BACKGROUND: Following clinical practice guidelines is widely recommended for treating many musculoskeletal diagnoses, including low back pain, but it is unknown if clinical practice guidelines for low back pain do.
OBJECTIVE: Assess whether clinical practice guidelines for low back pain reference publications from predatory journals or include retracted publications.
DESIGN: Meta-research.
METHODS: Clinical practice guidelines focusing on the management of adults with low back pain published between January 2010-June 2024 were included. All referenced publications in each guideline were evaluated for predatory categorization using a systematic process that included assessing publisher/journal websites, the Directory of Open Access Journals, Beall's List and major literature databases. The Retraction Watch Database was used to assess retraction status.
RESULTS: Nineteen clinical practice guidelines with 1617 unique publications met inclusion criteria. The majority of publications (1598/1617; 98.8 %) were categorized as 'non-predatory.' Fourteen publications (0.9 %) were categorized as 'predatory,' two (0.1 %) 'presumed predatory,' and three (0.2 %) were retracted. Four guidelines cited 'predatory' and/or 'presumed predatory' publications, and four guidelines cited the retracted publications.
CONCLUSION: Only 1.2 % of the cited publications included in clinical practice guidelines for the management of low back pain were deemed predatory or retracted, implying that guideline recommendations are unlikely to be influenced by their inclusion. There are currently no standard criteria for how to manage the inclusion of these publications in guidelines or systematic reviews. Future research should investigate the development of a valid and reliable checklist that allows authors to assess for and manage the presence of predatory or retracted publications.
