Diagnostic and management concordance between chiropractors and neurosurgeons for patients with low back pain
Abstract Low back pain is the leading contributor to disability worldwide and a major cause of primary care visits. Alternative models of care delivery drawing on musculoskeletal experts’ skills and knowledge have received increasing attention for their potential ability to improve timely access to...
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Nature Portfolio
2025-07-01
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| Online Access: | https://doi.org/10.1038/s41598-025-04529-9 |
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| author | Janny Mathieu Marie Beauséjour Claude-Édouard Châtillon Julie O’Shaughnessy Charles Tétreau Cesar A. Hincapié Petra Schweinhardt Martin Descarreaux Andrée-Anne Marchand |
| author_facet | Janny Mathieu Marie Beauséjour Claude-Édouard Châtillon Julie O’Shaughnessy Charles Tétreau Cesar A. Hincapié Petra Schweinhardt Martin Descarreaux Andrée-Anne Marchand |
| author_sort | Janny Mathieu |
| collection | DOAJ |
| description | Abstract Low back pain is the leading contributor to disability worldwide and a major cause of primary care visits. Alternative models of care delivery drawing on musculoskeletal experts’ skills and knowledge have received increasing attention for their potential ability to improve timely access to appropriate healthcare for patients with musculoskeletal disorders. The aim of this study was to evaluate diagnostic and management concordance between chiropractors, known as musculoskeletal experts, and neurosurgeons for patients with low back pain. Before being seen by a neurosurgeon, 101 eligible participants (mean age: 60.32 years) were evaluated by a chiropractor. Overall diagnostic agreement between chiropractors and neurosurgeons was 74.7%, with a moderate inter-rater diagnosis agreement (κ = 0.51; 95%CI [0.35–0.68]). Chiropractors were significantly less likely to attribute a diagnosis of non-specific LBP to participants (31.6%) compared to neurosurgeons (43.2%) (p = 0.02), with an agreement proportion of 80.0%. Overall management agreement was 82.0%, indicating that chiropractors possess good skills in triaging patients with low back pain, which can optimize patient trajectories by accelerating management of non-surgical cases and reducing waiting lists for spine surgery consultations. Prospective studies are needed to evaluate the impact of a chiropractor-informed triage on clinical outcomes and healthcare utilization for patients with low back pain. |
| format | Article |
| id | doaj-art-e9f3f7fc025841b5a2ea28ef9c09ec64 |
| institution | Kabale University |
| issn | 2045-2322 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Nature Portfolio |
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| series | Scientific Reports |
| spelling | doaj-art-e9f3f7fc025841b5a2ea28ef9c09ec642025-08-20T04:01:25ZengNature PortfolioScientific Reports2045-23222025-07-0115111310.1038/s41598-025-04529-9Diagnostic and management concordance between chiropractors and neurosurgeons for patients with low back painJanny Mathieu0Marie Beauséjour1Claude-Édouard Châtillon2Julie O’Shaughnessy3Charles Tétreau4Cesar A. Hincapié5Petra Schweinhardt6Martin Descarreaux7Andrée-Anne Marchand8Department of Anatomy, Université du Québec à Trois-RivièresDepartment of Community Health Sciences, Université de SherbrookeCentre intégré universitaire de Santé et de Services Sociaux de la Mauricie-et-du- Centre-du-QuébecChiropractic Department, Université du Québec à Trois-RivièresDepartment of Human Kinetics, Université du Québec à Trois-RivièresEpidemiology, Biostatistics and Prevention Institute (EBPI), University of ZurichDepartment of Chiropractic Medicine, Balgrist University HospitalDepartment of Human Kinetics, Université du Québec à Trois-RivièresChiropractic Department, Université du Québec à Trois-RivièresAbstract Low back pain is the leading contributor to disability worldwide and a major cause of primary care visits. Alternative models of care delivery drawing on musculoskeletal experts’ skills and knowledge have received increasing attention for their potential ability to improve timely access to appropriate healthcare for patients with musculoskeletal disorders. The aim of this study was to evaluate diagnostic and management concordance between chiropractors, known as musculoskeletal experts, and neurosurgeons for patients with low back pain. Before being seen by a neurosurgeon, 101 eligible participants (mean age: 60.32 years) were evaluated by a chiropractor. Overall diagnostic agreement between chiropractors and neurosurgeons was 74.7%, with a moderate inter-rater diagnosis agreement (κ = 0.51; 95%CI [0.35–0.68]). Chiropractors were significantly less likely to attribute a diagnosis of non-specific LBP to participants (31.6%) compared to neurosurgeons (43.2%) (p = 0.02), with an agreement proportion of 80.0%. Overall management agreement was 82.0%, indicating that chiropractors possess good skills in triaging patients with low back pain, which can optimize patient trajectories by accelerating management of non-surgical cases and reducing waiting lists for spine surgery consultations. Prospective studies are needed to evaluate the impact of a chiropractor-informed triage on clinical outcomes and healthcare utilization for patients with low back pain.https://doi.org/10.1038/s41598-025-04529-9Low back painConcordanceModels of careAccess to careSpecialized servicesTertiary care |
| spellingShingle | Janny Mathieu Marie Beauséjour Claude-Édouard Châtillon Julie O’Shaughnessy Charles Tétreau Cesar A. Hincapié Petra Schweinhardt Martin Descarreaux Andrée-Anne Marchand Diagnostic and management concordance between chiropractors and neurosurgeons for patients with low back pain Scientific Reports Low back pain Concordance Models of care Access to care Specialized services Tertiary care |
| title | Diagnostic and management concordance between chiropractors and neurosurgeons for patients with low back pain |
| title_full | Diagnostic and management concordance between chiropractors and neurosurgeons for patients with low back pain |
| title_fullStr | Diagnostic and management concordance between chiropractors and neurosurgeons for patients with low back pain |
| title_full_unstemmed | Diagnostic and management concordance between chiropractors and neurosurgeons for patients with low back pain |
| title_short | Diagnostic and management concordance between chiropractors and neurosurgeons for patients with low back pain |
| title_sort | diagnostic and management concordance between chiropractors and neurosurgeons for patients with low back pain |
| topic | Low back pain Concordance Models of care Access to care Specialized services Tertiary care |
| url | https://doi.org/10.1038/s41598-025-04529-9 |
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