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Clinical guidelines for the management of low back pain in primary care: an international comparison.

机译：基层医疗中治疗腰痛的临床指南：国际比较。

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STUDY DESIGN: Descriptive study. OBJECTIVES: To compare national clinical guidelines on low back pain. SUMMARY OF BACKGROUND DATA: To rationalize the management of low back pain, clinical guidelines have been issued in various countries around the world. Given that the available scientific evidence is the same, irrespective of the country, one would expect these guidelines to include more or less similar recommendations regarding diagnosis and treatment. METHODS: Guidelines were included that met the following criteria: the target group consisted of primary care health professionals, and the guideline was published in English, German, or Dutch. Only one guideline per country was included: the one most recently published. RESULTS: Clinical guidelines from 11 different countries published from 1994 until 2000 were included in this review. The content of the guidelines appeared to be quite similar regarding the diagnostic classification (diagnostic triage) and the use of diagnostic and therapeutic interventions. Consistent features were the early and gradual activation of patients, the discouragement of prescribed bed rest, and the recognition of psychosocial factors as risk factors for chronicity. However, there were discrepancies for recommendations regarding exercise therapy, spinal manipulation, muscle relaxants, and patient information. CONCLUSION: The comparison of clinical guidelines for the management of low back pain showed that diagnostic and therapeutic recommendations were generally similar. Updates of the guidelines are planned in most countries, although so far produced only in the United Kingdom. However, new evidence may lead to stronger conclusions and enable future guidelines to become even more concordant.
机译：研究设计：描述性研究。目的：比较下腰痛的国家临床指南。背景数据摘要：为了合理地管理下腰痛，世界各地的许多国家已经发布了临床指南。鉴于可获得的科学证据是相同的，无论是哪个国家/地区，人们都希望这些指南将包含有关诊断和治疗的或多或少相似的建议。方法：包括符合以下标准的指南：目标人群包括初级保健专业人员，并且该指南以英语，德语或荷兰语发布。每个国家仅包含一个指南：最近发布的一个。结果：1994年至2000年出版的来自11个不同国家的临床指南已包括在本评价中。关于诊断分类（诊断分类）以及使用诊断和治疗干预措施，指南的内容似乎非常相似。一致的特征是患者的早期和逐渐活跃，劝阻卧床休息以及将社会心理因素识别为慢性危险因素。但是，关于运动疗法，脊柱操纵，肌肉松弛剂和患者信息的建议存在差异。结论：对治疗下腰痛的临床指南进行的比较表明，诊断和治疗建议总体上相似。尽管迄今为止仅在联合王国制定，但大多数国家都计划对准则进行更新。但是，新的证据可能会得出更强有力的结论，并使未来的指导方针变得更加一致。

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