{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T20:07:26Z","timestamp":1775678846370,"version":"3.50.1"},"reference-count":51,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T00:00:00Z","timestamp":1759881600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Korea Health Technology R&D"},{"DOI":"10.13039\/501100003710","name":"Korea Health Industry Development Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003710","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008903","name":"Ministry of Health and Welfare","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008903","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Republic of Korea","award":["RS-2023-KH139336"],"award-info":[{"award-number":["RS-2023-KH139336"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Understanding the heterogeneity in treatment effectiveness is essential for developing personalized management strategies in clinical practice. We aimed to analyze the heterogeneity of outcomes related to pain, disability, and quality of life in patients undergoing conservative complementary and alternative medicine\u2013based treatment for lumbar disc herniation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>This is a prospective observational study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting and subjects<\/jats:title>\n                    <jats:p>We included 996 adults who had been diagnosed with lumbar disc herniation confirmed by magnetic resonance imaging findings within the prior 3\u2009years and who had been experiencing radiating pain with a numeric rating scale (NRS) score \u22655 for low back or radiating pain. Patients were recruited in Korean Medicine hospitals at 4 sites. Conservative complementary and alternative medicine\u2013based treatments included acupuncture, moxibustion, cupping, Chuna manual therapy, and herbal medicine. Baseline was measured, and the outcomes were followed up at 14\u2009days, discharge, and 6\u2009months after admission.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The main outcomes were pain (NRS), disability (Oswestry Disability Index [ODI]), and quality of life (EuroQol-5D-5L [EQ-5D-5L]). Latent trajectory analysis classified outcome groups. Baseline characteristics that were associated with prognosis were explored via logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 732 patients (73.5%) completed the 6-month follow-up. Patients were classified into 2 trajectory groups for each outcome. For back pain (NRS), 900 (90.4%) were in the \u201cImproved\u201d group, whereas 96 (9.6%) experienced relapse; leg pain showed a similar pattern. ODI classified patients into \u201cImproved\u201d (n\u2009=\u2009850, 85.3%) and \u201cLess Improved\u201d (n\u2009=\u2009146, 14.7%) groups. EQ-5D-5L divided patients into \u201cImproved\u201d (n\u2009=\u2009415, 41.7%) and \u201cHighly Improved\u201d (n\u2009=\u2009581, 58.3%) groups. Higher baseline scores for the respective outcomes were associated with a worse prognosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Distinct outcome trajectories highlight the heterogeneity in patient responses to conservative complementary and alternative medicine\u2013based treatments.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>ClinicalTrials.gov ID: NCT03750591; Clinical Research Information Service (CRIS) of Republic of Korea ID: KCT0003709.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/pm\/pnaf139","type":"journal-article","created":{"date-parts":[[2025,10,5]],"date-time":"2025-10-05T11:43:16Z","timestamp":1759664596000},"page":"434-442","source":"Crossref","is-referenced-by-count":0,"title":["Heterogeneity in effectiveness of 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