Participate in the International Delphi Study for Lumbar Spinal Stenosis Patients

Members & Publications


February 7, 2020

You are cordially invited to participate in the second round of an online survey conducted by the International Society for the Study of the Lumbar Spine (ISSLS) Taskforce on the Diagnosis and Management of Lumbar Spinal Stenosis. The study has been approved by the School of Healthcare Research Ethics Committee, University of Leeds, UK. Ethics Reference Number: HREC 18-007

They would like clinicians and academics who have expertise/experience in managing patients with Lumbar Spinal Stenosis (LSS) from a wide range of professional backgrounds and geographical regions to have the opportunity to take part. The aim of the study is to develop a consensus treatment pathway for people with LSS. This is the second of three questionnaires. Your participation in all or any of the questionnaires would be greatly valued, but is entirely voluntary. Please also feel free to share this invitation with professional colleagues involved in LSS research or clinical care who might be interested in participating.

The survey will take around 15-20 minutes to complete. It will remain open until March 30, 2020 and can be accessed via this link:

Below is the website introduction with participant information, should you wish to read this before opening the link. If you have any queries or concerns, please contact the study coordinator, Dr Christine Comer. Email:


*     *     *     *     *     *     *     *     *     *     *  PARTICIPANT INFORMATION  *     *     *     *     *     *     *     *     *     *     * 


Welcome to this Second Round of the International Delphi Study for the development of a consensus treatment pathway for people with Lumbar Spinal Stenosis!

What is the study about? The aim is to develop an agreed treatment pathway algorithm for patients with lumbar spine stenosis (LSS) based on research evidence and expert consensus. Expert opinion is required because of the limited research evidence currently available. The First Round of this Delphi study (which you may have participated in) took place in September/October 2019 and focused on selecting appropriate treatments. This Second Round survey will focus on ranking and ordering the selected treatments.

What will I need to do if I participate? This is the second of three survey rounds. As in Round One, the first few questions in this survey are about your clinical and academic background. We will then provide information on the treatments selected by experts who participated in Round One. We will ask you to rank or order these treatments, basing your responses on three different Lumbar Spinal Stenosis clinical phenotypes (as in Round One), this time also considering whether symptoms are mild-moderate or moderate-severe. The three clinical phenotypes are based on different types of symptoms associated with Lumbar Spinal Stenosis. This questionnaire is expected to take around 15 minutes to complete. The questionnaire will remain open until March 30, 2020. There will be one subsequent survey round after this (summer 2020) to conclude the study. You will be given the opportunity to participate in this final questionnaire in the same way. Participation in all or any of the questionnaires is voluntary.

Why have I been approached? The researchers conducting this study are approaching participants with expertise and experience in managing patients with LSS.  We are distributing the survey via spinal research societies, professional bodies, or through local contacts and recommendations. These contact routes will be used for recruitment purposes only, and we will not have any way of knowing who completed each questionnaire. Please share this invitation with any colleagues who might be interested in participating. If this survey is not relevant to you (i.e. if you do not have experience in managing patients with LSS) please still feel free to forward the invitation to others who may have the relevant expertise/ experience.

What will happen next? Once we have analyzed the results of this second round questionnaire and the research steering group has held a consensus meeting, we will send out the final round of questionnaires to evaluate the level of consensus for the resulting LSS treatment pathway algorithm. 

What are the risks? No significant risks are anticipated for participants other than a small amount of time required to participate in the survey questionnaires. Your personal contact information will not be stored by us, and your completed questionnaire will be entirely anonymous, and stored electronically on a password protected storage drive in line with University of Leeds policy. Only anonymised data will be shared with external collaborators for the purposes of this study. You can withdraw from further participation in the study at any point, however we will not be able to withdraw data already collected from you, as your questionnaire responses cannot be traced to you. Your participation in this survey will be taken to imply consent to include your anonymised responses in future survey iterations and analyses.

What is in it for you? The final outcome of this study will be an expert consensus on an evidence-based, standardized treatment pathway for patients with LSS symptoms.  We expect the results of this study to improve understanding of appropriate and standardized care for patients with LSS. We will publish the results of this study in a relevant peer-reviewed journal and share the findings at international spinal conferences.

This study has been approved by the School of Healthcare Research Ethics Committee, University of Leeds, UK. Ethics Reference Number: HREC 18-007

Dr. Christine Comer is funded by NIHR, Grant Reference ICA-CL-2017-03-015

Thank you,

Christine Comer, PhD, on behalf of the International Taskforce on Diagnosis and Management of Lumbar Spinal Stenosis


Please proceed to the survey via this link if you would like to take part:


Legislation Introduced to Alleviate Impact of Conversion Factor Cut for 2021

Nov 09, 2020

Last month, two bills were introduced in the House proposing solutions to the estimated 10.6% Physician Fee Schedule conversion factor cut expected to go into effect January 1, 2021.  The bills offer some relief to the cut, but do not reflect a comprehensive or long-term solution.  AAPM&R has therefore chosen to remain neutral regarding these bills. 

Your Academy continues to advocate for a permanent solution to the conversion factor cut while maintaining the important payment increases to office and outpatient evaluation and management services.