Models of care for managing non-specific low back pain.

Background: Alternative care models seek to improve the quality or efficiency of care, or both, and thus optimise patient health outcomes. They provide the same health care but change how, when, where, or by whom health care is delivered and co-ordinated. Examples include care delivered via telemedicine versus in-person care or care delivered to groups versus individual patients.

Cost savings of reducing opioid prescribing for the treatment of people with low back pain in general practice: a modelling study.

Background: Low back pain (LBP) is the leading cause of disability worldwide. Contrary to clinical guidelines, opioids are frequently prescribed early in the management of LBP in primary care, leading to potential harm and downstream healthcare costs. The objective of this study was to model the one-year impacts of strategies that reduce opioid prescribing for low back pain (LBP) in primary care on healthcare costs and overdose deaths Australia-wide and explore the potential for such strategies to be cost-neutral.

Imaging abnormalities of the acromioclavicular joint and subacromial space are common in asymptomatic shoulders: a systematic review.

Objectives: To determine the prevalence of acromioclavicular (AC) joint and subacromial space imaging abnormalities in asymptomatic adults, with a secondary objective of comparing findings between asymptomatic and symptomatic shoulders within the same study populations.

Methods: We conducted a systematic review of studies examining shoulder imaging abnormalities detected by X-ray, ultrasound (US), computed tomography (CT), and magnetic resonance imaging (MRI) in asymptomatic adults (PROSPERO registration CRD42018090041). This report focuses on AC joint and subacromial space abnormalities.

How Do Australians Manage Diagnostic Testing Risks? Focus Groups Linked to a Model of Behaviour Change.

Background: Diagnostic tests carry significant risks, and communications are needed to help lay people consider these. The development of communications has been hindered by poor knowledge about how lay people understand and negotiate testing risks. We examined lay Australians' perceptions of diagnostic testing risks and how these risks are managed.

Clinician and health service interventions to reduce the greenhouse gas emissions generated by healthcare: a systematic review.

Objective: To synthesise the available evidence on the effects of interventions designed to improve the delivery of healthcare that reduces the greenhouse gas (GHG) emissions of healthcare.

Design: Systematic review and structured synthesis.

Search Sources: Cochrane Central Register of Controlled Trials, PubMed, Web of Science and Embase from inception to 3 May 2023.

Are clinically unimportant findings qualified as benign in lumbar spine imaging reports? A content analysis of plain X-ray, CT and MRI reports.

Background: Lumbar spine diagnostic imaging reports may cause patient and clinician concern when clinically unimportant findings are not explicitly described as benign. Our primary aim was to determine the frequency that common, benign findings are reported in lumbar spine plain X-ray, computed tomography (CT) and magnetic resonance imaging (MRI) reports as either normal for age or likely clinically unimportant.

Methods: We obtained 600 random de-identified adult lumbar spine imaging reports (200 X-ray, 200 CT and 200 MRI) from a large radiology provider.

Evolving and evaluating the OMERACT fellows program: insights and implications from OMERACT 2023 fellows.

Objective: To describe the evolution of the OMERACT Fellows Program (OM FP) and to evaluate the innovative changes implemented in the 2023 program.

Methods: The OM FP, the first of its kind in global rheumatology, was developed in 2000 to mentor early career researchers in methods and processes for reaching evidence-driven consensus for outcome measures in clinical studies. The OM FP has evolved through continuing iterations of face to face and online feedback.

Association of state-level prescription drug monitoring program implementation with opioid prescribing transitions in primary care in Australia.

Aims: This study aimed to evaluate whether voluntary and mandatory prescription drug monitoring program (PDMP) use in Victoria, Australia, had an impact on prescribing behaviour, focusing on individual patients' prescribed opioid doses and transition to prescribing of nonmonitored medications.

Methods: This was a retrospective cross-sectional study using routinely collected primary healthcare data. A 90-day moving average prescribed opioid dose in oral morphine equivalents was used to estimate opioid dosage.

Referral Patterns for People With Musculoskeletal Complaints in General Practice: An Analysis From an Australian Primary Care Database.

Objective: Our objective was to examine referral patterns for people with musculoskeletal complaints presenting to Australian general practitioners (GPs).

Methods: This longitudinal analysis from the Population Level Analysis Reporting (POLAR) database includes 133,279 patients with low back (≥18 years old) or neck, shoulder, and/or knee (≥45 years old) complaints seen by 4,538 GPs across 269 practices from 2014 through 2018. Referrals to allied health and medical and/or surgical specialists were included.

Patterns of Imaging Requests By General Practitioners for People With Musculoskeletal Complaints: An Analysis From a Primary Care Database.

Objective: The aim of this study was to examine imaging requested by general practitioners (GPs) for patients with low back, neck, shoulder, and knee complaints over 5 years (2014-2018).

Methods: This analysis from the Australian Population Level Analysis and Reporting database included patients presenting with a diagnosis of low back, neck, shoulder, and/or knee complaints. Eligible imaging requests included low back and neck x-ray, computed tomography (CT), and magnetic resonance imaging (MRI); knee x-ray, CT, MRI, and ultrasound; and shoulder x-ray, MRI, and ultrasound.

Cohort profile: Using primary care data to understand Opioid Prescribing, Policy Impacts and Clinical Outcomes (OPPICO) in Victoria, Australia.

Purpose: The OPPICO cohort is a population-based cohort based on non-identifiable electronic health records routinely collected from 464 general practices in Victoria, Australia, created with the aim of understanding opioid prescribing, policy impacts and clinical outcomes. The aim of this paper is to provide a profile of the study cohort by summarising available demographic, clinical and prescribing characteristics.

Participants: The cohort described in this paper comprises people who were aged at least 14 years at cohort entry, and who were prescribed an opioid analgesic at least once at participating practices for a total of 1 137 728 person-years from 1 January 2015 to 31 December 2020.

Prevalence and characteristics of musculoskeletal complaints in primary care: an analysis from the population level and analysis reporting (POLAR) database.

Background: Electronic health record datasets have been used to determine the prevalence of musculoskeletal complaints in general practice but not to examine the associated characteristics and healthcare utilisation at the primary care level.

Aim: To describe the prevalence and characteristics of patients presenting to general practitioners with musculoskeletal complaints.

Design And Setting: A five-year analysis within three Primary Health Networks (PHNs) in Victoria, Australia.

The environmental impact of health care for musculoskeletal conditions: A scoping review.

Background: Health care has significant environmental impact. We performed a scoping review to map what is known about the environmental impact of health care for musculoskeletal conditions.

Methods: We included published papers of any design that measured or discussed environmental impact of health care or health support services for any musculoskeletal condition in terms of climate change or global warming (e.

How do people perceive different labels for rotator cuff disease? A content analysis of data collected in a randomised controlled experiment.

Objectives: Explore how people perceive different labels for rotator cuff disease in terms of words or feelings evoked by the label and treatments they feel are needed.

Setting: We performed a content analysis of qualitative data collected in a six-arm, online randomised controlled experiment.

Participants: 1308 people with and without shoulder pain read a vignette describing a patient with rotator cuff disease and were randomised to one of six labels: and .

Trends in management of hip and knee osteoarthritis in general practice in Australia over an 11-year window: a nationwide cross-sectional survey.

Background: We aimed to describe trends in knee and hip OA management by general medical practitioners (GPs) in Australia.

Methods: We analysed cross-sectional survey data from the Bettering the Evaluation and Care of Health (BEACH) program (1,000 randomly-selected GPs annually recording 100 consecutive patient encounters) over two periods: Period one April 1, 2005-March 31, 2010 and period two April 1, 2010-March 31, 2016. This included data from 10,738 GPs and 1,073,800 patient encounters with 6,565 GPs and 9,196 patient encounters for hip/knee OA.

How do people understand overtesting and overdiagnosis? Systematic review and meta-synthesis of qualitative research.

Rationale: The public should be informed about overtesting and overdiagnosis. Diverse qualitative studies have examined public understandings of this information. A synthesis was needed to systematise the body of evidence and yield new, generalisable insights.

Diagnostic Labels for Rotator Cuff Disease Can Increase People's Perceived Need for Shoulder Surgery: An Online Randomized Controlled Trial.

Objective: To investigate whether different labels for rotator cuff disease influence people's perceived need for surgery.

Design: Randomized controlled experiment.

Methods: Participants with and without shoulder pain read a vignette describing a patient with rotator cuff disease and were randomized to 1 of 6 terms describing rotator cuff disease: , , , , , and .

How do patients and the public understand overtesting and overdiagnosis? A protocol for a thematic meta-synthesis of qualitative research.

Introduction: Examining patient and public understanding of overtesting and overdiagnosis (OverTD) is vital for reducing the burden of OverTD. Studies from disparate contexts, disciplines and focusing on disparate healthcare issues have examined patient and public understanding of OverTD. A synthesis is needed to bring this literature together, examine common themes, strengthen conclusions and identify gaps.

The effect of transferring weekend physical therapy services from the acute to sub-acute setting in patients following hip and knee arthroplasty: a quasi-experimental study.

Background: Weekend physical therapy services in the acute and/or sub-acute setting may optimize postoperative recovery following hip and knee arthroplasty, though evidence supporting these services is limited.

Purpose: To explore the change in patient and service outcomes of transferring a weekend physical therapy service from the acute to the sub-acute setting following hip and knee arthroplasty.

Methods: This was a quasi-experimental research design nested within two stepped-wedge cluster randomized controlled trials.

Patients' experience of shoulder disorders: a systematic review of qualitative studies for the OMERACT Shoulder Core Domain Set.

Objectives: To describe the experiences (including symptoms and perceived impacts on daily living) of people with a shoulder disorder.

Methods: Systematic review of qualitative studies. We searched for eligible qualitative studies indexed in Ovid MEDLINE, Ovid Embase, CINAHL (EBSCO), SportDiscus (EBSCO) and Ovid PsycINFO up until November 2017.