scholarly journals Clinician, patient and general public beliefs about diagnostic imaging for low back pain: protocol for a qualitative evidence synthesis

BMJ Open ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. e019470 ◽  
Author(s):  
Adrian C Traeger ◽  
Benjamin J Reed ◽  
Denise A O’Connor ◽  
Tammy C Hoffmann ◽  
Gustavo C Machado ◽  
...  
Keyword(s):  
Qualitative Research ◽  
Low Back Pain ◽  
Back Pain ◽  
Diagnostic Imaging ◽  
General Public ◽  
Evidence Synthesis ◽  
Qualitative Evidence Synthesis ◽  
Low Back ◽  
Public Beliefs ◽  
Qualitative Evidence

IntroductionLittle is known about how to reduce unnecessary imaging for low back pain. Understanding clinician, patient and general public beliefs about imaging is critical to developing strategies to reduce overuse.ObjectiveTo synthesise qualitative research that has explored clinician, patient or general public beliefs about diagnostic imaging for low back pain.Methods and analysisWe will perform a qualitative evidence synthesis of relevant qualitative research exploring clinician, patient and general public beliefs about diagnostic imaging for low back pain. Exclusions will be studies not using qualitative methods and studies not published in English. Studies will be identified using sensitive search strategies in MEDLINE, EMBASE, CINAHL, AMED and PsycINFO. Two reviewers will independently apply inclusion and exclusion criteria, extract data, and use the Critical Appraisal Skills Programme quality assessment tool to assess the quality of included studies. To synthesise the data we will use a narrative synthesis approach that involves developing a theoretical model, conducting a preliminary synthesis, exploring relations in the data, and providing a structured summary. We will code the data using NVivo. At least two reviewers will independently apply the thematic framework to extracted data. Confidence in synthesis findings will be evaluated using the GRADE Confidence in the Evidence from Reviews of Qualitative Research tool.Ethics and disseminationEthical approval is not required to conduct this review. We will publish the results in a peer-reviewed journal.PROSPERO registration numberCRD42017076047.

scholarly journals Clinician and patient beliefs about diagnostic imaging for low back pain: a systematic qualitative evidence synthesis

BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e037820 ◽  
Author(s):  
Sweekriti Sharma ◽  
Adrian C Traeger ◽  
Ben Reed ◽  
Melanie Hamilton ◽  
Denise A O’Connor ◽  
...  
Keyword(s):  
Qualitative Research ◽  
Low Back Pain ◽  
Back Pain ◽  
Diagnostic Imaging ◽  
General Public ◽  
Evidence Synthesis ◽  
Qualitative Studies ◽  
Qualitative Evidence Synthesis ◽  
Low Back ◽  
Qualitative Evidence

ObjectiveOveruse of diagnostic imaging for patients with low back pain remains common. The underlying beliefs about diagnostic imaging that could drive overuse remain unclear. We synthesised qualitative research that has explored clinician, patient or general public beliefs about diagnostic imaging for low back pain.DesignA qualitative evidence synthesis using a thematic analysis.MethodsWe searched MEDLINE, EMBASE, CINAHL, AMED and PsycINFO from inception to 17 June 2019. Qualitative studies that interviewed clinicians, patients and/or general public exploring beliefs about diagnostic imaging for low back pain were included. Four review authors independently extracted data and organised these according to themes and subthemes. We used the Critical Appraisal Skills Programme tool to critically appraise included studies. To assess confidence in review findings, we used the GRADE-Confidence in the Evidence from Reviews of Qualitative Research method.ResultsWe included 69 qualitative studies with 1747 participants. Key findings included: Patients and clinicians believe diagnostic imaging is an important test to locate the source of low back pain (33 studies, high confidence); patients with chronic low back pain believe pathological findings on diagnostic imaging provide evidence that pain is real (12 studies, moderate confidence); and clinicians ordered diagnostic imaging to reduce the risk of a missed diagnosis that could lead to litigation, and to manage patients’ expectations (12 studies, moderate confidence).ConclusionClinicians and patients can believe that diagnostic imaging is an important tool for locating the source of non-specific low back pain. Patients may underestimate the harms of unnecessary imaging tests. These beliefs could be important targets for intervention.PROSPERO registration numberCRD42017076047.

scholarly journals Qualitative Evidence Synthesis: Where Are We at?

2021 ◽  
Vol 20 ◽  
pp. 160940692199327
Author(s):  
Kate Flemming ◽  
Jane Noyes
Keyword(s):  
Qualitative Research ◽  
Systematic Reviews ◽  
Evidence Synthesis ◽  
Synthesis Methods ◽  
Qualitative Evidence Synthesis ◽  
Policy Makers ◽  
Qualitative Evidence ◽  
Health And Social Care ◽  
Method Paper ◽  
Increasing Demand

Qualitative evidence syntheses (QES) have increased in prominence and profile over the last decade as a discrete set of methodologies to undertake systematic reviews of primary qualitative research in health and social care and in education. The findings from a qualitative evidence synthesis can enable a richer interpretation of a particular phenomenon, set of circumstances, or experiences than single primary qualitative research studies can achieve. Qualitative evidence synthesis methods were developed in response to an increasing demand from health and social professionals, policy makers, guideline developers and educationalists for review evidence that goes beyond “what works” afforded by systematic reviews of effectiveness. The increasing interest in the synthesis of qualitative research has led to methodological developments documented across a plethora of texts and journal articles. This “State of the Method” paper aims to bring together these methodological developments in one place, contextualizing advances in methods with exemplars to support readers in making choices in approach to a synthesis and aid understanding. The paper clarifies what a “qualitative evidence synthesis” is and explores its role, purpose and development. It details the kind of questions a QES can explore, the processes associated with a QES, including the methods for synthesis. The rational and methods for integrating a QES with systematic reviews of effectiveness are also detailed. Finally approaches reporting and recognition of what a “good” or rigorous QES look like are provided.

scholarly journals Barriers and enablers to monitoring and deprescribing opioid analgesics for chronic non-cancer pain: protocol for a qualitative evidence synthesis using the Theoretical Domains Framework

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e034039
Author(s):  
Amanda J Cross ◽  
Rachelle Buchbinder ◽  
Allison Bourne ◽  
Christopher Maher ◽  
Stephanie Mathieson ◽  
...  
Keyword(s):  
Qualitative Research ◽  
Cancer Pain ◽  
Assessment Tool ◽  
Data Extraction ◽  
Evidence Synthesis ◽  
Theoretical Domains Framework ◽  
Opioid Analgesics ◽  
Qualitative Evidence Synthesis ◽  
Barriers And Enablers ◽  
Qualitative Evidence

IntroductionThe over-prescription and overuse of opioid analgesics for chronic non-cancer pain (CNCP) is a growing issue. Synthesis of evidence about the barriers and enablers to reducing long-term opioid prescribing and use will enable the development of tailored interventions to address both problems.ObjectiveTo synthesise the barriers and enablers to monitoring the ongoing appropriateness of opioid treatment and deprescribing opioids for CNCP from the clinician, patient and general public point of view, and to map the findings to the Theoretical Domains Framework (TDF).Methods and analysisWe will perform a qualitative evidence synthesis using the TDF. We will include qualitative research that has explored clinician, patient and the general public’s perceptions regarding barriers and enablers to monitoring and deprescribing opioids for CNCP. Studies will be identified via searches in MEDLINE, EMBASE, CINAHL, AMED and PsycINFO. Databases will be searched from inception to July 2019, and the studies must be published in English. Article selection and data extraction will be completed independently by two review authors. Methodological quality of included studies will be independently assessed by two review authors using the Critical Appraisal Skills Programme quality assessment tool. We will conduct thematic synthesis and then map identified themes and sub-themes to TDF domains. Confidence in synthesis findings will be evaluated using the Grading of Recommendations Assessment, Development, and Evaluation Confidence in the Evidence from Reviews of Qualitative Research tool.Ethics and disseminationEthical approval is not required to conduct this review. We will publish the results in a peer-reviewed journal.PROSPERO registration numberCRD42019140784

scholarly journals A qualitative evidence synthesis using meta-ethnography to understand the experience of living with pelvic organ prolapse

2020 ◽  
Vol 31 (12) ◽  
pp. 2631-2644
Author(s):  
Francine Toye ◽  
Jeannine Pearl ◽  
Katy Vincent ◽  
Karen Barker
Keyword(s):  
Decision Making ◽  
Qualitative Research ◽  
Pelvic Organ Prolapse ◽  
Evidence Synthesis ◽  
Pelvic Organ ◽  
Qualitative Evidence Synthesis ◽  
Conceptual Approach ◽  
Qualitative Evidence ◽  
Healthcare Improvement ◽  
Healthcare Decision Making

Abstract Introduction and hypothesis Pelvic organ prolapse (POP) affects the lives of many people. We aimed to systematically search for, identify and synthesize qualitative research that explores what it is like to live with POP and make this knowledge available for healthcare improvement. Methods We systematically searched Medline, PsychInfo, Embase and CINAHL, from inception to March 2020, for qualitative research exploring the experience of living with POP. We used meta-ethnography to synthesize findings. This is a conceptual approach to qualitative evidence synthesis. We used the recent guidelines for reporting meta-ethnography. Results We screened 3103 titles and 255 abstracts and included 37 primary studies. These incorporated the experience of 777 women, (aged 18 to 95 years) from a range of countries. We organized 162 ideas into 27 conceptual categories and 10 themes. We developed a conceptual model that helps us to understand the experience of pelvic organ prolapse. This model indicates that (1) the physical losses of POP are intricately linked to loss of identity; (2) women conceptualized POP as part of womanhood, yet also its thief; (3) there is a vicious cycle of taboo, silence and misunderstanding about POP and its treatment; (4) this silence is exacerbated by a feeling that POP is not taken seriously in healthcare. Conclusions This meta-ethnography helps us to understand the experience of living with a POP. Our model illustrates the complex process of healthcare decision making. Further studies to explore the complexity of decision making from the perspective of patient and health professional are timely.

Surgical Approaches for Degenerative Lumbar Stenosis

2018 ◽  
Author(s):  
Doniel Drazin ◽  
Carlito Lagman ◽  
Christine Piper ◽  
Ari Kappel ◽  
Terrence T. Kim
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Diagnostic Imaging ◽  
Surgical Management ◽  
Surgical Approaches ◽  
Low Back ◽  
Lumbar Stenosis ◽  
Instrumented Fusion ◽  
Common Causes ◽  
Ancillary Studies

This chapter discusses the evaluation of patients presenting with low back pain and the surgical management of three common causes of low back pain in adults: stenosis, spondylolisthesis, and scoliosis. Components of the history and physical examination, diagnostic imaging, and ancillary studies are reviewed. Surgical management includes decompression including laminectomy or laminotomy, and instrumented fusion. Indications, contraindications, general procedural steps, and potential complications are covered. Recent published literature is reviewed when appropriate.

scholarly journals Postsurgical rehabilitation for adults with low back pain with or without radiculopathy who were treated surgically: protocol for a mixed studies systematic review

BMJ Open ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. e036817 ◽  
Author(s):  
Carol Cancelliere ◽  
Jessica J. Wong ◽  
Hainan Yu ◽  
Margareta Nordin ◽  
Silvano Mior ◽  
...  
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Back Pain ◽  
Sports Medicine ◽  
Evidence Synthesis ◽  
Meta Analysis ◽  
Empirical Studies ◽  
Qualitative Studies ◽  
Low Back ◽  
Sequential Approach

IntroductionSurgical rates for low back pain (LBP) have been increasing in Europe, North America and Asia. Many patients treated surgically will require postsurgical rehabilitation. Little is known about the effectiveness of postsurgical rehabilitation interventions on health outcomes or about patients’ experiences with these interventions.ObjectivesTo conduct a mixed studies systematic review of quantitative and qualitative studies regarding: (1) the effectiveness and safety of postsurgical rehabilitation interventions for adults with LBP treated surgically and (2) the experiences of patients, healthcare providers, caregivers or others involved with the rehabilitation.Methods and analysisWe will search MEDLINE, Embase, PsycINFO, CINAHL, the Index to Chiropractic Literature, the Cochrane Controlled Register of Trials and the Rehabilitation & Sports Medicine Source for peer-reviewed empirical studies published from inception in any language. Studies using quantitative, qualitative and mixed methodologies will be included. We will also search reference lists of all eligible articles. Data extraction will include type of presurgical pathology, indication for surgery, surgical procedure, how the intervention was delivered and by whom, context and setting. We will conduct a quality assessment of each study and consider study quality in our evidence synthesis. We will use a sequential approach at the review level to synthesise and integrate data. First, we will synthesise the quantitative and qualitative studies independently, conducting a meta-analysis of the quantitative studies if appropriate and thematic synthesis of the qualitative studies. Then, we will integrate the quantitative and qualitative evidence by juxtaposing the findings in a matrix.Ethics and disseminationEthical approval is not required for this knowledge synthesis. Findings will be disseminated through knowledge translation activities including: (1) presentations at national and international conferences and scientific meetings; (2) presentations to local and international stakeholders; (3) publications in peer-reviewed journals and (4) posts on organisational websites.PROSPERO registration numberCRD42019134607.

scholarly journals Qualitative evidence synthesis for complex interventions and guideline development: clarification of the purpose, designs and relevant methods

2019 ◽  
Vol 4 (Suppl 1) ◽  
pp. e000882 ◽  
Author(s):  
Kate Flemming ◽  
Andrew Booth ◽  
Ruth Garside ◽  
Özge Tunçalp ◽  
Jane Noyes
Keyword(s):  
Qualitative Research ◽  
Systematic Reviews ◽  
Guideline Development ◽  
Evidence Synthesis ◽  
Complex Interventions ◽  
Real Life ◽  
Synthesis Methods ◽  
Qualitative Evidence Synthesis ◽  
Qualitative Evidence ◽  
Broad Term

This paper is one of a series exploring the implications of complexity for systematic reviews and guideline development, commissioned by the WHO. The paper specifically explores the role of qualitative evidence synthesis. Qualitative evidence synthesis is the broad term for the group of methods used to undertake systematic reviews of qualitative research evidence. As an approach, qualitative evidence synthesis is increasingly recognised as having a key role to play in addressing questions relating to intervention or system complexity, and guideline development processes. This is due to the unique role qualitative research can play in establishing the relative importance of outcomes, the acceptability, fidelity and reach of interventions, their feasibility in different settings and potential consequences on equity across populations. This paper outlines the purpose of qualitative evidence synthesis, provides detail of how qualitative evidence syntheses can help establish understanding and explanation of the complexity that can occur in relation to both interventions and systems, and how qualitative evidence syntheses can contribute to evidence to decision frameworks. It provides guidance for the choice of qualitative evidence synthesis methods in the context of guideline development for complex interventions, giving ‘real life’ examples of where this has occurred. Information to support decision-making around choice qualitative evidence synthesis methods in the context of guideline development is provided. Approaches for reporting qualitative evidence syntheses are discussed alongside mechanisms for assessing confidence in the findings of a review.

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