Evaluation of the Usefulness of 2 Prediction Models of Clinical Prediction Models in Physical Therapy: A Qualitative Process Evaluation

Oort, L. van; Verhagen, Arianne P.; Koes, Bart W.; Vet, Henrica C.W. de; Anema, Han; Heymans, Martijn W.

doi:10.1016/j.jmpt.2013.09.008

Cited by 6 publications

(7 citation statements)

References 11 publications

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“…There have been fewer attempts to explain why risk-scoring tools as a whole have not been effectively adopted by GPs in the UK. Some studies have evaluated the impact of individual tools [16,17], another appraised the current guidance [9], and others have considered clinicians' views on risk-scoring tools in general [14,18]. There remains a need to expand our understanding of the attitudes towards risk-scoring tools in the medical field, so that solutions and explanations may be offered for their variable adoption.…”

Section: Introductionmentioning

confidence: 99%

What are medical students’ attitudes to clinical risk-scoring tools? An exploratory study

Tomlinson

Willis

2019

Education for Primary Care

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Section: Introductionmentioning

confidence: 99%

What are medical students’ attitudes to clinical risk-scoring tools? An exploratory study

Tomlinson

Willis

2019

Education for Primary Care

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“…There are several examples of initiatives to move away from traditional pain location diagnostics, e.g., by launching clinical prediction rules [33][34][35], prediction models [36,37], and clustering in risk strata [10]. This development is however still in the molding and progressing slowly [38,39], and introduction of prediction models in the clinic is not straight forward [40]. Our approach adds to this literature by arching the whole biopsychosocial domain of known prognostic factors across common MSK pain conditions.…”

Section: Discussionmentioning

confidence: 99%

Recovery trajectories in common musculoskeletal complaints by diagnosis contra prognostic phenotypes

Aasdahl

Granviken

Meisingset

et al. 2021

BMC Musculoskelet Disord

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Background There are large variations in symptoms and prognostic factors among patients sharing the same musculoskeletal (MSK) diagnosis, making traditional diagnostic labelling not very helpful in informing treatment or prognosis. Recently, we identified five MSK phenotypes across common MSK pain locations through latent class analysis (LCA). The aim of this study was to explore the one-year recovery trajectories for pain and functional limitations in the phenotypes and describe these in relation to the course of traditional diagnostic MSK groups. Methods We conducted a longitudinal observational study of 147 patients with neck, back, shoulder or complex pain in primary health care physiotherapy. Data on pain intensity and function were collected at baseline (week 0) and 1, 2, 3, 4, 6, 8, 12, 26 and 52 weeks of follow up using web-based questionnaires and mobile text messages. Recovery trajectories were described separately for the traditional diagnostic MSK groups based on pain location and the same patients categorized in phenotype groups based on prognostic factors shared among the MSK diagnostic groups. Results There was a general improvement in function throughout the year of follow-up for the MSK groups, while there was a more modest decrease for pain intensity. The MSK diagnoses were dispersed across all five phenotypes, where the phenotypes showed clearly different trajectories for recovery and course of symptoms over 12 months follow-up. This variation was not captured by the single trajectory for site specific MSK diagnoses. Conclusion Prognostic subgrouping revealed more diverse patterns in pain and function recovery over 1 year than observed in the same patients classified by traditional diagnostic groups and may better reflect the diversity in recovery of common MSK disorders.

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“…Prior research on RPTs examined the perspective of physicians pertaining to diabetes, cardiovascular disease, post-operative nausea, and physical therapy [ 13 – 16 , 19 – 21 ]. While some of those studies identified potential patient barriers (i.e.…”

Section: Discussionmentioning

confidence: 99%

“…As a result, others have argued for more research on factors that influence the adoption and use of RPTs, and how to implement them in order to maximize benefits and minimize potential harms such as over-medicalization, false assurances and anxiety [ 13 , 14 , 17 , 18 ]. Barriers of RPT use are present at the physician (threat to physician decision-making authority, evidence not provided on determinants of predicted risk, perceived importance of clinical issue, practicality of integrating tools into practice) and patient (understanding results, concerns about results) levels [ 19 – 21 ].…”

Section: Introductionmentioning

confidence: 99%

“…The existing literature suggests that that RPTs require physicians to purposefully integrate their clinical experience with probabilistic data, weigh the risks and benefits for a given patient, reach a decision, and translate all of that for patients to support patient engagement in decision-making, which is complex and challenging [ 19 ]. However, these barriers were revealed in studies of RPTs for post-operative nausea [ 19 ], diabetes [ 20 ], and physical therapy [ 21 ], none of which are associated with such clinically profound implications as IgAN. Given that there is no research on factors that influence the adoption and use of RPTs by patients with IgAN, and factors influencing patient use of RPTs may differ by disease, there is no evidence to inform the development of the patient education tool by the International IgAN Network.…”

Section: Introductionmentioning

confidence: 99%

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How to optimize the design and implementation of risk prediction tools: focus group with patients with IgA nephropathy

Gagliardi

Reich

Cattran

et al. 2020

BMC Med Inform Decis Mak

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Background IgA nephropathy (IgAN) is a common type of chronic immune-mediated kidney disease with variable risk of progression to end-stage kidney disease. Risk stratification helps clinicians weight the potential risks and benefits of immunosuppressive therapy for individual patients, and can inform patient-centred communication. No prior research examined barriers of risk predication tools (RPT) specific to IgAN. The purpose of this study was to explore determinants (facilitators, barriers) of RPT use from the patient perspective. Methods We conducted a single focus group with English-speaking adults aged 18 or older with biopsy-proven IgAN. We asked about how they would use an IgAN RPT, and how to improve its design and implementation. We analyzed the transcript using constant comparison to inductively derive themes, and complied with qualitative research reporting criteria. Results The 5 participants were Caucasian men who varied in age from 35 to 55. The glomerular filtration rate ranged from 29 to 71 mL/min/1.73m2, and proteinuria ranged from 0.36 to 1.41 g/d. Participants identified both benefits and harms of the risk score. They said physicians should first ask patients for permission to use it. To make it more useful, participants offered suggestions to enhance RTP design: visual display, information on how to interpret the risk score, risk categories, health implications, modifiable risk factors, multiple scenarios, and comparison with similar patients. They offered additional suggestions to enhance RPT implementation: it should not replace patient-provider discussion, it should be accompanied by self-management education so that patients can take an active role in their health. Participants appreciated information from members of the multidisciplinary team in addition to physicians. Participants also said that physicians should monitor patient emotions or concerns on an ongoing basis. Conclusions Patients with IgAN identified numerous ways to enhance the design and use of an RPT. Others could use this information to design and implement RPTs for patients with other conditions, but should employ user-centred design to develop RPTs that address patient preferences.

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Evaluation of the Usefulness of 2 Prediction Models of Clinical Prediction Models in Physical Therapy: A Qualitative Process Evaluation

Cited by 6 publications

References 11 publications

What are medical students’ attitudes to clinical risk-scoring tools? An exploratory study

What are medical students’ attitudes to clinical risk-scoring tools? An exploratory study

Recovery trajectories in common musculoskeletal complaints by diagnosis contra prognostic phenotypes

How to optimize the design and implementation of risk prediction tools: focus group with patients with IgA nephropathy

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