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1992.04.20 :  Clinical Practice Guidelines

Contact: Bob Isquith (301)227-8370
April 20, 1992

     HHS Assistant Secretary for Health James Mason, M.D., today
announced the formation of a 23-member panel of private-sector
health care experts and consumers to develop clinical practice
guidelines for diagnosing and treating low back problems in
working-age adults.  The panel is sponsored by the Public Health
Service's Agency for Health Care Policy and Research.
        "No other health problem affects working-age Americans as
much as low back dysfunction," said Dr. Mason, who heads the Public
Health Service. "It reduces quality of life, cuts a person's
productivity and costs society billions of dollars every year," 
Dr. Mason said.
        One recent study estimated that the cost of medical
treatment alone was roughly $18 billion a year.  But diagnostic
tests, workers' compensation payments, money lost through reduced
productivity and related expenses drive the true cost of low back
dysfunction much higher.
        Diagnosing the cause of back pain can be difficult
and there is disagreement among physicians as to what constitutes
appropriate treatment.
        The formation of the new guideline development panel is
part of an AHCPR-led effort to improve the effectiveness of health
care in the United States.

     The panel will focus on the diagnosis and treatment of common
low back problems within the first three months of symptoms, taking
psychosocial, economic and legal issues into consideration.
        According to AHCPR Administrator J. Jarrett Clinton, M.D.,
who appointed the panel members, one of the goals of the guideline
will be to reduce the number of persons disabled by low back
problems by improving treatment of acute symptoms.
        The panel members were selected based on their training,
clinical experience and research in low back problems; leadership
in the field; commitment to the need for clinical guidelines and
other criteria.
        The group includes practicing physicians, nurses, physical
and occupational therapists, chiropractors, researchers and a
consumer representative. The members are:
        Stanley J. Bigos, M.D. (panel chair), professor, department
of orthopaedics, University of Washington School of Medicine,
Seattle, Wash.;
     
     Rev. 0. Richard Bowyer, The Wesley Foundation at Fairmont
State College, Fairmont, W.Va.;
     
     G. Richard Braen, M.D., professor and chairman, department of
emergency medicine, State University of New York at Buffalo, N.Y.;
     
     Kathleen C. Brown, Ph.D., R.N., professor of nursing,
University of Alabama School of Nursing, Birmingham, Ala.;
     
     Richard A. Deyo, M.D., M.P.H., associate professor of medicine
and health services, University of Washington, and principal
investigator of the AHCPR-funded Back Pain Outcome 
Assessment Team, Seattle, Wash.;

     Scott Haldeman, M.D., Ph.D., D.C., assistant clinical
professor, University of California, Irvine, Calif.;
     
     John L. Hart, D.O., chairman, department of physical medicine
and rehabilitation, University of Missouri-Columbia School of
Medicine, Columbia, Mo.;
     
     Ernest W. Johnson, M.D., professor, department of physical
medicine, Ohio State University College of Medicine, Columbus,
Ohio;
     
     Robert B. Keller, M.D., Cobb Medical Building, Belfast, Maine;
     
     Daniel K. Kido, M.D., professor of radiology, Mallinckrodt
Institute of Radiology, Washington University Medical Center, St.
Louis, Mo.;
     
     Matthew H. Liang, M.D., M.P.H., associate professor of
medicine, Harvard Medical School, Brigham and Women's Hospital,
Boston, Mass.;

        Roger M. Nelson, Ph.D., P.T., professor and chairman,
department of physical therapy, Thomas Jefferson University,
Philadelphia, Pa.;

     Margareta Nordin, Ph.D., Occupational and Industrial
Orthopaedic Center, Hospital for Joint Diseases, New York, N.Y.;

        Bernice D. Owen, Ph.D., R.N., professor, community health
services, University of Wisconsin-Madison School of Nursing,
Madison, Wis.;

        Malcolm H. Pope, Dr. Med. Sc., Ph.D., McClure professor
of musculoskeletal research, director of orthopaedic research and
director of the Vermont Rehabilitation Engineering Center for Low
Back Pain, department of orthopaedics and rehabilitation,
University of Vermont College of Medicine, Burlington, Vt.;

        Richard K. Schwartz, M.S., O.T.R., chairman and associate
professor, director of the industrial injury prevention
laboratory, department of occupational therapy, University of
Texas Health Science Center at San Antonio, San Antonio, Texas;

     Donald H. Stewart Jr., M.D., Syracuse, N.Y.;

     Jeffery L. Susman, M.D., assistant professor, department of
family practice, University of Nebraska Medical Center, Omaha,
Neb.;

        John J. Triano, D.C., M.A., director, Spinal Ergonomics and
Joint Research Laboratory, National College of Chiropractic,
Lombard, Ill.;

        Lucius Tripp, M.D., M.P.H., regional medical director,
Northern Region, General Motors Technical Center, Medical
Department, Warren, Mich.;

        Dennis C. Turk, Ph.D., director and professor, department
of psychiatry, anesthesiology and behavioral science, Pain
Evaluation and Treatment Institute, Pittsburgh, Pa.;

        Clark Watts, M.D., J.D., professor of surgery, University
of Maryland and director, department of neurosurgery, Maryland
Institute for Emergency Medical Services Systems, R. Adams Cowley
Shock Trauma Center, Baltimore, Md.;

        James Weinstein, D.O., professor of orthopaedics,
department of orthopaedics and director, Spine Diagnostic and
Treatment Center, Iowa City, Iowa.

        Once the panel has drafted the guideline, it will be
reviewed by other experts on low back problems and evaluated in
clinics and hospitals before being made available to
practitioners, patients, medical educators and others.
     
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