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BACKGROUND Back pain remains a challenge for primary care internationally. One model that has not been tested is stratification of the management according to the patient's prognosis (low, medium, or high risk). We compared the clinical effectiveness and cost-effectiveness of stratified primary care (intervention) with non-stratified current best practice(More)
OBJECTIVE To develop and validate a tool that screens for back pain prognostic indicators relevant to initial decision making in primary care. METHODS The setting was UK primary care adults with nonspecific back pain. Constructs that were independent prognostic indicators for persistence were identified from secondary analysis of 2 existing cohorts and(More)
STUDY OBJECTIVES To investigate the incidence, persistence, and consequences of insomnia and their associations with psychological health and pain. DESIGN A population based, longitudinal, cohort study using postal questionnaires at baseline and 12-month follow-up. Sleep problems in the past month were assessed using 4 questions: insomnia was defined as(More)
OBJECTIVES To compare the validity, responsiveness to change, and user friendliness of four self completed, shoulder-specific questionnaires in primary care. METHODS A cross sectional assessment of validity and a longitudinal assessment of responsiveness to change of four shoulder questionnaires was carried out: the Dutch Shoulder Disability Questionnaire(More)
The objective of the study was to examine the 1-year cumulative incidence of episodic neck pain and to explore its associations with individual risk factors, including a history of previous neck injury. A baseline cross-sectional survey of an adult general population sample made up of all 7669 adults aged 18-75 years, registered with two family practices in(More)
BACKGROUND Recommendations for the management of low back pain in primary care emphasise the importance of recognising and addressing psychosocial factors at an early stage. We compared the effectiveness of a brief pain-management programme with physiotherapy incorporating manual therapy for the reduction of disability at 12 months in patients consulting(More)
OBJECTIVE To determine the clinical effectiveness and cost-effectiveness of nurse-led care (NLC) for people with rheumatoid arthritis (RA). METHODS In a multicentre pragmatic randomised controlled trial, the assessment of clinical effects followed a non-inferiority design, while patient satisfaction and cost assessments followed a superiority design.(More)
RATIONALE The concept of evidence-based practice (EBP) encourages health care professionals to provide the most effective health care, and to be accountable for the interventions they provide. Little work has been undertaken to examine how practically allied health professionals' encompass EBP and how they perceptive and understand the concept of EBP. The(More)
OBJECTIVE To compare the clinical effectiveness of local corticosteroid injection, standard non-steroidal anti-inflammatory drugs, and simple analgesics for the early treatment of lateral epicondylitis in primary care. DESIGN Multicentre pragmatic randomised controlled trial. SETTING 23 general practices in North Staffordshire and South Cheshire. (More)
OBJECTIVE To investigate methods to determine the size of a pilot study to inform a power calculation for a randomized controlled trial (RCT) using an interval/ratio outcome measure. STUDY DESIGN Calculations based on confidence intervals (CIs) for the sample standard deviation (SD). RESULTS Based on CIs for the sample SD, methods are demonstrated(More)