Cost-based evaluations of the treatment of back pain: A primer for health-care professionals

Background context: There is an extensive literature on the costs of back pain and on cost-based evaluations of the effectiveness of alternative modes of care for back pain. An understanding of the adequacy of a study often requires information that is not part of the experience or training of health-care professionals. The article seeks to provide clinicians with some criteria by which to judge the validity of cost-based evaluations of the treatment and consequences of back pain. Purpose: This article is not a comprehensive, critical review of the research literature on the costs of back pain or the relative cost-effectiveness of different methods of care for back pain. It presents, instead, a discussion of some important characteristics of cost-related studies of back pain and some criteria that can be used to evaluate the validity of cost estimates and cost-effectiveness analyses related to back pain. Study design: A guide for the evaluation of cost-based studies of back pain. Methods: A summary of criteria for the evaluation of the validity of cost-based studies of back pain. Results: Three sets of criteria for evaluation, ranked from most important to least important. Conclusions: Application of the suggested criteria can enhance the ability of health-care professionals to better understand the limits and relative adequacy of cost-based studies of back pain.