Acute low back pain and economics of therapy: The iterative loop approach

Valerie A. Lawrence, Peter Tugwell, Amiram Gafni, Weerachai Kosuwon, Walter O. Spitzer

Research output: Contribution to journalArticlepeer-review

21 Scopus citations


We use the measurement iterative loop as a conceptual framework to examine the economics of common therapies for acute non-specific low back pain. The measurement iterative loop systematically assesses the interlocking facets of an illness from the community health perspective, including quantifying burden of illness, etiology, assessment of therapeutic effectiveness, and economic evaluation of therapies. The iterative loop reveals that: (1) burden of illness, although known to be substantial, is so far inaccurately measured, (2) little is known about such factors as provider and patient compliance; and (3) the economics of therapy can guide us in this time of clinical uncertainty when no therapy appears clearly superior. For therapies with at least some support from randomized controlled trials, bedrest appears to be economically superior. Besides burden of illness, compliance, and current therapies, future research should address such "therapeutic" options as early return to work and patient self-management.

Original languageEnglish (US)
Pages (from-to)301-311
Number of pages11
JournalJournal of Clinical Epidemiology
Issue number3
StatePublished - Mar 1992


  • Acute non-specific low-back pain
  • Community health perspective
  • Economic evaluation
  • Measurement iterative loop

ASJC Scopus subject areas

  • Epidemiology


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