{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T03:55:25Z","timestamp":1793332525156,"version":"4.5.0"},"reference-count":32,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2020,12,17]],"date-time":"2020-12-17T00:00:00Z","timestamp":1608163200000},"content-version":"unspecified","delay-in-days":351,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Prim Health Care Res Dev"],"published-print":{"date-parts":[[2020]]},"abstract":"<jats:title>Abstract<\/jats:title>\n\t  <jats:sec id=\"S1463423620000626_as1\">\n\t    <jats:title>Aim:<\/jats:title>\n\t    <jats:p>Systematic identification, characterization and analysis of recommendations concerning the diagnosis and treatment of non-specific low back pain (LBP) in primary care provided in international evidence-based guidelines from high-income countries.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S1463423620000626_as2\">\n\t    <jats:title>Background:<\/jats:title>\n\t    <jats:p>LBP is one of the most common reasons for consulting a primary care physician and its prevalence is higher in high-income than in middle- or low-income countries. The majority of LBP is non-specific and treatment recommendations are not often based on high-quality and patient-oriented evidence.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S1463423620000626_as3\">\n\t    <jats:title>Methods:<\/jats:title>\n\t    <jats:p>We systematically searched PubMed and major guideline databases from 2013 to 2020. Two independent reviewers performed literature selection and the quality assessment of included guidelines using the AGREE II tool. We extracted all relevant recommendations including the corresponding Grade of Recommendation. We grouped all included recommendations by topic and compared them to each other.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S1463423620000626_as4\">\n\t    <jats:title>Findings:<\/jats:title>\n\t    <jats:p>This overview includes 10 current guidelines and overall 549 relevant recommendations. Recommendations covered aspects of assessment and diagnosis (15%), non-pharmacological interventions (46%), pharmacological interventions (26%), invasive treatments (8%) and multimodal pain management (5%). In total, 30% of all recommendations were strong and 57% weak or very weak. The proportion of recommendations for and against an intervention was 45% and 38%, respectively. The recommendations from the different guidelines were largely in good agreement. We identify only a small number of contradictory recommendations, mostly dealing with very specific interventions.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S1463423620000626_as5\">\n\t    <jats:title>Conclusion:<\/jats:title>\n\t    <jats:p>In conclusion, current evidence-based guidelines published in high-income countries provide recommendations for all major aspects of the management of people with LBP in primary care. Recommendations from different guidelines were largely consistent. More than 50% of these recommendations were weak or very weak and a high proportion of recommendation advised against an intervention.<\/jats:p>\n\t  <\/jats:sec>","DOI":"10.1017\/s1463423620000626","type":"journal-article","created":{"date-parts":[[2020,12,17]],"date-time":"2020-12-17T04:45:23Z","timestamp":1608180323000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":40,"title":["Management of non-specific low back pain in primary care \u2013 A systematic overview of recommendations from international evidence-based guidelines"],"prefix":"10.1017","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9292-4291","authenticated-orcid":false,"given":"Cornelia","family":"Krenn","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7251-042X","authenticated-orcid":false,"given":"Karl","family":"Horvath","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaus","family":"Jeitler","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carolin","family":"Zipp","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6980-2103","authenticated-orcid":false,"given":"Andrea","family":"Siebenhofer-Kroitzsch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1763-7855","authenticated-orcid":false,"given":"Thomas","family":"Semlitsch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2020,12,17]]},"reference":[{"key":"S1463423620000626_ref27","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpain.2010.03.002"},{"key":"S1463423620000626_ref1","unstructured":"AGREE Next Steps Consortium (2017) The AGREE II Instrument [Online] Retrieved December 2017 from http:\/\/www.agreetrust.org."},{"key":"S1463423620000626_ref12","doi-asserted-by":"publisher","DOI":"10.1007\/s00508-017-1301-0"},{"key":"S1463423620000626_ref8","unstructured":"Bundes\u00e4rztekammer (B\u00c4K), Kassen\u00e4rztliche Bundesvereinigung (KBV), Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF) (NVL) (2017) Nationale VersorgungsLeitlinie Nicht-spezifischer Kreuzschmerz \u2013 Langfassung, 2. 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DOI: 10.6101\/AZQ\/000353 [Online] Retrieved 30 May 2018 from www.kreuzschmerz.versorgungsleitlinien.de."},{"key":"S1463423620000626_ref29","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.18.226050"},{"key":"S1463423620000626_ref25","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-1331.2009.02648.x"},{"key":"S1463423620000626_ref22","unstructured":"North American Spine Society (NASS) (2020) Diagnosis and Treatment of Low Back Pain [Online] Retrieved 10 September 2020 from https:\/\/www.spine.org\/Research-Clinical-Care\/Quality-Improvement\/Clinical-Guidelines."},{"key":"S1463423620000626_ref28","doi-asserted-by":"publisher","DOI":"10.1093\/jamia\/ocy010"},{"key":"S1463423620000626_ref15","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2017.12.009"},{"key":"S1463423620000626_ref20","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2013.8992"},{"key":"S1463423620000626_ref6","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.i6748"},{"key":"S1463423620000626_ref13","doi-asserted-by":"publisher","DOI":"10.1136\/ebmed-2017-110704"},{"key":"S1463423620000626_ref21","unstructured":"National Guideline Centre. 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[Online] Retrieved May 2018 from https:\/\/www.who.int\/whr\/2003\/en\/."},{"key":"S1463423620000626_ref11","unstructured":"Department of Defense, Department of Veterans Affairs, Veterans Health Administration (VA\/DoD) (2017) VA\/DoD clinical practice guideline for diagnosis and treatment of low back pain [Online] Retrieved 30 May 2018 from https:\/\/www.guideline.gov\/summaries\/summary\/51134\/vadod-clinical-practice-guideline-for-diagnosis-and-treatment-of-low-back-pain."},{"key":"S1463423620000626_ref33","unstructured":"Institute for Clinical Systems Improvement (ICSI) (2018) Adult acute and subacute low back pain [Online] Retrieved 10 September 2020 from https:\/\/www.g-i-n.net\/library\/international-guidelines-library\/guidelines\/ahrq-us\/adult-low-back-pain-institute-for-clinical-systems."}],"container-title":["Primary Health Care Research &amp; Development"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S1463423620000626","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,12,17]],"date-time":"2020-12-17T04:46:15Z","timestamp":1608180375000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S1463423620000626\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020]]},"references-count":32,"alternative-id":["S1463423620000626"],"URL":"https:\/\/doi.org\/10.1017\/s1463423620000626","relation":{},"ISSN":["1463-4236","1477-1128"],"issn-type":[{"value":"1463-4236","type":"print"},{"value":"1477-1128","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020]]},"assertion":[{"value":"\u00a9 The Author(s) 2020","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is unaltered and is properly cited. The written permission of Cambridge University Press must be obtained for commercial re-use or in order to create a derivative work.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e64"}}