Skip to main content

Table 3 Changes Made in the Chronic Neck Pain Panel for Spinal Mobilization

From: The impact of patient preferences and costs on the appropriateness of spinal manipulation and mobilization for chronic low back pain and chronic neck pain

 

No other adequate conservative care

Nonmanipulative conservative care has failed

Final ratings following traditional RUAM

At home ratings

In-person ratings not due to presentations

In-person ratings due to presentations

Final ratings following traditional RUAM

At home ratings

In-person ratings not due to presentations

In-person ratings due to presentations

Average median (1–9 scale)

4.3

4.3

4.3

4.2

4.7

4.7

4.6

4.6

Average MAD from median

1.2

1.3

1.1

1.1

1.2

1.1

1.0

1.0

Agreement [n (%)]*

70 (37.6%)

65 (34.9%)

76 (40.9%)

78 (41.9%)

82 (44.1%)

81 (43.5%)

91 (48.9%)

92 (49.5%)

Uncertain [n (%)]

114 (61.3%)

119 (64.0%)

110 (59.1%)

108 (58.1%)

100 (53.8%)

101 (54.3%)

95 (51.1%)

94 (50.5%)

Disagreement [n (%)]

2 (1.1%)

2 (1.1%)

0 (0.0%)

0 (0.0%)

4 (2.2%)

4 (2.2%)

0 (0.0%)

0 (0.0%)

Inappropriate

64 (34.4%)

65 (34.9%)

67 (36.0%)

69 (37.1%)

51 (10.0%)

51 (27.4%)

58 (31.2%)

58 (31.2%)

Equivocal

95 (51.1%)

95 (51.1%)

94 (50.5%)

92 (49.5%)

97 (65.8%)

96 (51.6%)

90 (48.4%)

90 (48.4%)

 Agreement and equivocal

10 (5.4%)

7 (3.8%)

14 (7.5%)

13 (7.0%)

19 (10.2%)

19 (10.2%)

24 (12.9%)

24 (12.9%)

 Disagreement

2 (1.1%)

2 (1.1%)

0 (0.0%)

0 (0.0%)

4 (2.2%)

4 (2.2%)

0 (0.0%)

0 (0.0%)

 Uncertain and equivocal

83 (44.6%)

86 (46.2%)

80 (43.0%)

79 (42.5%)

74 (39.8%)

73 (39.2%)

66 (35.5%)

66 (35.5%)

Appropriate

27 (14.5%)

26 (14.0%)

25 (13.4%)

25 (13.4%)

38 (20.4%)

39 (21.0%)

38 (20.4%)

38 (20.4%)

Total

186

186

186

186

186

186

186

186

  1. RUAM = RAND/UCLA Appropriateness Method – the traditional version of this did not consider patient preferences and cost
  2. *The numbers of clinical scenarios for which there was agreement across panelists increased significantly between at-home and in-person ratings; p < .001 for when there was no other adequate conservative care and p = .0076 for when nonmanipulative conservative care has failed