Joel M Stevans

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BACKGROUND AND PURPOSE Our nation's suboptimal health care quality and unsustainable costs can be linked to the failure to implement evidence-based interventions. Implementation is the bridge between the decision to adopt a strategy and its sustained use in practice. The purpose of this case report is threefold: (1) to outline the historical implementation(More)
OBJECTIVE The purpose of this study was to produce prevalence estimates and identify determinants of variability in chiropractic use in the US adult population. METHODS The Medical Expenditure Panel Survey was used to estimate prevalence for the adult population and subpopulations according to several sociodemographic, geographic, and health(More)
OBJECTIVE The primary aim of this study was to report nationally representative estimates of the visit utilization, per visit expenditures, and total expenditures for chiropractic episodes of care in the US adult population. The secondary aim was to identify clinical, demographic, geographic, and payment factors associated with variation in the levels of(More)
BACKGROUND Chronic low back pain causes substantial morbidity and cost to society while disproportionately impacting low-income and minority adults. Several randomized controlled trials show yoga is an effective treatment. However, the comparative effectiveness of yoga and physical therapy, a common mainstream treatment for chronic low back pain, is(More)
OBJECTIVE A health care facility (Jordan Hospital) implemented a multidimensional spine care pathway (SCP) using the National Center for Quality Assurance (NCQA) Back Pain Recognition Program (BPRP) as its foundation. The purpose of this report is to describe the implementation and results of a multidisciplinary, evidence-based, standardized process to(More)
OBJECTIVES The purpose of the study was to compare patterns of utilization and charges generated by medical doctors (MDs), doctors of chiropractic (DCs), and physical therapists (PTs) for the treatment of headache in North Carolina. METHODS Retrospective analysis of claims data from the North Carolina State Health Plan for Teachers and State Employees(More)
OBJECTIVES The purpose of the study was to compare utilization and charges generated by medical doctors (MD), doctors of chiropractic (DC) and physical therapists (PT) by patterns of care for the treatment of low back pain in North Carolina. METHODS This was an analysis of low-back-pain-related closed claim data from the North Carolina State Health Plan(More)
OBJECTIVES The purpose of the study was to compare utilization and charges generated by medical doctors (MD), doctors of chiropractic (DC) and physical therapists (PT) by provider patterns of care for the treatment of neck pain in North Carolina. METHODS This was an analysis of neck-pain-related closed claim data from the North Carolina State Health Plan(More)
STUDY DESIGN Randomized controlled trial with follow-up to 6 months. OBJECTIVE This was a comparative effectiveness trial of manual-thrust manipulation (MTM) versus mechanical-assisted manipulation (MAM); and manipulation versus usual medical care (UMC). SUMMARY OF BACKGROUND DATA Low back pain (LBP) is one of the most common conditions seen in primary(More)
The treatment-based classification (TBC) system for the treatment of patients with low back pain (LBP) has been in use by clinicians since 1995. This perspective article describes how the TBC was updated by maintaining its strengths, addressing its limitations, and incorporating recent research developments. The current update of the TBC has 2 levels of(More)