Abstract:
OBJECTIVE:To evaluate the effectiveness of an integrated care programme, combining a patient directed and a workplace directed intervention, for patients with chronic low back pain. DESIGN:Population based randomised controlled trial. SETTING:Primary care (10 physiotherapy practices, one occupational health service, one occupational therapy practice) and secondary care (five hospitals). PARTICIPANTS:134 adults aged 18-65 sick listed for at least 12 weeks owing to low back pain. INTERVENTION:Patients were randomly assigned to usual care (n=68) or integrated care (n=66). Integrated care consisted of a workplace intervention based on participatory ergonomics, involving a supervisor, and a graded activity programme based on cognitive behavioural principles. MAIN OUTCOME MEASURES:The primary outcome was the duration of time off work (work disability) due to low back pain until full sustainable return to work. Secondary outcome measures were intensity of pain and functional status. RESULTS:The median duration until sustainable return to work was 88 days in the integrated care group compared with 208 days in the usual care group (P=0.003). Integrated care was effective on return to work (hazard ratio 1.9, 95% confidence interval 1.2 to 2.8, P=0.004). After 12 months, patients in the integrated care group improved significantly more on functional status compared with patients in the usual care group (P=0.01). Improvement of pain between the groups did not differ significantly. CONCLUSION:The integrated care programme substantially reduced disability due to chronic low back pain in private and working life. Trial registration Current Controlled Trials ISRCTN28478651.
journal_name
BMJjournal_title
BMJ (Clinical research ed.)authors
Lambeek LC,van Mechelen W,Knol DL,Loisel P,Anema JRdoi
10.1136/bmj.c1035subject
Has Abstractpub_date
2010-03-16 00:00:00pages
c1035eissn
0959-8138issn
1756-1833journal_volume
340pub_type
杂志文章,多中心研究,随机对照试验abstract::One hundred and two patients returned structured questionnaires sent to clinics for sickle cell disease in the United Kingdom in order to gain greater insight into the patients' perception of painful crises. Most patients who suffer pain crises experience a prodromal stage that should be investigated further to find o...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.297.6646.452
更新日期:1988-08-13 00:00:00
abstract::The import of the HIV or AIDS epidemic for heterosexuals in Britain is difficult to evaluate at this stage. By June 1988, only 60 cases of heterosexually acquired AIDS are known, out of 1598 reported AIDS cases. Of these, only 6 women and 4 men presumably were infected in Britain, the rest abroad. But, judging from...
journal_title:BMJ (Clinical research ed.)
pub_type: 社论
doi:10.1136/bmj.298.6671.401
更新日期:1989-02-18 00:00:00
abstract::In a series of papers published during the past decade Richard Wilkinson has advanced the view that income inequality is the key determinant of variations in average life expectancy at birth among developed countries. Yet a careful examination of the two sources of data on income distribution most often used by Wilkin...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.311.7015.1282
更新日期:1995-11-11 00:00:00
abstract:OBJECTIVE:To determine the association between exposure to radiotherapy for the treatment of prostate cancer and subsequent second malignancies (second primary cancers). DESIGN:Systematic review and meta-analysis of observational studies. DATA SOURCES:Medline and Embase up to 6 April 2015 with no restrictions on year...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.i851
更新日期:2016-03-02 00:00:00
abstract::About 70% of all abortions performed in Delhi, India, are terminations due to the fetus being female. Private clinics make a profit out of offering sex determination tests. The new bill (the Prenatal Diagnostic Techniques Bill) introduced in Lok Sabha by Deputy Health Minister Pawan Singh Ghatowatr would stop "sex d...
journal_title:BMJ (Clinical research ed.)
pub_type: 新闻
doi:10.1136/bmj.309.6952.428
更新日期:1994-08-13 00:00:00
abstract:OBJECTIVES:To evaluate the risk of venous thromboembolic events associated with the use of progestin-only contraception and whether that risk differs with the mode of drug delivery (oral, intrauterine, or depot injection). DESIGN:Systematic review and meta-analysis of randomised controlled trials and observational stu...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.e4944
更新日期:2012-08-07 00:00:00
abstract:OBJECTIVES:To investigate the association between intake of fish and n-3 polyunsaturated fatty acids (n-3 PUFA) and the risk of breast cancer and to evaluate the potential dose-response relation. DESIGN:Meta-analysis and systematic review of prospective cohort studies. DATA SOURCES:PubMed and Embase up to December 20...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.f3706
更新日期:2013-06-27 00:00:00
abstract:OBJECTIVE:To examine the associations between neuraxial anaesthesia or general anaesthesia and clinical outcomes, length of hospital stay, and readmission in adults undergoing lower limb revascularisation surgery. DESIGN:Comparative effectiveness study using linked, validated, population based databases. SETTING:Onta...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.m4104
更新日期:2020-11-25 00:00:00
abstract:OBJECTIVES:To determine the effectiveness of tai chi interventions compared with aerobic exercise, a current core standard treatment in patients with fibromyalgia, and to test whether the effectiveness of tai chi depends on its dosage or duration. DESIGN:Prospective, randomized, 52 week, single blind comparative effec...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,随机对照试验
doi:10.1136/bmj.k851
更新日期:2018-03-21 00:00:00
abstract:OBJECTIVE:To determine the relative importance of appropriate prescribing for asthma in explaining high rates of hospital admission for asthma among east London general practices. DESIGN:Poisson regression analysis describing relation of each general practice's admission rates for asthma with prescribing for asthma an...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.314.7079.482
更新日期:1997-02-15 00:00:00
abstract::The place of balloon dilatation of the aortic valve in the treatment of calcific aortic stenosis is controversial. Thirty two patients (mean age 76) in whom valve replacement was contraindicated were followed up for three to 24 months (mean 8); 25 were in functional class III or IV according to the New York Heart Asso...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.297.6655.1007
更新日期:1988-10-22 00:00:00
abstract:OBJECTIVE:To study the dynamic function of hypothalamic 5-hydroxytryptamine receptors in patients with postviral fatigue syndrome. DESIGN:Prospective comparison of patients with postviral fatigue syndrome with two control groups. SETTING:Department of neurology, University of Glasgow, Southern General Hospital; depar...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.304.6833.1010
更新日期:1992-04-18 00:00:00
abstract:OBJECTIVE:To estimate the costs of diagnosis and treatment of diabetes in Tanzania. DESIGN:Costs estimated from the reported and recorded experience of patients with newly presenting diabetes in 1989-90 and of diabetic patients first seen in 1981-2. SETTING:Muhimbili Medical Centre, Dar es Salaam. SUBJECTS:464 patie...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.304.6836.1215
更新日期:1992-05-09 00:00:00
abstract:OBJECTIVE:To analyse the cost effectiveness of a national programme to screen blood donors for infection with the human T cell leukaemia/lymphoma virus. DESIGN:Three models for calculating the costs and benefits of screening were developed. The first model analysed the cost of continuously testing all donations; the s...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.316.7142.1417
更新日期:1998-05-09 00:00:00
abstract:OBJECTIVE:To compare four potential screening strategies, and subsequent interventions, for the prevention and treatment of type 2 diabetes: (a) screening for type 2 diabetes to enable early detection and treatment, (b) screening for type 2 diabetes and impaired glucose tolerance, intervening with lifestyle interventio...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.39545.585289.25
更新日期:2008-05-24 00:00:00
abstract:OBJECTIVE:To determine the outcome of administration of neuroleptics to patients with senile dementia of Lewy body type confirmed at necropsy. DESIGN:Retrospective analysis of clinical notes blind to neuropathological diagnosis. SETTING:Specialist psychogeriatric assessment units referring cases for necropsy to a tea...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.305.6855.673
更新日期:1992-09-19 00:00:00
abstract:OBJECTIVE:To evaluate the relative efficacy of the World Health Organization 2005 campaign (WHO-5) and other interventions to promote hand hygiene among healthcare workers in hospital settings and to summarize associated information on use of resources. DESIGN:Systematic review and network meta-analysis. DATA SOURCES...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.h3728
更新日期:2015-07-28 00:00:00
abstract:OBJECTIVE:To see whether the issue of AIDS has influenced the observed decline in blood donation in Scotland. DESIGN:Two methods: a quantitative survey using personal interviews based on a questionnaire and a qualitative survey based on group discussions. SETTING:Interviews based on the questionnaire were conducted i...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.298.6679.1012
更新日期:1989-04-15 00:00:00
abstract::The aim of the study was to determine the outcome in 181 diabetic patients with advanced, previously untreated renal impairment who had been identified in a survey conducted in six health regions in the United Kingdom in 1985. Late in 1987 questionnaires were sent to the consultant physicians, geriatricians, and nephr...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.299.6708.1135
更新日期:1989-11-04 00:00:00
abstract:OBJECTIVE:To determine whether maternal smoking during pregnancy causes impairment in growth after birth. DESIGN:Longitudinal study. SETTING:Six medical university centres of six towns of north, central, and south Italy. SUBJECTS:12,987 babies (10,238 born from non-smoking mothers, 2276 from mothers smoking one to n...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.310.6982.768
更新日期:1995-03-25 00:00:00
abstract:OBJECTIVE:To estimate trends between 1972-6 and 1996 in the prevalences of asthma and hay fever in adults. DESIGN:Two epidemiological surveys 20 years apart. Identical questions were asked about asthma, hay fever, and respiratory symptoms at each survey. SETTING:Renfrew and Paisley, two towns in the west of Scotland....
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.321.7253.88
更新日期:2000-07-08 00:00:00
abstract:OBJECTIVE:To determine whether screening Danish men aged 65 or more for abdominal aortic aneurysms reduces mortality. DESIGN:Single centre randomised controlled trial. SETTING:All five hospitals in Viborg County, Denmark. PARTICIPANTS:All 12,639 men born during 1921-33 and living in Viborg County. In 1994 we include...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/bmj.38369.620162.82
更新日期:2005-04-02 00:00:00
abstract:OBJECTIVE:To determine the contribution of inheritance to the incidence of squamous cell carcinoma of the head and neck. DESIGN:Historical cohort study. First degree relatives of cases with squamous cell carcinoma of the head and neck made up the exposed cohort and first degree relatives of spouses of cases made up th...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.313.7059.716
更新日期:1996-09-21 00:00:00
abstract:OBJECTIVE:To assess the impact of a theoretically based sex education programme (SHARE) delivered by teachers compared with conventional education in terms of conceptions and terminations registered by the NHS. DESIGN:Follow-up of cluster randomised trial 4.5 years after intervention. SETTING:NHS records of women who...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.39014.503692.55
更新日期:2007-01-20 00:00:00
abstract:OBJECTIVE:To evaluate dynamic contrast enhanced computed tomography for detecting and localising pancreatic necrosis in acute pancreatitis. DESIGN:Prospective evaluation with blind reporting of scans. SETTING:Single teaching hospital. PATIENTS:60 Consecutive patients with acute pancreatitis suspected to have pancrea...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.300.6737.1425
更新日期:1990-06-02 00:00:00
abstract:OBJECTIVE:To quantify the association between exposure to higher temperatures and the risk of myocardial infarction at an hourly temporal resolution. DESIGN:Case-crossover study. SETTING:England and Wales Myocardial Ischaemia National Audit Project (MINAP) database. PARTICIPANTS:24,861 hospital admissions for myocar...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.e8050
更新日期:2012-12-13 00:00:00
abstract:OBJECTIVE:To determine whether prophylactic treatment with low molecular weight heparin reduces the incidence of thrombosis in patients who have had general or orthopaedic surgery. DESIGN:Meta-analysis of results from 52 randomised, controlled clinical studies (29 in general surgery and 23 in orthopaedic surgery) in w...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,meta分析,随机对照试验
doi:10.1136/bmj.305.6859.913
更新日期:1992-10-17 00:00:00
abstract:OBJECTIVE:To assess long term survival (> 5 years) and quality of life in severely ill patients referred for urgent cardiac transplantation. SETTING:Tertiary referral centres: before transplantation at the National Heart Hospital (late 1984 to end 1986); after transplantation at Harefield Hospital. SUBJECTS:Eighteen ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.306.6870.98
更新日期:1993-01-09 00:00:00
abstract:OBJECTIVES:To determine whether the dose of vitamin A currently recommended by the World Health Organization or half this dose gives better protection against childhood morbidity and mortality. DESIGN:Randomised study. SETTING:A combined oral polio vaccine and vitamin A supplementation campaign in Guinea-Bissau, Afri...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,随机对照试验
doi:10.1136/bmj.38670.639340.55
更新日期:2005-12-17 00:00:00
abstract::In the absence of any systematic evaluation of the changes it has made to the NHS, the government cites three "indicators of success." These are record numbers of patients treated, shorter waiting times for hospital treatment, and more children being immunised against the main childhood diseases. Closer inspection of ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:
更新日期:1995-04-22 00:00:00