How to use this survey to make decisions

How can other people's experiences with medical treatments help me?

Consumer Reports surveys of patients' experiences provide "real life" accounts of thousands of people. They reveal what it's like to live with a health condition and what strategies might make it better or worse. The questions are designed to allow us to describe the process of trying and discarding treatments that people go through until (hopefully) a successful treatment strategy is found.

How do Consumer Reports surveys compare with clinical studies?

Clinical studies usually include objective diagnostic measures–a blood test, a biopsy–combined with a physical exam to assess whether a treatment is effective. Clinical studies may also follow patients over time. Consumer Reports surveys are based on reports of people's experiences at one point in time.

Clinical studies may be randomized controlled trials, considered the "gold standard" in medical research. They permit comparison between relatively similar samples randomly assigned to treatment alternatives. It is the most definitive method we have for determining whether a treatment really works. But there are inherent limitations that may include small sample sizes, inadequate length of the study, and high dropout rates, as well as potential biases due to the source of funding for the trial. The more precise a clinical trial, the less it may apply to lots of people.

Randomized controlled trials usually have selection criteria that exclude individuals with multiple conditions or more complicated symptoms. Participants are those who are willing and able to be in a research study, which makes them different from a "typical" patient. A real strength of this Consumer Reports survey on back pain is that it includes a wide range of individuals with varying causes of pain, types of pain, and timing of treatments. The respondents to the back-pain survey were all ConsumerReports.org subscribers.

How should I use Consumer Reports survey data to make my own treatment decisions?

Treatment decisions are complex. Think of a treatment decision as a three-legged stool: The first leg is the clinical evidence, the second is the doctor's expertise, and the third is the patient's values and preferences. Doctors need to integrate the evidence, their clinical expertise, and their years of experience treating patients, and you in particular, into their treatment recommendations. But at the same time, they should be receptive to questions about what the research shows, and responsive to your values and preferences.

Consumer Reports survey data can help you: (1) think through your values and preferences; (2) provide some information when clinical evidence is uncertain or lacking, and (3) engage your doctor with questions about various back pain treatment options and the order in which to try them.

Is this survey representative of the general population?

This back-pain treatment survey is based on a sample of ConsumerReports.org subscribers and therefore is not nationally representative. For example, in light of subscribers' relatively high education levels, socioeconomic status, and greater inclination to do research, they may have had easier access to doctors and more resources for learning about back-pain treatment options than others in the U.S. population. Respondents were also primarily white, which limits the ability to generalize about other ethnic groups. Nonetheless, the survey results may provide you with some ideas to discuss with your doctor.