Introducing Spineopedia

Spineopedia is an online based website whose goal is to become the global source for unbiased, high quality, and comprehensive information relating to spine care for providers and patients. Spineopedia was born to fill a void that currently exists in obtaining comprehensive spine information that is free of commercial bias, with relative ease. Simply put, Spineopedia is a repository and dissemination site for the most up-to-date clinical investigations, trending news, and information that can help spine care providers and patients make more informed decisions about a particular treatment or condition.

Spineopedia Reviewed Studies

Healthcare is shifting to a value based approach. There is a strong need for high quality evidence to help us make the appropriate clinical decisions for our patients and avoid prescribing treatment that has no scientific merit. Unfortunately, many of the published studies that we use in support of performing a particular surgical procedure or making a clinical decision are outdated but continue to be used, often as the “gold source.” Studies published in the 80’s, 90’s and early 2000s continue to be cited by physicians, researchers, health insurance carriers, and other healthcare entities to help prove (or disprove) a certain degree of efficacy. As we know, clinical knowledge, diagnostic imaging methods, and treatment outcomes have improved significantly over the last 25 years. In line with this, we continue to improve upon research methods that limit subjectivity and have identified more meaningful and objective outcome measures. Many of the commonly cited historical studies within spine surgery have added to our knowledge database and have led to further scientific investigations, however a large portion of these cited works have numerous methodological flaws including various forms of bias that limit validity and reliability of that particular study.

As humans and healthcare professionals, we all are biased in some capacity. While we are consciously aware of some of our own biases, many are not as readily apparent to us as individuals. Our behaviors and decision making is driven by this. Different types of associations that we may have, relationships, education, training, and declared beliefs, lead us to unconsciously make some decisions or reach conclusions that will lead to explicit endorsement or condemnation. This can be amplified by our competitive nature to be the best, pressures from within an institution to publish or in some cases, for personal gain. Unfortunately as we know, this can have a profound effect on the outcome of clinical investigations. Transparency and helping the reader identify potential biases within an investigation is imperative to the mission of Spineopedia. To minimize our biases, the authors of Spineopedia have no conflicts of interest and the website does not have any paid advertising. In other words, there are no outside influences on the studies we review, the manner in which we review them, or the conclusions that we publish. Furthermore, we encourage scholarly debate and commentary from authors and spine professionals in regards to our study reviews.

Spineopedia Aggregation of Current Published Information

As a physician, surgeon or healthcare professional, many of us subscribe to one or more professional journals monthly. While some do read it cover to cover, many just skim the study titles or abstracts in search of something interesting or relevant to their practice. There are at least 6 or 7 high-quality, well known, peer reviewed journals that cover the practice of spine surgery along with several other news sources. Large amounts of information (studies) are published in these journals on a regular basis, but most of us are only able to read a fraction of this, let alone take the time to critically evaluate it.

In lieu of reading the journals, many professionals have turned to various medical publisher or society based websites to see the latest headlines from within the profession or review current studies. Unfortunately, not only do we run into the same issues of having to spend a significant amount of time navigating the web to find what we are looking for, but the information disseminated by these particular organizations is often selectively chosen by the particular Society, organization, editor or review board. Ultimately we may be missing out on relevant, additional information that is found elsewhere.

The same holds true for attending national and regional meetings. Data that is presented at these meetings is often outdated, limited by committees, and outcomes can be influenced by sponsors.

We all know that the internet is the main conduit of information and credibility is always a concern. A Google search of “outcomes of minimally invasive lumbar discectomy” nets over 82,000 hits. As you can appreciate, some of the information presented is outdated, some copied multiple times from the original source, some of it has been pirated illegally, some represents one’s personal experience or knowledge, and some it is heavily biased based on the source. Databases such as PubMed, Medline, Scopus, and Cochrane allow for a more streamlined search in finding the appropriate information, but even this approach usually leads to thousands of citations depending on the search term(s). While additional filters can be applied to scale this down, most physicians or surgeons do not have the time to invest into an exhaustive search.

Spineopedia offers the practicing healthcare professional the opportunity to go to one site to be able to find the most up to date abstracts and published information from the leading journals and new sources that cover the specialty of spine. To enhance access and save time for the reader, Spineopedia classifies that information into specific subspecialties areas of spine care including degenerative, trauma, deformity, tumor, developmental, rehabilitation, and biomechanical. Furthermore, trending headlines focusing on the business of spine and economics of practice is also included on Spineopedia.

Information is plentiful. Finding it can often be an arduous, time consuming task. Critical evaluation of the literature to determine validity and relevance is imperative if we wish to use this information to make sound judgements and decisions in treating patients with spinal disorders. Most do not have the time or in some cases, expertise, to adequately perform this. Spineopedia has been developed to provide healthcare providers and patients with easier access to this information, aggregated in one site with the goals of providing unbiased reviews, transparency and scholarly engagement.

In this case, less is more. Less time searching, less time spent analyzing, more time spent forming opinions and making decisions. We must always ask, how good is the evidence?