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A video programme plus a booklet was more effective than a booklet alone for increasing patient knowledge about lumbar spine treatment options for low back pain

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QUESTION: Is an interactive video programme plus a booklet more effective than a booklet alone for increasing the knowledge necessary to make informed choices about surgical compared with non-surgical lumbar spine treatment for low back pain?


Randomised (allocation concealed), unblinded, controlled trial with follow up between 27 and 56 days.


An academic, orthopaedic surgical practice in Iowa, USA.


100 patients ≥20 years of age (mean age 50 y, 56% men, 59% with a diagnosis of herniated disc) who were candidates for lumbar spine surgery and who had received non-surgical treatment for ≥4 weeks. Exclusion criteria were emergent indication for surgery, no indication of a surgically correctable lesion, previous low back surgery, pregnancy, cancer or infection causing back pain, severe hearing or visual impairment, unfamiliarity with English, inaccessibility because of a planned move, or lack of a home telephone. Follow up was 90%.


47 patients were allocated …

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  • Sources of funding: The Agency for Health Care Policy and Research and the Foundation for Informed Medical Decision Making.

  • For correspondence: Dr E A Phelan, Medicine/Gerontology and Geriatric Medicine, Harborview Medical Center, 325 9th Avenue, Box 359755, Seattle, WA 98104-2499, USA. Fax + 1 206 731 8527.