Acute and Subacute Neck Pain
Authors: Gert Bronfort
Journal: Annals of Internal Medicine (2012)

Letters1 May 2012Acute and Subacute Neck PainGert Bronfort, DC, PhD, Roni Evans, DC, MS, and Richard Grimm, MD, MPH, PhDGert Bronfort, DC, PhDFrom Wolfe-Harris Center for Clinical Studies, Northwestern Health Sciences University, Bloomington, MN 55431, and Berman Center for Outcomes and Clinical Research, Minneapolis, MN 55404Search for more papers by this author, Roni Evans, DC, MSFrom Wolfe-Harris Center for Clinical Studies, Northwestern Health Sciences University, Bloomington, MN 55431, and Berman Center for Outcomes and Clinical Research, Minneapolis, MN 55404Search for more papers by this author, and Richard Grimm, MD, MPH, PhDFrom Wolfe-Harris Center for Clinical Studies, Northwestern Health Sciences University, Bloomington, MN 55431, and Berman Center for Outcomes and Clinical Research, Minneapolis, MN 55404Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-156-9-201205010-00019 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:In response to Dr. Ernst, our study was a pragmatic trial designed to assess the comparative effectiveness of 3 commonly used management options for neck pain. The design was chosen to represent as closely as possible what happens in the real-world clinical setting in which treatment is tailored to individual patients (1). Pragmatic trials are not meant to control for placebo and nonspecific effects (different environments, time spent with patients, and others). Control of such effects requires an explanatory or fastidious trial.As described in the Discussion section of our article, both comparative effectiveness and fastidious trial designs ...References1. Luce BR, Kramer JM, Goodman SN, Connor JT, Tunis S, Whicher D, et al. Rethinking randomized clinical trials for comparative effectiveness research: the need for transformational change. Ann Intern Med. 2009;151:206-9. [PMID: 19567619] LinkGoogle Scholar2. Smith WS, Johnston SC, Skalabrin EJ, Weaver M, Azari P, Albers GW, et al. Spinal manipulative therapy is an independent risk factor for vertebral artery dissection. Neurology. 2003;60:1424-8. [PMID: 12743225] CrossrefMedlineGoogle Scholar3. Cassidy JD, Boyle E, Côté P, He Y, Hogg-Johnson S, Silver FL, et al. Risk of vertebrobasilar stroke and chiropractic care: results of a population-based case-control and case-crossover study. Spine (Phila Pa 1976). 2008;33:S176-83. [PMID: 18204390] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Gert Bronfort, DC, PhD; Roni Evans, DC, MS; Richard Grimm, MD, MPH, PhDAffiliations: From Wolfe-Harris Center for Clinical Studies, Northwestern Health Sciences University, Bloomington, MN 55431, and Berman Center for Outcomes and Clinical Research, Minneapolis, MN 55404Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M11-0299. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoRethinking Randomized Clinical Trials for Comparative Effectiveness Research: The Need for Transformational Change Bryan R. Luce , Judith M. Kramer , Steven N. Goodman , Jason T. Connor , Sean Tunis , Danielle Whicher , and J. Sanford Schwartz Spinal Manipulation, Medication, or Home Exercise With Advice for Acute and Subacute Neck Pain Gert Bronfort , Roni Evans , Alfred V. Anderson , Kenneth H. Svendsen , Yiscah Bracha , and Richard H. Grimm Acute and Subacute Neck Pain Edzard Ernst Acute and Subacute Neck Pain Guy Chapman Metrics 1 May 2012Volume 156, Issue 9 Page: 669 Keywords Arteries Comparative effectiveness research Conflicts of interest Disclosure Spine Stroke ePublished: 1 May 2012 Issue Published: 1 May 2012 Copyright & PermissionsCopyright © 2012 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...