Ottawa Panel evidence-based clinical practice guidelines on therapeutic massage for low back pain.

OBJECTIVE: To update evidence-based clinical practice guidelines (EBCPG) on massage therapy compared to control or other treatment for adults (>18 years) suffering from acute, sub-acute and chronic low back pain (LBP). METHODS: A literature search was performed for relevant articles between January 1, 1948 and December 31, 2010. Eligibility criteria were then applied focussing on participants, interventions, controls, and outcomes, as well as methodological quality. Recommendations based on this evidence were then assigned a grade (A, B, C, C+, D, D+, D-) based on their strength. RESULTS: A total of 100 recommendations were formulated from 11 eligible articles, including 37 positive recommendations (25 grade A and 12 grade C+) and 63 neutral recommendations (49 grade C, 12 grade D, and 2 grade D+). DISCUSSION: These guidelines indicate that massage therapy is effective at providing pain relief and improving functional status. CONCLUSION: The Ottawa Panel was able to demonstrate that massage interventions are effective to provide short term improvement of sub-acute and chronic LBP symptoms and decreasing disability at immediate post treatment and short term relief when massage therapy is combined with therapeutic exercise and education.

The Value of Clinical Needs Assessments for Point-of-Care Diagnostics.

Most entrepreneurial ventures fail long before the core technology can be brought to the marketplace because of disconnects in performance and usability measures such as accuracy, cost, complexity, assay stability, and time requirements between technology developers' specifications and needs of the end-users. By going through a clinical needs assessment (CNA) process, developers will gain vital information and a clear focus that will help minimize the risks associated with the development of new technologies available for use within the health care system. This article summarizes best practices of the principal investigators of the National Institute of Biomedical Imaging and Bioengineering point-of-care (POC) centers within the National Institute of Biomedical Imaging and Bioengineering POC Technologies Research Network. Clinical needs assessments are particularly important for product development areas that do not sufficiently benefit from traditional market research, such as grant-funded research and development, new product lines using cutting-edge technologies developed in start-up companies, and products developed through product development partnerships for low-resource settings. The objectives of this article were to (1) highlight the importance of CNAs for development of POC devices, (2) discuss methods applied by POC Technologies Research Network for assessing clinical needs, and (3) provide a road map for future CNAs.