{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T16:19:34Z","timestamp":1764260374922,"version":"3.46.0"},"reference-count":70,"publisher":"Wiley","issue":"S2","license":[{"start":{"date-parts":[[2024,10,23]],"date-time":"2024-10-23T00:00:00Z","timestamp":1729641600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["PM&amp;amp;R"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To perform a secondary review of low back pain (LBP) clinical practice guidelines (CPG) identified in a recently conducted systematic review and to synthesize and summarize low\u2010value recommendations as practices that may be candidates for deimplementation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Literature Survey<\/jats:title>\n                    <jats:p>LBP (subacute or chronic) CPGs in English (symptom based, created by a governmental or professional society, published between January 1990 and May 2020) were previously identified using MEDLINE, EMBASE, CINAHL, Ortho Guidelines, CPG Infobase, Emergency Care Research Institute, Guidelines International Network, National Institute of Health and Care Excellence, and Scottish Intercollegiate Guideline Network.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methodology<\/jats:title>\n                    <jats:p>Twenty\u2010one CPGs were reviewed from a systematic review (previously published). Full\u2010text review of all 21 CPGs was conducted, and three recommendation categories indicative of low value (recommend strongly against, recommend weakly against, inconclusive\/insufficient evidence) were identified using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) language and approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Synthesis<\/jats:title>\n                    <jats:p>\n                      One hundred thirty\u2010five low\u2010value recommendations were identified and classified under eight intervention categories: orthotics\/support, traction, physical modalities, pharmacological interventions, injections, surgery, bed rest, and miscellaneous. Traction, transcutaneous electrical nerve stimulation (TENS), therapeutic ultrasound (TUS), and selective serotonin reuptake inhibitors (SSRI) had the most CPGs recommend strongly against their usage. Opioids were recommended strongly against by four CPGs. No significant difference (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&gt;\u2009.05) was found between CPG quality and a specific deimplementation recommendation or between CPG quality and the number of strongly against, weakly against, and inconclusive\/insufficient evidence recommendations.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Clinicians managing patients with chronic LBP should consider deimplementing these low\u2010value interventions (traction, TENS, TUS, and SSRI).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pmrj.13270","type":"journal-article","created":{"date-parts":[[2024,10,24]],"date-time":"2024-10-24T02:28:40Z","timestamp":1729736920000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Low\u2010value interventions to deimplement: A secondary analysis of a systematic review of low back pain clinical practice guidelines"],"prefix":"10.1002","volume":"17","author":[{"given":"Daniel","family":"Tai","sequence":"first","affiliation":[{"name":"UT Southwestern Medical Center  Dallas Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eunyeop","family":"Kim","sequence":"additional","affiliation":[{"name":"UT Southwestern Medical Center  Dallas Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Prateek","family":"Grover","sequence":"additional","affiliation":[{"name":"Penn State Health Milton S. Hershey Medical Center Physical Medicine &amp; Rehabilitation  Hershey Pennsylvania USA"},{"name":"Penn State Health Rehabilitation Hospital  Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alejandro","family":"Rodriguez","sequence":"additional","affiliation":[{"name":"UT Southwestern Medical Center  Dallas Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Timothy J.","family":"Olivier","sequence":"additional","affiliation":[{"name":"UT Southwestern Medical Center  Dallas Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3969-9221","authenticated-orcid":false,"given":"Thiru M.","family":"Annaswamy","sequence":"additional","affiliation":[{"name":"Penn State Health Milton S. Hershey Medical Center Physical Medicine &amp; Rehabilitation  Hershey Pennsylvania USA"},{"name":"Penn State Health Rehabilitation Hospital  Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,10,23]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11916\u2010019\u20100757\u20101"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140\u20106736(18)30480\u2010x"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.mcna.2014.01.003"},{"key":"e_1_2_8_5_1","unstructured":"InformedHealth.org.Cologne Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006\u2010. What are clinical practice guidelines?2016Updated September 8 2016.https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK390308\/."},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10926\u2010009\u20109167\u20102"},{"issue":"2","key":"e_1_2_8_7_1","first-page":"S1","article-title":"An update of comprehensive evidence\u2010based guidelines for interventional techniques in chronic spinal pain. Part I: introduction and general considerations","volume":"16","author":"Manchikanti L","year":"2013","journal-title":"Pain Physician"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913\u2010020\u201005827\u2010w"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/ejp.1524"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/pmrj.12760"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2014.5444"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.h4534"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2019.13978"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1186\/1748\u20105908\u20109\u20101"},{"issue":"2","key":"e_1_2_8_15_1","first-page":"S49","article-title":"An update of comprehensive evidence\u2010based guidelines for interventional techniques in chronic spinal pain. Part II: guidance and recommendations","volume":"16","author":"Manchikanti L","year":"2013","journal-title":"Pain Physician"},{"volume-title":"Low Back Pain and Sciatica in over 16s: Assessment and Management","year":"2020","author":"National Institute for Health and Care Excellence (NICE)","key":"e_1_2_8_16_1"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586\u2010017\u20105099\u20102"},{"volume-title":"Low Back Pain: Early Management of Persistent Non\u2010specific Low Back Pain","year":"2009","author":"Savigny P","key":"e_1_2_8_18_1"},{"key":"e_1_2_8_19_1","first-page":"49","volume-title":"Adult Acute and Subacute Low Back Pain","author":"Institute for Clinical Systems Improvement (ICSI)","year":"2018"},{"key":"e_1_2_8_20_1","unstructured":"North American Spine Society (NASS).Evidence\u2010Based Clinical Guidelines for Multidisciplinary Spine Care: Diagnosis and Treatment of Low Back Pain.2020https:\/\/www.spine.org\/Portals\/0\/assets\/downloads\/ResearchClinicalCare\/Guidelines\/LowBackPain.pdf"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/rapm\u20102019\u2010101243"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586\u2010006\u20101072\u20101"},{"volume-title":"Minor Revision 2017 (3rd Edition) Evidence\u2010Informed Primary Care Management of low Back Pain: Clinical Practice Guideline","year":"2015","author":"Toward Optimized Practice (TOP) Low Back Pain Working Group","key":"e_1_2_8_23_1"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.36076\/ppj.2020\/23\/S1"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e3181a1390d"},{"key":"e_1_2_8_26_1","unstructured":"Van WambekeP DesomerA AillietL et al.Low Back Pain and Radicular Pain: Assessment and Management. Good Clinical Practice (GCP) Brussels: Belgian Health Care Knowledge Centre (KCE).2017KCE Reports 287."},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2019.06.004"},{"issue":"1","key":"e_1_2_8_28_1","first-page":"S1","article-title":"Responsible, safe, and effective use of biologics in the Management of low Back Pain: American Society of Interventional Pain Physicians (ASIPP) guidelines","volume":"22","author":"Navani A","year":"2019","journal-title":"Pain Physician"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-019-05086-4"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1111\/papr.12318"},{"key":"e_1_2_8_31_1","unstructured":"EBHC KT (SA) \u2013 Chair of Evidence\u2010based Healthcare and Knowledge translation CoM King Saud University. KSUMC Evidence\u2010Based Clinical Practice Guideline for Management of Persistent Non\u2010specific Low Back Pain (KSUMC CPG 1st Edition 2013): Adapted from source CPG: Low back pain: early management of persistent non\u2010specific low back pain (CG 88\u20132009) National Collaborating Centre for Primary Care (NCCPC) Royal College of General Practitioners (RCGP) and National Institute of Health and Care Excellence (NICE).2013https:\/\/faculty.ksu.edu.sa\/sites\/default\/files\/low_back_pain_cpg_final_2014.pdf"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.3171\/2014.4.SPINE14281"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aet172"},{"volume-title":"The Management of Acute\/Subacute Soft Tissue Injuries to the Low Back: Evidence Update and Recommendations for Clinical Practice","year":"2009","author":"Ju H","key":"e_1_2_8_34_1"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.14412\/2074\u20102711\u20102019\u20102s\u20107\u201016"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1002\/pmrj.12930"},{"key":"e_1_2_8_37_1","doi-asserted-by":"publisher","DOI":"10.1111\/papr.13033"},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD003010.pub3"},{"key":"e_1_2_8_39_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD003010.pub4"},{"key":"e_1_2_8_40_1","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD003010.pub5"},{"key":"e_1_2_8_41_1","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2015.6036"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms18112483"},{"key":"e_1_2_8_43_1","unstructured":"North American Spine Society: Five Things Physicians and Patients Should Question. Choosing Wisely An Initiative of the ABIM Foundation.2021Updated April 8 2019. Accessed July 26 2021.https:\/\/www.choosingwisely.org\/societies\/north-american-spine-society"},{"key":"e_1_2_8_44_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2017.4361"},{"key":"e_1_2_8_45_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2019.3842"},{"key":"e_1_2_8_46_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916\u2010015\u20100488\u2010z"},{"key":"e_1_2_8_47_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102018\u2010027370"},{"key":"e_1_2_8_48_1","doi-asserted-by":"publisher","DOI":"10.1111\/papr.13032"},{"key":"e_1_2_8_49_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13012\u2010022\u201001238\u2010z"},{"key":"e_1_2_8_50_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00586\u2010022\u201007378\u20106"},{"key":"e_1_2_8_51_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525\u20101497.2003.10205.x"},{"key":"e_1_2_8_52_1","doi-asserted-by":"publisher","DOI":"10.2519\/jospt.2022.10731"},{"key":"e_1_2_8_53_1","doi-asserted-by":"publisher","DOI":"10.1080\/09638288.2020.1743777"},{"key":"e_1_2_8_54_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13012\u2010016\u20100509\u20100"},{"issue":"3","key":"e_1_2_8_55_1","first-page":"95","article-title":"Can evidence change the rate of back surgery? A randomized trial of community\u2010based education","volume":"4","author":"Goldberg HI","year":"2001","journal-title":"Eff Clin Pract"},{"key":"e_1_2_8_56_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13012\u2010015\u20100209\u20101"},{"key":"e_1_2_8_57_1","doi-asserted-by":"publisher","DOI":"10.1111\/hex.13211"},{"key":"e_1_2_8_58_1","doi-asserted-by":"publisher","DOI":"10.2147\/JMDH.S78458"},{"key":"e_1_2_8_59_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0065471"},{"key":"e_1_2_8_60_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12875\u2010016\u20100441\u2010z"},{"key":"e_1_2_8_61_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13012\u2010023\u201001262\u20107"},{"key":"e_1_2_8_62_1","doi-asserted-by":"publisher","DOI":"10.1093\/pm\/pny085"},{"key":"e_1_2_8_63_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13012\u2010020\u201000990\u20104"},{"key":"e_1_2_8_64_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13012\u2010022\u201001199\u20103"},{"key":"e_1_2_8_65_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13012\u2010022\u201001251\u20102"},{"key":"e_1_2_8_66_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606\u2010020\u201006254\u20107"},{"key":"e_1_2_8_67_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.47178"},{"key":"e_1_2_8_68_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2018.3044"},{"key":"e_1_2_8_69_1","doi-asserted-by":"publisher","DOI":"10.1177\/2164956119855629"},{"key":"e_1_2_8_70_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2018.0235"},{"key":"e_1_2_8_71_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp2032396"}],"container-title":["PM&amp;R"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pmrj.13270","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T14:27:21Z","timestamp":1764253641000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pmrj.13270"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,10,23]]},"references-count":70,"journal-issue":{"issue":"S2","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1002\/pmrj.13270"],"URL":"https:\/\/doi.org\/10.1002\/pmrj.13270","archive":["Portico"],"relation":{},"ISSN":["1934-1482","1934-1563"],"issn-type":[{"type":"print","value":"1934-1482"},{"type":"electronic","value":"1934-1563"}],"subject":[],"published":{"date-parts":[[2024,10,23]]},"assertion":[{"value":"2023-04-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-07-17","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-10-23","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}