatments for the secondary prevention of cLBP. There is some evidence that treatments addressing psychosocial factors in higher risk patients are more effective than usual care. However, most clinical trials on acute and subacute LBP have evaluated interventions irrespective of prognosis. Methods We have designed a phase 3 randomized trial with a 2x2 factorial design. The study is also a Hybrid type 1 trial with focus on intervention effectiveness while simultaneously considering plausible implementation strategies. Adults (n = 1000) with acute/subacute LBP at moderate to high risk of chronicity based on the STarT Back screening tool will be randomized in to 1 of 4 interventions lasting up to 8 weeks: supported self-management (SSM), spinal manipulation therapy (SMT), both SSM and SMT, or medical care. The primary objective is to assess intervention effectiveness; the secondary objective is to assess barriers and facilitators impacting future implementation. Primary effectiveness outcome measures are: (1) average pain intensity over 12 months post-randomization (pain, numerical rating scale); (2) average low back disability over 12 months post-randomization (Roland-Morris Disability Questionnaire); (3) prevention of cLBP that is impactful at 10-12 months follow-up (LBP impact from the PROMIS-29 Profile v2.0). Secondary outcomes include: recovery, PROMIS-29 Profile v2.0 measures to assess pain interference, physical function, anxiety, depression, fatigue, sleep disturbance, and ability to participate in social roles and activities. Other patient-reported measures include LBP frequency, medication use, healthcare utilization, productivity loss, STarT Back screening tool status, patient satisfaction, prevention of chronicity, adverse events, and dissemination measures. Objective measures include the Quebec Task Force Classification, Timed Up & Go Test, the Sit to Stand Test, and the Sock Test assessed by clinicians blinded to the patients' intervention assignment. Discussion By targeting those subjects at higher risk this trial aims to fill an important gap in the scientific literature regarding the effectiveness of promising non-pharmacological treatments compared to medical care for the management of patients with an acute episode of LBP and the prevention of progression to a severe chronic back problem. Trial registration: ClinicalTrials.gov Identifier: NCT03581123.

Published
2023
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