RT info:eu-repo/semantics/article
T1 Physician-Related Variability in the Outcomes of an Invasive Treatment for Neck and Back Pain: A Multi-Level Analysis of Data Gathered in Routine Clinical Practice
A1 Royuela Vicente, Ana
A1 Kovacs, Francisco M.
A1 Seco Calvo, Jesús Ángel
A1 Fernández Félix, Borja Manuel
A1 Abraira Santos, Víctor
A1 Zamora Romero, Javier
A2 Fisioterapia
K1 Fisioterapia
K1 Pain
K1 Disability
K1 Neuroreflexotherapy
K1 Post-marketing surveillance
K1 Variability
K1 Learning curve
AB [EN] Neuro-reflexotherapy (NRT) is a proven effective, invasive treatment for neck and back pain. To assess physician-related variability in results, data from post-implementation surveillance of 9023 patients treated within the Spanish National Health Service by 12 physicians were analyzed. Separate multi-level logistic regression models were developed for spinal pain (SP), referred pain (RP), and disability. The models included all patient-related variables predicting response to NRT and physician-related variables. The Intraclass Correlation Coefficient (ICC) and the Median Odds Ratio (MOR) were calculated. Adjusted MOR (95% CI) was 1.70 (1.47; 2.09) for SP, 1.60 (1.38; 1.99) for RP, and 1.65 (1.42; 2.03) for disability. Adjusted ICC (95%CI) values were 0.08 (0.05; 0.15) for SP, 0.07 (0.03; 0.14) for RP, and 0.08 (0.04; 0.14) for disability. In the sensitivity analysis, in which the 6920 patients treated during the physicians’ training period were excluded, adjusted MOR was 1.38 (1.17; 1.98) for SP, 1.37 (1.12; 2.31) for RP, and 1.25 (1.09; 1.79) for disability, while ICCs were 0.03 (0.01; 0.14) for SP, 0.03 (0.00; 0.19) for RP, and 0.02 (0.00; 0.10) for disability. In conclusion, the variability in results obtained by different NRT-certified specialists is reasonable. This suggests that current training standards are appropriate
PB MDPI
LK https://hdl.handle.net/10612/19498
UL https://hdl.handle.net/10612/19498
NO Royuela, A., Kovacs, F. M., Seco-Calvo, J., Fernández-Félix, B. M., Abraira, V., & Zamora, J. (2021). Physician-related variability in the outcomes of an invasive treatment for neck and back pain: A multi-level analysis of data gathered in routine clinical practice. International Journal of Environmental Research and Public Health, 18(8). https://doi.org/10.3390/IJERPH18083855
DS BULERIA. Repositorio Institucional de la Universidad de León
RD Jul 12, 2024