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Editor's Correspondence
June 28, 2010

Appropriate Discard of “Best” Practice Guidelines for Acute Low Back Pain

Author Affiliations

Author Affiliation: Tufts University School of Medicine, New England Medical Center, Boston, Massachusetts, and St Joseph Medical Center, Nashua, New Hampshire.

Arch Intern Med. 2010;170(12):1087-1088. doi:10.1001/archinternmed.2010.190

Evidence-based guidelines for acute low back pain (LBP)1 are clearly appropriately viewed by clinicians as recommendations as opposed to rigid mandates. Practitioners use training, wisdom, experience, and logic to accurately redefine “best practice care” by occasionally rejecting “expert” guidelines.

Precedent is exemplified by authors in JAMA2 and the Cleveland Clinic Journal of Medicine3 recommending that mammograms remain encouraged at age 40 years, despite US Preventive Services Task Force November 2009 guidelines recommending initial breast cancer screenings at age 50 years.

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