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Clinical validation of grouping conservative treatments in neck pain for use in a network meta-analysis: a Delphi consensus study

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Abstract

Background

A network meta-analysis aims to help clinicians make clinical decisions on the most effective treatment for a certain condition. Neck pain is multifactorial, with various classification systems and treatment options. Classifying patients and grouping interventions in clinically relevant treatment nodes for a NMA is essential, but this process is poorly defined.

Objective

Our aim is to obtain consensus among experts on neck pain classifications and the grouping of interventions into nodes for a future network meta-analysis.

Design

A Delphi consensus study involving neck pain experts worldwide.

Methods

We invited authors of neck pain clinical practice guidelines published from 2014 onwards. The Delphi baseline questionnaire was developed based on the findings of a scoping review, including four items on classifications and 19 nodes. Participants were asked to record their level of agreement on a seven-point Likert scale or using Yes/No/Not sure answer options for the various statements. We used descriptive analysis to summarise the responses on each statement with content analysis of the free-text comments.

Results

In total, 18/80 experts (22.5%) agreed to participate in one or more Delphi rounds. We needed three rounds to reach consensus for two classification of neck pain: one based on aetiology and one on duration. In addition, we also reached consensus on the grouping of interventions, including a definition of each node, with the number of nodes reduced to 17.

Conclusion

With this consensus we clinically validated two neck pain classifications and grouped conservative treatments into 17 well-defined and clinically relevant nodes.

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Acknowledgements

We would like to thank all Dephi participants for their collaboration: Carlo Ammendolia, Paul Beattie, Jasper Bier, Peter Blanpied, Andre Bussieres, Ian Cameron, Pierre Côte, Joseph Godges, Anita Gross, Inge Ris Hansen, Jill Hayden, Joseph Ierano, Per Kjaer, Henrik Hein Lauridsen, Joy Macdermid, Margaretha Nordin, Jesper Nørregaard, Isabelle Pagé, Jan Pool, Pasqualine Santaguida, Michelle Sterling, David Walton, and Jessica Wong. This research was conducted as part of the PhD candidature of the first author at the University of Technology Sydney, funded by an Australian Government Research Training Program Scholarship.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Graduate School of Health, Discipline of Physiotherapy, University of Technology Sydney, 100 Broadway, Ultimo, 2007, Australia

    Iqra Ishaq, Poonam Mehta & Arianne P. Verhagen

  2. School of Allied Health Exercise and Sports Sciences, Charles Sturt University, Port Macquarie, NSW, Australia

    Ian W. Skinner

  3. School of Physical Therapy, Western University, London, ON, Canada

    David M. Walton

  4. Department of General Practice, Erasmus MC, Rotterdam, The Netherlands

    Jasper Bier

  5. FS Fysio, Capelle aan den IJssel, The Netherlands

    Jasper Bier

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  1. Iqra Ishaq
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Correspondence to Arianne P. Verhagen.

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Ishaq, I., Skinner, I.W., Mehta, P. et al. Clinical validation of grouping conservative treatments in neck pain for use in a network meta-analysis: a Delphi consensus study. Eur Spine J 33, 166–175 (2024). https://doi.org/10.1007/s00586-023-08025-4

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