Overall , as a therapeutic intervention , structured patient education was equal or less effective than other conservative treatments including massage , supervised exercise , and physiotherapy .
However , structured patient education may provide small benefits when combined with physiotherapy .
Either mode of delivery ( ie , oral or written education ) provides similar results in patients with recent WAD .
Results suggest that structured patient education alone can not be expected to yield large benefits in clinical effectiveness compared with other conservative interventions for patients with WAD or NAD .
Moreover , structured patient education may be of benefit during the recovery of patients with WAD when used as an adjunct therapy to physiotherapy or emergency room care .
These benefits are small and short lived
BACKGROUND CONTEXT In 2008 , the Bone and Joint Decade 2000 to 2010 Task Force on Neck Pain and Its Associated Disorders recommended patient education for the management of neck pain .
However , the effectiveness of education interventions has recently been challenged .
PURPOSE To up date the findings of the Bone and Joint Decade 2000 to 2010 Task Force on Neck Pain and Its Associated Disorders and evaluate the effectiveness of structured patient education for the management of patients with whiplash-associated disorders ( WAD ) or neck pain and associated disorders ( NAD ) .
OUTCOME MEASURES Self-rated recovery , functional recovery ( eg , disability , return to activities , work , or school ) , pain intensity , health-related quality of life , psychological outcomes such as depression or fear , or adverse effects .
A new system for grading recommendations in evidence based guidelines
The Scottish Intercollegiate Guidelines Network ( SIGN ) develops evidence based clinical guidelines for the NHS in Scotl and . The key elements of the methodology are ( a ) that guidelines are developed by multidisciplinary groups ; ( b ) they are based on a systematic review of the scientific evidence ; and ( c ) recommendations are explicitly linked to the supporting evidence and grade d according to the strength of that evidence . Until recently , the system for grading guideline recommendations was based on the work of the US Agency for Healthcare Research and Quality ( formerly the Agency for Health Care Policy and Research ) . 1 2 However , experience over more than five years of guideline development led to a growing awareness of this system 's weaknesses . Firstly , the grading system was design ed largely for application to questions of effectiveness , where r and omised controlled trials are accepted as the most robust study design with the least risk of bias in the results . However , in many areas of medical practice r and omised trials may not be practical or ethical to undertake ; and for many questions other types of study design may provide the best evidence . Secondly , guideline development groups often fail to take adequate account of the method ological quality of individual studies and the overall picture presented by a body of evidence rather than individual studies or they fail to apply sufficient judgment to the overall strength of the evidence base and its applicability to the target population of the guideline . Thirdly , guideline users are often not clear about the implication s of the grading system . They misinterpret the grade of recommendation as relating to its importance , rather than to the strength of the supporting evidence , and may therefore fail to give due weight to low grade recommendations . # # # # Summary points A revised system of determining levels of evidence and grade s
Overall , as a therapeutic intervention , structured patient education was equal or less effective than other conservative treatments including massage , supervised exercise , and physiotherapy .
However , structured patient education may provide small benefits when combined with physiotherapy .
Either mode of delivery ( ie , oral or written education ) provides similar results in patients with recent WAD .
Results suggest that structured patient education alone can not be expected to yield large benefits in clinical effectiveness compared with other conservative interventions for patients with WAD or NAD .
Moreover , structured patient education may be of benefit during the recovery of patients with WAD when used as an adjunct therapy to physiotherapy or emergency room care .
These benefits are small and short lived
BACKGROUND CONTEXT In 2008 , the Bone and Joint Decade 2000 to 2010 Task Force on Neck Pain and Its Associated Disorders recommended patient education for the management of neck pain .
However , the effectiveness of education interventions has recently been challenged .
PURPOSE To up date the findings of the Bone and Joint Decade 2000 to 2010 Task Force on Neck Pain and Its Associated Disorders and evaluate the effectiveness of structured patient education for the management of patients with whiplash-associated disorders ( WAD ) or neck pain and associated disorders ( NAD ) .
OUTCOME MEASURES Self-rated recovery , functional recovery ( eg , disability , return to activities , work , or school ) , pain intensity , health-related quality of life , psychological outcomes such as depression or fear , or adverse effects .