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Christopher K. Lynn, MD
Medical College of Ohio Toledo

JAMA. 1988;259(8):1181.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.

—Although I would like to believe the findings of the recent article by Mayer et al¹ concerning functional restoration of patients with low back injury, this submission has significant flaws in methodology.

The most important flaw is the assignment of patients to treatment and nontreatment groups on the basis of whether their insurance plan would reimburse the costs of the three-week rehabilitation program, ranging from $5000 to $9000. Although we are assured that the two groups are comparable, the data presented in tabular form neglect several important variables. Were the two groups comparable in regard to specific jobs being performed, previous frequency of visits to health care professionals, or prior training that might enable them to seek employment in a more sedentary industry? Since the nontreatment group was not objectively evaluated in terms of degree of disability, were the two groups comparable on this basis? Patients . . . [Full Text PDF of this Article]

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