The Maine Lumbar Spine Study, part I: Background and concepts

摘要: Study Design. This paper describes the backgroung and factors that led to development implementation of Maine Lumbar Spine Study, a prospective cohort study patients undergoing surgical non-surgical treatment herniated lumbar disc with sciatica symptomatic spinal stenosis. Objectives. To define leading methods designing implementing community-based effectiveness evaluate outcomes intervertebral Summary Background Data. Variations in utilization surgery for these conditions physicians' uncertainty regarding best way manage them resulted support alternatives. Methods. A design was used. Methods patient enrollment, data collection, management, analysis are described. An innovative method ascertaining representativeness enrolled versus nonenrolled population is presented. Results. The importance developing networks physicians discussed. Conclusions. These play an important role analyzing practice pattern variations stimulatting participating research. Because studies must be conducted at community level, mechanisms developed which implement efforts.