In addition, some studies had multiple outcomes within the analysis

(e.g. a prospective cohort study reports on incident risk and follows up on disability or a study that report’s findings both on co-worker support and supervisor support) and were included within the findings more than once. Studies were then stratified dependent on whether or not they reported a significant association of employment support on risk outcome (i.e. risk of LBP) or prognosis (i.e. sickness absence, return to work status). The analysis centred find more on comparisons between studies that reported an association or not using key aspects of extracted data, measurement of social support (studies that used a measure that included multiple items to assess support type were judged as adequate, studies that used a single item or did not specify were judged as poor), geographic location (countries where studies were carried out), worker sample

(e.g. industrial workers, office workers, general workers), analysis type (e.g. univariate, multivariate), assessment of back pain (e.g. pain intensity, disability, mechanical assessment, medical codes, prevalence and duration), factors of study bias (sample size, baseline response, attrition, length of follow-up). Assessment of strength of association was carried out following criteria guidelines (Hartvigsen et al. 2004; Iles et al. 2008); individual study results are described as: none (e.g. non-significant result), weak (e.g. OR/RR 1.01–1.49), moderate (e.g. OR/RR 1.50–1.99) or strong (e.g. OR/RR ≥ 2.0) in the support of an association between employment eFT508 datasheet social support and back pain outcomes. Results Systematic searching identified 375 publications (see Fig. 1). An additional 72 articles were included via alternative search strategies (hand search, CH5424802 expert consultation, and citation search). 378 articles were excluded following

abstract screening (e.g. not nonspecific LBP population, duplicates) with a further 37 articles excluded following full text screening. The reasons for exclusion at the full text screening stage were studies solely focusing on family support, cross-sectional Cytidine deaminase studies, studies on specific spinal pain populations (e.g. spondylolithesis, lumbar stenosis, spinal injury), or populations that focused on chronic pain patients outside of this study’s inclusion criteria (e.g. migraines, fibromyalgia, chronic widespread pain). This resulted in 32 suitable articles included within the review. Fig. 1 Flow diagram of review procedure Quality assessment analysis Taken together, all studies offered a clear research objective, 91 % described their recruitment procedure adequately, 69 % described the demographics of their study populations and 56 % reached a quality target criteria of a 70 % participation rate (see “Appendix 2” for quality assessment scores for each study). Most (81 %) of the studies employed a citable measure of employment social support.