Background
Methods
Search strategy
Selection criteria
Study selection and data collection
Critical appraisal
Analysis
Meta-analyses
Meta-regression
Assessing the quality of evidence (GRADE)
Results
Study characteristics
Study | Location of study | Duration of data collection | ED Setting | Health Care System Funding | Age (Mean/ Median) | Sex (%Fem) | Definition of LBP | Coding System, | Sample Size | Prevalence Estimate |
---|---|---|---|---|---|---|---|---|---|---|
Angeletti, 2013 | Italy | 1-12 months | Non-Standard ED: Presidium (Post Seismic Period) | Private | 53c
| 36d
| Narrow | Diagnosis-Patient Charts | 958 | 4.9% |
Astete, 2016 | Spain | 1-5 Years | Standard ED: Metropolitan | Public | 57 | 61 | Narrow | Diagnosis | 2000g
| 2.9% |
Cordell, 2002 | USA | <Month | Standard ED: Metropolitan | Private | 30 | 55 | Narrow | Complaint | 1665 | 7.6% |
Dutch, 2008 | Australia | 1-5 Years | 3 Standard EDs: Metropolitan | Private | >18 | - | Broad | Complaint | 104 705g
| 3.3% |
Fialho, 2011 | Brazil | <Month | Standard ED: Metropolitan | Public | 41c
| 58d
| Narrow | Complaint- Patient Charts | 392 | 8.4% |
Hoppe, 2013 | USA | 1-12 Months | Standard ED: Metropolitan | Private | 38 | 49 | Broad | Complaint-EDIS | 3007
| 5.4% |
Kao, 2014a
| USA | ≥5 Years | Standard ED: National Representation | Private | 44 | 45 | Broad | Diagnosis-ICD-9f
| 323 186- 1.1 Billion | 3.99% |
Friedman, 2010a
| USA | ≥5 Years | Standard ED: National Representation | Private | 40 | 51 | Narrowe
| Diagnosis-ICD-9f
| 183 64 3 -114 million | 2.3% |
Niska, 2010a
| USA | 1-5 Years | Standard ED: National Representation | Private | >18 | 47 | Narrow | Diagnosis-ICD-9f
| 39 393 000 | 1.9% |
Lovegrove, 2011 | Australia | 1-5 Years | Standard ED: Metropolitan (All EDs in Perth) | Private | 46c
| 51d
| Broad | Complaint-EDIS | 1 171 731 | 1.9% |
Mapoure, 2015 | Cameroon | ≥5 Years | Standard ED: Metropolitan | Public | 40 | 51 | Narrowe
| Diagnosis-ICD-9f
| 183 633 | 2.3% |
Marinos, 2008 | Greece | 1-5 Years | Non-Standard ED: Orthopedic | Private | >18 | 47 | Narrow | Diagnosis-ICD-9 | 39 172 | 17.1% |
NHAMCS, 2010 | USA | 1-5 Years | Standard ED: National Representation | Private | 37b
| 57 | Narrow | Diagnosis-ICD-9 | 84 886 000 | 3.7% |
Owens, 2008 | USA | 1-5 Years | Standard ED: National Representation | Private | 47 | 57 | Broad | Complaint-ICD-9f
| 128 350 000 | 5.8% |
Philips 2012 | Barbados | 1-12 Months | Non-Standard ED: Emergency Calls | Private | - | - | Broad | Complaint | 8875 | 0.9% |
Ross, 2003 | USA | ≥5 Years | Standard ED: Metropolitan Observation Unit | Private | 53 | 59 | Broad | Diagnosis | 22530 | 4.9% |
Silman, 2000 | UK | 1-12 months | 2 Standard EDs: Metropolitan | Public | >18 | - | Narrow | Complaint-Survey | A: 5147 B: 1459 | A: 3.2% B: 4.7% (Pooled 3.5) |
Tcherny-Lessenot, 2003 | France | <Month | Standard ED: Metropolitan | Public | 37 | 50 | Broad | Complaint-Survey | 729g
| 10.8% |
Thiruga-nasamban-damoorthy, 2014 | Canada | 1-12 months | 2 Standard EDs: Metropolitan | Public | 49c
| 51d
| Narrow | Diagnosis-ICD-10f
| 31705 | 2.2% |
Waterman, 2012 | USA | ≥5 Years | Standard ED: National Representation | Private | 39c
| 49d
| Narrow | Diagnosis-ICD-9f
| 1 820 000 | 3.15% |
Yan, 2015 | Cambodia | 1-12 months | 2 Standard EDs: Metropolitan | Private | 42 | 64 | Broad | Complaint | 1295 | 5.6% |
Authors | Sampling frame represent target population? | Random selection for sample or census? | Likelihood of nonresponse bias minimal? | Data collected directly from subjects? | Acceptable case definition? | Study Instrument has validity and reliability? | Same mode of data collection for all subjects? | Length of prevalence period appropriate? | Appropriate numerator and denominator? | Overall Risk Assessment |
---|---|---|---|---|---|---|---|---|---|---|
Angeletti | L | L | L | L | L | H | L | H | L | Mod |
Astete | L | L | L | L | L | H | L | L | L | Mod |
Cordell | L | L | L | L | L | H | L | H | L | Mod |
Dutch | L | L | L | L | H | H | L | L | L | Mod |
Fialho | L | L | L | L | L | H | L | H | L | Mod |
Hoppe | L | L | L | L | H | H | L | H | L | High |
Kaoa
| L | L | L | L | L | L | L | L | L | Low |
Friedmana
| L | L | L | L | L | L | L | L | L | Low |
Niskaa
| L | L | L | L | L | H | L | L | L | Mod |
Lovegrove | L | L | L | L | L | L | L | L | L | Low |
Mapoure | L | L | L | L | L | H | L | H | L | Mod |
Marinos | L | L | L | L | H | H | L | L | L | Mod |
NHAMCS | L | L | L | L | L | H | L | L | L | Mod |
Owens | L | L | L | L | L | L | L | L | L | Low |
Philips | L | L | L | L | H | H | L | L | L | Mod |
Ross | L | L | L | L | H | H | L | L | L | Mod |
Silman | L | H | H | L | L | H | L | H | L | High |
Tcherny-Lessenot | H | H | H | L | H | H | L | H | L | High |
Thiruga-nasamban-damoorthy | L | L | L | L | L | L | L | H | L | Mod |
Waterman | L | L | L | L | L | L | L | L | L | Low |
Yan | L | L | L | L | H | H | L | H | L | High |
Analyses
Subgroup | Category | Arcsine prevalence, 95% CI | Inter-group heterogeneity | Sensitivity analysis, 95% CI (Arcsine Excluding High ROB), | Inter-group heterogeneity |
---|---|---|---|---|---|
Back Pain Definition | Broad | 4.9% (3.1-7.1) |
p = 0.1850 | 3.9% (1.9-6.4) |
p = 0.8574 |
Narrow | 3.6% (3.2-4.0) | 3.6% (3.2-4.1) | |||
Coding | Complaint | 5.5% (3.5-7.8) |
p = 0.0459 | 5.0% (2.6-8.2) |
p = 0.2289 |
Diagnosis | 3.4% (3.1-3.8) | 3.4% (3.1-3.8) | |||
Health System | Private | 4.3% (3.4-5.3) |
p = 0.9464 | 4.1% (3.2-5.2) |
p = 0.2106 |
Public | 4.4% (3.4-5.3) | 3.3% (2.6-4.1) | |||
Emergency Setting | Standard | 4.4% (3.7-5.2) |
p = 0.7734 | 4.0% (3.2-4.9) |
p = 0.7149 |
Non-Standard | 6.1% (0.0-2.3) | 6.1% (0.00-23.2) |
Covariate | Coefficient | 95% Confidence interval |
P-value | |
---|---|---|---|---|
Coding | -0.01989 | -0.04472 | 0.00493 | 0.106 |
ROB | 0.01032 | -0.02085 | 0.04149 | 0.485 |
Health System | 0.00309 | -0.02580 | 0.03199 | 0.819 |