Outcomes research is an area which is receiving increasing attention, particularly in the present climate, in which evidence-based practice and clinical guidelines are seen as the way forward for providing effective health care. However, much of the evidence which informs clinical guidelines continues to originate from the scientific research paradigm, which may be, at least in part, not entirely appropriate when considering conditions such as chronic back pain. The present paper describes alternative approaches to research inquiry and accompanying shifts in the types of outcome measures used to judge the efficacy of treatment regimes in the research selling. The argument is made that these directions will need to be embraced if future research evidence is to remain relevant and meaningful to the individual patient in the clinical setting.