Low back pain is the most common global health problem. There are a massive number of treatment methods available for this massive problem. That these have not all been assessed is an acute problem. Randomised studies are published on medical treatments for back pain of course, but they do not cover alternative treatments or the general public's tricks for treating pain. However, a researchers group at the University of Oulu (UniOulu) developed Kipuriihi tool that assesses the effectiveness of treatments for lower back pain using the wisdom of the crowds. Kipuriihi has already been accepted to the ACM Conference on Human Factors in Computing Systems (CHI).
Jaro Karppinen, Professor of Physiatry at the University of Oulu, said the harm caused by low back pain has increased by approximately 50% over the past 25 years, and at any given time half a billion people are suffering from it. There is an abundance of treatments that are difficult to research with randomised set-ups. It would be advisable to also bring forth the views of back pain patients on the effectiveness of the various treatment forms. The Kipuriihi tool created by Karppinen and Simo Hosio, Postdoctoral researcher of Ubiquitous Computing at the University of Oulu, aims to meet this challenge. It gathers assessments by both the general public and doctors on forms of treatment and combines these into a general assessment for which the user can select the criteria.
The forms of treatment include both treatments given by medical professionals and self-care treatments by patients. According to Hosio, the latter of these is of great importance because in nearly 90% of cases people seek treatment methods independently online. The wisdom of the crowds theory, which was developed in the early 1900s, has been adopted to support the reliability of the Kipuriihi tool. Hosio sums up the core idea in the following way: if researchers gather a large enough group of people from different backgrounds and they give their independent assessment on a topic, the sum of the assessments is on average smarter than an individual's assessment. The collective voice is close to the truth.
The new aspect the team has added is dressing the old theory up into interactive form, as a web interface, which the user can utilise to assess forms of treatment and to search for the wisdom of the crowds assessments on these. Hosio stated that by using valid mathematical methods, researchers can determine a large set of tested treatments from thousands of opinions. As the wisdom of the crowds requires a large mass of assessments, the development of the Kipuriihi tool began three years go with data collection. A total of nearly ten thousand assessments were submitted by hundreds of members of the general public and 70 doctors. These assessments covered around one hundred forms of treatment.
One of the conditions for participation was that respondents responded independently separate from one another. In this way, researchers can avoid the speaking over one another type of phenomenon common on discussion forums, which allows the most prominent and noisiest participants to mould opinions. Setting the research question for data collection and fine-tuning the wisdom of the crowds platform were complex tasks, but the end result is easy to use: anyone can go on the web page and select whether they want to search for treatments assessed by professionals (i.e. doctors and physical therapists), the general public (laymen) or both.
After this, the user can adjust the perspective to anything they like; variables include cost, the speed of impact, the permanence of impact and the effectiveness of the treatment. For example, professionals named pharmacotherapy, exercise and stretching as the cheapest and fastest treatment forms, while the crowd's suggestions for the best methods were 'don't get stuck', the constructive rest position and stretching. Whereas suggestions by professionals represent official medicine, the crowd's methods are in a vernacular and common sense, and can in principle be anything at all.
Although the actual data collection stage has already ended, users can continue to suggest and assess forms of treatment. Jaro Karppinen said that the question arises of how medical treatments fare in comparison to the crowd's methods. However, no such analysis has yet been conducted. At this point in time, it is most important to get the patients' voices heard and facilitate a comparison assessment from patients for patients. Crowd assessments are necessary from the perspective of medical science when we want to know how patients feel about treatments, whether they are successful or whether information campaigns are effective. For doctors, Kipuriihi is predominantly a monitoring tool, a means to hear patients' voices.
In the future, it would be beneficial if Kipuriihi users could also see the opinions of medical professionals on treatment methods proposed by the general public. Hosio noted that no restrictions as such should be specified for methods listed by the general public in Kipuriihi. A treatment methods such as unicorn therapy could prove very interesting due to how it will be assessed by peers. Now, citizens have not assessed the treatment types articulated by doctors as any better than those articulated by citizens themselves. This indicates that lower back pain is a challenging issue. There are no evident treatment methods that everyone feels are effective.
The next step, if the project can get more funding, could be to monitor the results. Hosio envisioned that a questionnaire could be sent for example once a month on the treatment methods listed in Kipuriihi to people's mobile phones, and after half a year the application could indicate how many people felt the treatment method was effective.