Non-specific neck pain: diagnosis and treatment - KCE

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10 Non-Specific Neck Pain: diagnosis and treatment KCE Reports 119 Figure 1: Flow chart: final results of the screening of the literature – first search 2.2.4 New search for diagnosis and prognosis The database of 55 full text (systematic) reviews was checked for content of diagnosis and prognosis. One systematic review of Borghouts et al was included for prognosis 15 . The search strategy has been further completed for the diagnosis part because of the limited information found after the strategy described above. An adjuvant search was performed in PubMed and Embase using ‘neck pain’ as a term and “Neck Pain”[Mesh] in clinical queries for diagnosis and with limits: humans, last 10 years, adults and with a narrow search (sensitivity 64%, specificity 98%). This search resulted in 135 possible relevant publications. After screening the articles on diagnosis or prognosis, five publications met the inclusion criteria for diagnosis and two for prognosis (one from the first search and one from the second search). One book has been added i.e., a narrative review advised by experts 16 . Finally, three publications 17-19 for additional information were found by hand search.
KCE Reports 119 Non-Specific Neck Pain: diagnosis and treatment 11 Figure 2: Flow chart: final results of the second search for diagnosis and prognosis 2.3 DATA EXTRACTION Based on the selection described above, two researchers independently extracted the data of the included systematic reviews using prepiloted forms. Data were reported in an evidence table (appendix 2) containing four main themes ‘Diagnosis’, ‘Assessment of pain and disability’, ‘Prognosis’ and ‘Treatment’. For the screening of the RCT’s and the publications on diagnosis and prognosis on full text, one researcher extracted the data of the included publications (respectively see appendix 3 and appendix 4). Data from the selected guidelines were extracted by one researcher. Finally, the results from these selected guidelines have been compared to the conclusions from the literature search by two researchers. The results of the data extractions are reported in appendix 5 and chapter 3.4. The results from the literature are defined per main theme and subtheme in the following paragraphs and where possible the level of evidence in “Grade” is given, 20, 21 . • “Grade A”, highest level of evidence: RCTs without important limitations or overwhelming evidence from observational studies; • “Grade B”, moderate level of evidence: RCTs with important limitations (inconsistent results, methodological flaws, indirect, or imprecise) or exceptionally strong evidence from observational studies; • “Grade C”, lowest level of evidence: studies with lower level of evidence than above.
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Non-specific neck pain: diagnosis and treatment - KCE

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