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B10 Developing appropriateness criteria for radiofrequency in chronic low back and neck pain: a RAND/UCLA appropriateness study
  1. S Eldabe1,
  2. J De Andrés Ares2,
  3. F Huygen3,
  4. G Baranidharan4,
  5. J-L Barat5,
  6. A Bhaskar6,
  7. F Cassini7,
  8. S Gillner8,
  9. JW Kallewaard9,
  10. S Klessinger10,
  11. P Mavrocordatos11,
  12. F Occhigrossi12,
  13. J Van Zundert13,
  14. N Helsen14 and
  15. H Stoevelaar14
  1. 1The James Cook University Hospital, Middlesbrough, UK
  2. 2Hospital Universitario La Paz-Madrid, Madrid, Spain
  3. 3Erasmus University Medical Center, Rotterdam, Netherlands
  4. 4Leeds Teaching Hospitals, Leeds, UK
  5. 5Clairval Private Hospital, Marseille, France
  6. 6Imperial College Healthcare NHS Trust Haemodialysis Clinic, Hayes, UK
  7. 7Ospedale Alessandria, Alessandria, Italy
  8. 8University Hospital of Düsseldorf, Düsseldorf, Germany
  9. 9Rijnstate Hospital, Velp, Netherlands
  10. 10University of Ulm, Ulm, Germany
  11. 11Swiss Pain Institute, Lausanne, Switzerland
  12. 12San Giovanni Addolorata Hospital, Rome, Italy
  13. 13Ziekenhuis Oost-Limburg, Genk, Belgium
  14. 14Ismar Healthcare, Lier, Belgium


Background and Aims Despite routine use of radiofrequency (RF) for the treatment of chronic low back and neck pain, there remains uncertainty on the most appropriate patient selection criteria. This study aimed at developing appropriateness criteria for RF (ablation and pulsed) in relation to relevant patient characteristics.

Methods The RAND/UCLA Appropriateness Method (RUAM) was used to reach an expert consensus on the appropriateness of RF for a variety of clinical scenarios. A panel consisting of 13 European RF experts rated the appropriateness of RF for a total of 1,296 clinical scenarios, divided over two indication areas: chronic low back and neck pain. The results from the first rating round were discussed during a panel meeting held on March 4th, 2022.

Results During the first rating round, RF was considered appropriate in 9% of the clinical scenarios and was associated with specific patient characteristics. The appropriateness of RF was strongly determined by the response to a diagnostic/prognostic block. The second most determining factor of appropriateness was the location of tenderness on palpation for chronic low back pain and the predominant pain trigger for chronic neck pain.

Conclusions The RUAM proved to be useful to identify patient-specific criteria for RF in chronic low back and neck pain. The initial scenarios will be refined in the second rating round and embedded in an educational e-health tool, aiming to support patient selection and application of the RF technique.

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