颈部疼痛患者潜在严重病理的危险信号:临床实践指南的系统回顾。

IF 2.1 Q1 REHABILITATION
Archives of physiotherapy Pub Date : 2024-12-04 eCollection Date: 2024-01-01 DOI:10.33393/aop.2024.3245
Daniel Feller, Alessandro Chiarotto, Bart Koes, Filippo Maselli, Firas Mourad
{"title":"颈部疼痛患者潜在严重病理的危险信号:临床实践指南的系统回顾。","authors":"Daniel Feller, Alessandro Chiarotto, Bart Koes, Filippo Maselli, Firas Mourad","doi":"10.33393/aop.2024.3245","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>We conducted a systematic review of clinical practice guidelines to identify red flags for serious pathologies in neck pain mentioned in clinical practice guidelines, to evaluate agreement in red flag recommendations across guidelines, and to investigate the level of evidence including what study type the recommendations are based on.</p><p><strong>Methods: </strong>We searched for guidelines focusing on specific and nonspecific neck pain in MEDLINE, EMBASE, and PEDro up to June 9, 2023. Additionally, we searched for guidelines through citation tracking strategies, by consulting experts in the field, and by checking guideline organization databases.</p><p><strong>Results: </strong>We included 29 guidelines, 12 of which provided a total of 114 red flags for fracture (n = 17), cancer (n = 21), spinal infection (n = 14), myelopathy (n = 15), injury to the spinal cord (n = 1), artery dissection (n = 7), intracranial pathology (n = 3), inflammatory arthritis (n = 2), other systemic disease (n = 6), or unrelated to a specific condition (n = 19). Overall, there is very little agreement (median Fleiss' kappa of 0) between guidelines on the red flags to screen for serious pathologies.</p><p><strong>Conclusion: </strong>Red flags were mainly supported by expert opinions. We also observed a general lack of consensus among guidelines regarding which red flags to endorse. Considering the current limitations of the evidence, specific recommendations on which red flags to use cannot be provided, except for using the Canadian C-Spine rule for screening posttraumatic fractures.</p>","PeriodicalId":72290,"journal":{"name":"Archives of physiotherapy","volume":"14 ","pages":"105-115"},"PeriodicalIF":2.1000,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11618059/pdf/","citationCount":"0","resultStr":"{\"title\":\"Red flags for potential serious pathologies in people with neck pain: a systematic review of clinical practice guidelines.\",\"authors\":\"Daniel Feller, Alessandro Chiarotto, Bart Koes, Filippo Maselli, Firas Mourad\",\"doi\":\"10.33393/aop.2024.3245\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>We conducted a systematic review of clinical practice guidelines to identify red flags for serious pathologies in neck pain mentioned in clinical practice guidelines, to evaluate agreement in red flag recommendations across guidelines, and to investigate the level of evidence including what study type the recommendations are based on.</p><p><strong>Methods: </strong>We searched for guidelines focusing on specific and nonspecific neck pain in MEDLINE, EMBASE, and PEDro up to June 9, 2023. Additionally, we searched for guidelines through citation tracking strategies, by consulting experts in the field, and by checking guideline organization databases.</p><p><strong>Results: </strong>We included 29 guidelines, 12 of which provided a total of 114 red flags for fracture (n = 17), cancer (n = 21), spinal infection (n = 14), myelopathy (n = 15), injury to the spinal cord (n = 1), artery dissection (n = 7), intracranial pathology (n = 3), inflammatory arthritis (n = 2), other systemic disease (n = 6), or unrelated to a specific condition (n = 19). Overall, there is very little agreement (median Fleiss' kappa of 0) between guidelines on the red flags to screen for serious pathologies.</p><p><strong>Conclusion: </strong>Red flags were mainly supported by expert opinions. We also observed a general lack of consensus among guidelines regarding which red flags to endorse. Considering the current limitations of the evidence, specific recommendations on which red flags to use cannot be provided, except for using the Canadian C-Spine rule for screening posttraumatic fractures.</p>\",\"PeriodicalId\":72290,\"journal\":{\"name\":\"Archives of physiotherapy\",\"volume\":\"14 \",\"pages\":\"105-115\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2024-12-04\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11618059/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Archives of physiotherapy\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.33393/aop.2024.3245\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q1\",\"JCRName\":\"REHABILITATION\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Archives of physiotherapy","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.33393/aop.2024.3245","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"REHABILITATION","Score":null,"Total":0}
引用次数: 0

摘要

我们对临床实践指南进行了系统回顾,以识别临床实践指南中提到的颈部疼痛严重病理的危险信号,评估指南中危险信号建议的一致性,并调查证据水平,包括建议所基于的研究类型。方法:我们在MEDLINE、EMBASE和PEDro中检索了截至2023年6月9日的针对特异性和非特异性颈部疼痛的指南。此外,我们通过引文跟踪策略、咨询该领域的专家以及检查指南组织数据库来搜索指南。结果:我们纳入了29份指南,其中12份提供了114个危险信号,包括骨折(n = 17)、癌症(n = 21)、脊柱感染(n = 14)、脊髓病(n = 15)、脊髓损伤(n = 1)、动脉夹层(n = 7)、颅内病理(n = 3)、炎性关节炎(n = 2)、其他全身性疾病(n = 6)或与特定疾病无关(n = 19)。总的来说,在筛查严重病理的危险信号方面,指南之间的一致性非常低(Fleiss kappa中值为0)。结论:红旗主要由专家意见支持。我们还观察到,对于支持哪些危险信号,指导方针之间普遍缺乏共识。考虑到目前证据的局限性,除了使用加拿大C-Spine规则筛查创伤后骨折外,无法提供关于使用危险信号的具体建议。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Red flags for potential serious pathologies in people with neck pain: a systematic review of clinical practice guidelines.

Introduction: We conducted a systematic review of clinical practice guidelines to identify red flags for serious pathologies in neck pain mentioned in clinical practice guidelines, to evaluate agreement in red flag recommendations across guidelines, and to investigate the level of evidence including what study type the recommendations are based on.

Methods: We searched for guidelines focusing on specific and nonspecific neck pain in MEDLINE, EMBASE, and PEDro up to June 9, 2023. Additionally, we searched for guidelines through citation tracking strategies, by consulting experts in the field, and by checking guideline organization databases.

Results: We included 29 guidelines, 12 of which provided a total of 114 red flags for fracture (n = 17), cancer (n = 21), spinal infection (n = 14), myelopathy (n = 15), injury to the spinal cord (n = 1), artery dissection (n = 7), intracranial pathology (n = 3), inflammatory arthritis (n = 2), other systemic disease (n = 6), or unrelated to a specific condition (n = 19). Overall, there is very little agreement (median Fleiss' kappa of 0) between guidelines on the red flags to screen for serious pathologies.

Conclusion: Red flags were mainly supported by expert opinions. We also observed a general lack of consensus among guidelines regarding which red flags to endorse. Considering the current limitations of the evidence, specific recommendations on which red flags to use cannot be provided, except for using the Canadian C-Spine rule for screening posttraumatic fractures.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
CiteScore
3.60
自引率
0.00%
发文量
0
审稿时长
10 weeks
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信