GPs' management of acute back pain

doi:10.1136/bmj.312.7044.1480a

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Is evidence based

Nicholas Summerton

Senior registrar in public health Clinical Development Directorate, Huddersfield NHS Trust, Huddersfield Royal Infirmary, Huddersfield HD3 3EA

EDITOR,—Paul Little and colleagues have examined the nature of the evidence underpinning clinical guidelines on the management of acute back pain in general practice and general practitioners' compliance with such guidelines.1 I take issue with both the authors' interpretation of the published evidence and the findings of their survey.

The authors are rather nihilistic about the generalisability to general practice of several of the good quality epidemiological studies. Gener-alisability is always a matter of judgment, but, as …