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End date: 2023 × Start date: 2023 × Version: publishedVersion × Publisher: San Francisco, California, US : PLOS × Subject: human ×

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    Effect on healthcare utilization and costs of spinal manual therapy for acute low back pain in routine care: A propensity score matched cohort study
    (San Francisco, California, US : PLOS, 2017) Walker, Jochen; Mertens, Ulf Kai; Schmidt, Carsten Oliver; Chenot, Jean-François
    Spinal manual therapy (SMT) is a popular treatment option for low back pain (LBP). The aim of our analysis was to evaluate the effects of manual therapy delivered by general practitioners and ambulatory orthopedic surgeons in routine care on follow up consultations, sick leave, health service utilization and costs for acute LBP compared to matched patients not receiving manual therapy. This is a propensity score matched cohort study based on health claims data. We identified a total of 113.652 adult patients with acute LBP and no coded red flags of whom 21.021 (18%) received SMT by physicians. In the final analysis 17.965 patients in each group could be matched. Balance on patients' coded characteristics, comorbidity and prior health service utilization was achieved. The provision of SMT for acute LBP had no relevant impact on follow up visits and days of sick leave for LBP in the index billing period and the following year. SMT was associated with a higher proportion of imaging studies for LBP (30.6% vs. 23%, SMD: 0.164 [95% CI 0.143-0.185]). SMT did not lead to meaningful savings by replacing other health services for LBP. SMT for acute non-specific LBP in routine care was not clinically meaningful effective to reduce sick leave and reconsultation rates compared to no SMT and did not lead to meaningful savings by replacing other health services from the perspective of health insurance. This does not imply that SMT is ineffective but might reflect a problem with selection of suitable patients and the quality and quantity of SMT in routine care. National Manual Medicine societies should state clearly that imaging is not routinely needed prior to SMT in patients with low suspicion of presence of red flags and monitor the quality of provided services.
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    Research data management in agricultural sciences in Germany: We are not yet where we want to be
    (San Francisco, California, US : PLOS, 2022) Senft, Matthias; Stahl, Ulrike; Svoboda, Nikolai
    To meet the future challenges and foster integrated and holistic research approaches in agricultural sciences, new and sustainable methods in research data management (RDM) are needed. The involvement of scientific users is a critical success factor for their development. We conducted an online survey in 2020 among different user groups in agricultural sciences about their RDM practices and needs. In total, the questionnaire contained 52 questions on information about produced and (re-)used data, data quality aspects, information about the use of standards, publication practices and legal aspects of agricultural research data, the current situation in RDM in regards to awareness, consulting and curricula as well as needs of the agricultural community in respect to future developments. We received 196 (partially) completed questionnaires from data providers, data users, infrastructure and information service providers. In addition to the diversity in the research data landscape of agricultural sciences in Germany, the study reveals challenges, deficits and uncertainties in handling research data in agricultural sciences standing in the way of access and efficient reuse of valuable research data. However, the study also suggests and discusses potential solutions to enhance data publications, facilitate and secure data re-use, ensure data quality and develop services (i.e. training, support and bundling services). Therefore, our research article provides the basis for the development of common RDM, future infrastructures and services needed to foster the cultural change in handling research data across agricultural sciences in Germany and beyond.