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Comment & Response
March 2014

Assessment and Management of Back Pain—Reply

Author Affiliations
  • 1Division of Primary Care and General Internal Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts
  • 2Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
JAMA Intern Med. 2014;174(3):479-480. doi:10.1001/jamainternmed.2013.13683

In Reply We thank Kao and colleagues for raising awareness about the racial, ethnic, and sex disparities in opiate use found in our report.1 We agree that although opiates likely are overused for back pain, the disparities we observed in opiate use by race, ethnicity, and sex likely reflect equally important disparities related to pain management within our health care system. As can be seen in supplemental eTable 7, which was published with our article,1 we did not find evidence of additional racial, ethnic, or sex disparities in receiving referrals to other physicians or ordering of advanced imaging including computed tomography or magnetic resonance imaging. We agree that future studies should investigate causes of disparities in pain management in order to eliminate them.

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