The DECISION project: DiscrEte Choice experIment Spinal manipulative therapy for lOw back paiN: A study protocol

Area of Science:

• Health Sciences
• Rehabilitation Medicine
• Clinical Decision Making

Background:

• Low back pain (LBP) is a prevalent condition with various treatment options.
• Spinal manipulative therapy (SMT) is a common intervention for LBP, but its smallest worthwhile effect (SWE) is not well-defined.
• Understanding patient preferences is crucial for optimizing SMT treatment and shared decision-making.

Purpose of the Study:

• To establish the smallest worthwhile effect (SWE) of spinal manipulative therapy (SMT) for low back pain (LBP).
• To investigate how different attributes of SMT are valued and traded off by patients when making treatment choices.
• To inform clinical practice and patient guidance regarding SMT for LBP.

Main Methods:

• A mixed-methods approach combining qualitative interviews and consensus groups with quantitative Discrete Choice Experiment (DCE).
• Part 1: Qualitative data collection from SMT providers and LBP patients to identify key treatment attributes.
• Part 2: DCE survey administered to LBP patients with limited SMT experience to assess attribute preferences and trade-offs.

Main Results:

• (Study pending results) The study aims to identify and prioritize attributes influencing SMT choice for LBP.
• (Study pending results) The DCE will quantify the relative importance of different SMT attributes and establish the SWE.
• (Study pending results) Findings will provide insights into patient-centered value in SMT for LBP.

Conclusions:

• (Study pending results) Establishing the SWE of SMT for LBP will enhance treatment efficacy and patient satisfaction.
• (Study pending results) Understanding patient preferences will facilitate more informed and personalized SMT treatment decisions.
• (Study pending results) This research will contribute to evidence-based guidelines for SMT in managing LBP.