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The clinical-practice guidelines for the management of acute low back pain that were published in 1994 by the Agency for Health Care Policy and Research (AHCPR) are widely recognized to have been a watershed. On the one hand, they marked an important scientific accomplishment in that a rigorous evaluation of more than 10,000 published studies on the management of this ubiquitous condition was completed. On the other hand, the reaction from some quarters to the recommendations of the agency's expert multidisciplinary panel was so negative and, indeed, at times vitriolic, that the agency and the guidelines-generating business have
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