Simon Dagenais

• DC, PhD, MSc
• Owner at Spine Research, LLC

Real‐world data (RWD) and real‐world evidence (RWE) are now being routinely used in epidemiology, clinical practice, and post‐approval regulatory decisions. Despite the increasing utility of the methodology and new regulatory guidelines in recent years, there remains a lack of awareness of how this approach can be applied in clinical pharmacology a...

Objectives Loss of appetite in older adults can lead to malnutrition, weight loss, frailty, and death, but little is known about its epidemiology in the United States (US). The objective of this study was to estimate the annual prevalence and incidence of anorexia in older adults with Medicare fee-for-service (FFS) health insurance. Design Retrosp...

Interest in real‐world data (RWD) and real‐world evidence (RWE) to expedite and enrich the development of new biopharmaceutical products has proliferated in recent years, spurred by the 21st Century Cures Act in the United States and similar policy efforts in other countries, willingness by regulators to consider RWE in their decisions, demands fro...

Purpose Low back pain (LBP) is a leading cause of lost work time (LWT) in firefighters and is related to poor muscle endurance. Although exercise can improve muscle endurance, it must be continued to sustain benefits, and it is unknown if it can reduce LWT. This study conducted an economic evaluation of an extended worksite exercise intervention in...

Objective: This study assessed worksite exercise delivered by on-site supervision (supervised) or telehealth to reduce lost work time (LWT) related to low back pain (LBP) in firefighters. Methods: A cluster randomized controlled trial assigned 264 career firefighters to supervised (n = 86) or telehealth (n = 95) back and core exercises 2X/week f...

Background context The North American Spine Society's (NASS) Evidence Based Clinical Guideline for the Diagnosis and Treatment of Low Back Pain features evidence-based recommendations for diagnosing and treating adult patients with nonspecific low back pain. The guideline is intended to reflect contemporary treatment concepts for nonspecific low ba...

The objective of the North American Spine Society (NASS) Clinical Guideline for the Diagnosis and Treatment of Low Back Pain is to provide evidence-based recommendations to address key clinical questions surrounding the diagnosis and treatment of adult patients with nonspecific low back pain. This guideline is based upon a systematic review of the...

Aims: Effective postsurgical analgesia hastens recovery, reduces hospital length of stay (LOS), and decreases hospitalization costs for total hip arthroplasty (THA). Improving these outcomes is critical for value-based surgical bundled payment programs such as the Medicare Comprehensive Care for Joint Replacement and similar programs for commercial...

Aims: Postsurgical pain experienced by patients undergoing total knee arthroplasty (TKA) can be severe. Enhanced recovery after surgery programs incorporating multimodal analgesic regimens have evolved in an attempt to improve patient care while lowering overall costs. We examined clinical and economic outcomes in hospitals using liposomal bupivaca...

Background: Local anesthetic systemic toxicity (LAST) is a rare but potentially serious adverse event . Methods: Data from the US Food and Drug Administration Adverse Event Reporting System were examined for liposomal bupivacaine (LB), bupivacaine, or other injectable local anesthetics. Possible LAST cases were identified based on MedDRA system org...

Perspective: The FPRS Steering Committee created 5 WGs to identify research needs and make recommendations in key areas of research. This article reports the results of one-the Prevention of Acute and Chronic Pain group. Several research priorities emerged, and recommendations made to fill existing knowledge gaps.

Aims: To estimate the cost to hospitals of materials (ie, medications, equipment, and supplies) required to administer common interventions for postsurgical analgesia after TKA, including single-injection peripheral nerve block (sPNB), continuous peripheral nerve block (cPNB), periarticular infiltration of multi-drug cocktails, continuous epidural...

Commentary On: Castro-Sánchez AM, Lara-Palomo IC, Matarán-Peñarrocha GA, Fernández-de-las-Peñas C, Saavedra-Hernández M, Cleland J, et al. Short-term effectiveness of spinal manipulative therapy versus functional technique in patients with chronic non-specific low back pain: a pragmatic randomized controlled trial. Spine J 2016:16:302-312 (in this...

Background Although chiropractors in the United States (US) have long suggested that their approach to managing spine pain is less costly than other health care providers (HCPs), it is unclear if available evidence supports this premise. Methods A systematic review was conducted using a comprehensive search strategy to uncover studies that compare...

Obesity and low back pain are equally complex medical conditions with multi-factorial etiologies. Their clinical practice guidelines both include recommendations for screening and examination that can be easily implemented. There is sufficient information to compile a framework for the primary care provider, partnering with the patient and appropri...

Recognizing that the increasing incidence of obesity coincides with the rising prevalence of LBP, there is growing interest in establishing the relationship between over-weight and back pain. It is likely that any association is multi-factorial and that the connection is not as mechanistically simple as previously believed. Systemic inflammation as...

Objectives: The aim of the present study was to assess the prevalence and patterns of complementary and alternative medicine (CAM) use among pediatric patients with gastrointestinal (GI) disorders at academic clinics in Canada. Methods: The survey was carried out at 2 hospital-based gastroenterology clinics: the Stollery Children's Hospital in E...

Previous studies have found that up to 60% of children with neurologic conditions have tried complementary and alternative medicine (CAM). To assess the use of CAM among patients presenting to neurology clinics at two academic centers in Canada. A survey instrument was developed to inquire about use of CAM products and therapies, including reasons...

The use of complementary and alternative medicine (CAM) has increased in recent years, with especially high prevalence in individuals with chronic illnesses. In the United States, the prevalence of CAM use in pediatric asthma patients is as high as 89%. To investigate the epidemiology of pediatric CAM use in respiratory subspecialty clinics. A surv...

To the Editor We wish to congratulate Mafi and colleagues1 on their article “Worsening Trends in the Management and Treatment of Back Pain.” The assessment and management of back pain has long been recognized as suboptimal in the United States, with perceived overutilization of health services that are not in accordance with recommendations from ev...

Purpose Low back pain is a leading cause of disability in firefighters and is related to poor muscular endurance. This study examined the impact of supervised worksite exercise on back and core muscular endurance in firefighters. Design A cluster randomized controlled trial was used for this study Setting The study occurred in fire stations of a...

Various studies have previously reported on the rising utilization and costs of diagnostic imaging for low back pain (LBP) in the United States (US). However, it is unclear if the methods used in these studies allowed for meaningful comparisons, or if the reported utilization data can be used to develop evidence-based benchmarks. The primary purpos...

Objectifs L’objectif de ce travail est d’évaluer l’efficacité des thérapeutiques manuelles dans le traitement de la cervicalgie commune. Méthode Une revue systématique fut entreprise à partir de Medline et de la Cochrane Library afin d’identifier les essais cliniques randomisés évaluant l’effet des manipulations ou des mobilisations seules ou avec...

Firefighters are at increased risk for back injuries, which may be mitigated through exercise therapy to increase trunk muscle endurance. However, long-term adherence to exercise therapy is generally poor, limiting its potential benefits. Focus groups can be used to identify key barriers and facilitators to exercise adherence among study participan...

Objective: Complementary and alternative medicine (CAM) use is high among children and youth with chronic illnesses. The objective of this study was to assess the prevalence and patterns of CAM use in 10 subspecialty clinics in Canada and to compare CAM use between 2 geographically diverse locations. Methods: This survey was carried out at 1 Chi...

Background. The use of complementary and alternative medicine (CAM) is high among children and youths with chronic illnesses, including cancer. The objective of this study was to assess prevalence and patterns of CAM use among pediatric oncology outpatients in two academic clinics in Canada. Procedure. A survey was developed to ask patients (or the...

Covering all commonly used interventions for acute and chronic low back pain conditions, Evidence-Based Management of Low Back Pain consolidates current scientific studies and research evidence into a single, practical resource. Its multidisciplinary approach covers a wide scope of treatments from manual therapies to medical interventions to surger...

Covering all commonly used interventions for acute and chronic low back pain conditions, Evidence-Based Management of Low Back Pain consolidates current scientific studies and research evidence into a single, practical resource. Its multidisciplinary approach covers a wide scope of treatments from manual therapies to medical interventions to surger...

Covering all commonly used interventions for acute and chronic low back pain conditions, Evidence-Based Management of Low Back Pain consolidates current scientific studies and research evidence into a single, practical resource. Its multidisciplinary approach covers a wide scope of treatments from manual therapies to medical interventions to surger...

Commentary on: Schofield DJ, Shrestha RN, Percival R, et al. The personal and national costs of early retirement because of spinal disorders: impacts on income, taxes, and government support payments. Spine J 2012;12:1111-8 (in this issue).

The purpose of this study was to assess the relationships between obesity and measures of back and core muscular endurance in firefighters. Methods. A cross-sectional study was conducted in career firefighters without low back pain. Obesity measures included body mass index (BMI) and body fat percentage assessed with air displacement plethysmograph...

Objective: To evaluate the effectiveness of manual therapies in the treatment of nonspecific neck pain. Materials and methods: Medline and the Cochrane Library were searched for randomized controlled trials of manual therapy or mobilization, used alone or with exercises to treat pain and functional impairment related to nonspecific neck pain. Co...

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). A literature search was performed for relevant articles between January 1, 1948 and December 31, 2010. Eligibility criteria were then applied...

To update evidence-based clinical practice guideline (EBCPG) on the use of massage compared to a control or other treatments for adults (>18 years) suffering from sub-acute and chronic neck pain. A literature search was performed from January 1, 1948 to December 31, 2010 for relevant articles. The Ottawa Panel created inclusion criteria focusing on...

Spinal disorders and especially back and neck pain affect more people and have greater impact on work capacity and health-care costs than any other musculoskeletal condition. One of the difficulties in reducing the burden of spinal disorders is the wide and heterogeneous range of specific diseases and non-specific musculoskeletal disorders that can...

The purpose of this study was to propose questions that may be helpful to educate patients considering treatment approaches to manage low back pain (LBP) and to determine if the information currently presented in informed consent (IC) documents at chiropractic colleges is sufficient to help a patient considering chiropractic management of LBP make...

Although various occupational physical activities are suspected of contributing to low back pain (LBP), causal relationships have not been confirmed, complicating adjudication of work injuries, return to work instructions and preventive efforts. To summarize eight systematic review (SR) reports that examined evidence supporting causal relationships...

Optimal timing for surgical stabilization of the fractured spine is controversial. Early stabilization facilitates mobilization and theoretically reduces associated complications. We identified consecutive patients without neurologic injury requiring stabilization surgery for a spinal fracture at an academic tertiary-care hospital over a 12-year pe...

Low back pain (LBP) is a prevalent and costly condition. Although its etiology is largely unknown, a link to obesity is suspected, and weight loss programs are often recommended to obese patients with LBP. To assess the efficacy of a pilot, multidisciplinary, medically supervised, nonsurgical weight loss program involving meal replacement, caloric...

To determine the prevalence of nocturnal hypoglycemia (NH) in pediatric type 1 diabetes, to compare the prevalence of NH detected by continuous glucose monitoring (CGM) and self-monitored blood glucose (SMBG), and to compare the prevalence of NH using different thresholds. Twenty-five patients wore a continuous glucose monitor for 3 nights and also...

Low back pain (LBP) continues to be a very prevalent, disabling, and costly spinal disorder. Numerous interventions are routinely used for symptoms of acute LBP. One of the most common approaches is spinal manipulation therapy (SMT). To assess the current scientific literature related to SMT for acute LBP. Not applicable. Not applicable. Systematic...

Low back pain (LBP) is a common musculoskeletal disorder associated with a considerable social and economic burden within the working-age population. Despite an unclear etiology, numerous physical activities are suspected of leading to LBP. Declaring a causal relationship between occupational activities and LBP remains challenging and requires a me...

Low back pain (LBP) is a prevalent, costly, and challenging condition to manage. Clinicians must choose among numerous assessment and management options. Several recent clinical practice guidelines (CPGs) on LBP have attempted to inform these decisions by evaluating and summarizing the best available supporting evidence. The quality and consistency...

Low back pain (LBP) is a prevalent and expensive musculoskeletal condition that predominantly occurs in working-age individuals of industrialized nations. Although numerous occupational physical activities have been implicated in its etiology, determining the causation of occupational LBP still remains a challenge. To conduct a systematic review ev...

Low back pain (LBP) is a disorder that commonly affects the working population, resulting in disability, health-care utilization, and a heavy socioeconomic burden. Although the etiology of LBP remains uncertain, occupational activities have been implicated. Evaluating these potentially causal relationships requires a methodologically rigorous appro...

Occupational low back pain (LBP) is a common musculoskeletal disorder that results in high healthcare use and a heavy societal burden from morbidity and medical costs. The etiology of LBP is unclear, although numerous physical activities in the workplace have been implicated in its development. Determining the causal relationship between LBP and sp...

Low back pain (LBP) is a common and disabling musculoskeletal disorder that often occurs in a working-age population. Determining the precise causation of LBP remains difficult. Any attempt to implicate a specific occupational activity in the genesis of LBP requires a methodologically rigorous approach. To conduct a systematic review of the scienti...

Several clinical studies have shown that lateral pinning alone is of equal stability to crossed pins in the treatment of supracondylar fractures. The aim of this study was to compare the stability of parallel and varied divergent lateral pin configurations to provide an easily reproducible technique for optimal pin placement. Twelve third-generatio...

Low back pain (LBP) is a widespread musculoskeletal condition that frequently occurs in the working-age population. Numerous occupational physical activities have been implicated in its etiology. To conduct a systematic review establishing a causal relationship between occupational standing or walking and LBP. Systematic review of the literature. S...

Chronic low back pain (LBP) is a common and potentially disabling condition in all adults, including those who are physically active. It currently is challenging for clinicians and patients to choose among the numerous treatment options. This review summarizes recommendations from recent clinical practice guidelines and systematic reviews about com...

COMMENTARY ON: Haas M, Spegman A, Peterson D, et al. Dose-response and efficacy of spinal manipulation for chronic cervicogenic headache: a pilot randomized controlled trial. Spine J 2010;10:blacksquare, square, filled-blacksquare, square, filled (in this issue).

Waiting times to see a spinal surgeon are among the highest in Canada. However, most patients who are referred would not benefit from surgical care. Effective triaging of surgical candidates may reduce morbidity related to prolonged waiting times and optimize use of limited resources. We administered a questionnaire consisting of 3 items identifyin...

Low back pain (LBP) is a prevalent and costly musculoskeletal disorder that often occurs in the working-age population. Although numerous physical activities have been implicated in its complex etiology, determining causation remains challenging and requires a methodologically rigorous approach. To conduct a systematic review of the scientific lite...

Head injury causes substantial morbidity and mortality in children. The ThinkFirst For Kids (TFFK) program improves knowledge of safe behaviours in kindergarten to Grade 6 students. This study evaluated the TFFK curriculum for grade 7/8 students. Knowledge acquisition was assessed quantitatively by an injury prevention test at baseline, at curricul...

Low back pain (LBP) is associated with high health-care utilization and lost productivity. Numerous interventions are routinely used, although few are supported by strong evidence. Cost utility analyses (CUAs) may be helpful to inform decision makers. To conduct a systematic review of CUAs of interventions for LBP. Systematic review. A search strat...

Low back pain (LBP) is a common musculoskeletal disorder that often occurs in the working-age population. Although numerous physical activities have been implicated in its etiology, determining causation remains challenging and requires a methodologically rigorous approach. To conduct a systematic review focused on establishing a causal relationshi...

Prolotherapy is one of the many treatments available for chronic musculoskeletal disorders. A commonly used drug contains dextrose 12.5%, glycerin 12.5%, phenol 1.0%, and lidocaine hydrochloride 0.25% in aqueous solution (recently termed Proliferol). For chronic low back pain, this is injected into lumbosacral ligaments to stimulate connective tiss...