1
|
Hill CJ, Banerjee A, Hill J, Stapleton C. Diagnostic clinical prediction rules for categorising low back pain: A systematic review. Musculoskeletal Care 2023; 21:1482-1496. [PMID: 37807828 DOI: 10.1002/msc.1816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 08/31/2023] [Indexed: 10/10/2023]
Abstract
BACKGROUND Low back pain (LBP) is a common complex condition, where specific diagnoses are hard to identify. Diagnostic clinical prediction rules (CPRs) are known to improve clinical decision-making. A review of LBP diagnostic-CPRs by Haskins et al. (2015) identified six diagnostic-CPRs in derivation phases of development, with one tool ready for implementation. Recent progress on these tools is unknown. Therefore, this review aimed to investigate developments in LBP diagnostic-CPRs and evaluate their readiness for implementation. METHODS A systematic review was performed on five databases (Medline, Amed, Cochrane Library, PsycInfo, and CINAHL) combined with hand-searching and citation-tracking to identify eligible studies. Study and tool quality were appraised for risk of bias (Quality Assessment of Diagnostic Accuracy Studies-2), methodological quality (checklist using accepted CPR methodological standards), and CPR tool appraisal (GRade and ASsess Predictive). RESULTS Of 5021 studies screened, 11 diagnostic-CPRs were identified. Of the six previously known, three have been externally validated but not yet undergone impact analysis. Five new tools have been identified since Haskin et al. (2015); all are still in derivation stages. The most validated diagnostic-CPRs include the Lumbar-Spinal-Stenosis-Self-Administered-Self-Reported-History-Questionnaire and Diagnosis-Support-Tool-to-Identify-Lumbar-Spinal-Stenosis, and the StEP-tool which differentiates radicular from axial-LBP. CONCLUSIONS This updated review of LBP diagnostic CPRs found five new tools, all in the early stages of development. Three previously known tools have now been externally validated but should be used with caution until impact evaluation studies are undertaken. Future funding should focus on externally validating and assessing the impact of existing CPRs on clinical decision-making.
Collapse
|
2
|
Computer Kinesiology: New Diagnostic and Therapeutic Tool for Lower Back Pain Treatment (Pilot Study). BIOMED RESEARCH INTERNATIONAL 2020; 2020:2987696. [PMID: 32908878 PMCID: PMC7463396 DOI: 10.1155/2020/2987696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 07/29/2020] [Indexed: 11/18/2022]
Abstract
The aim of this study was to demonstrate the effectiveness of the diagnostic and therapeutic medical information system Computer Kinesiology in physiotherapy in patients with low back pain who were not responding to conventional therapy. Computer Kinesiology is primarily intended for the diagnostics and therapy of functional disorders of the locomotor system. This pilot study population included 55 patients (Group 1) with acute and chronic back pain and 51 persons (Group 2) without back pain. The third group was a control group of 67 healthy volunteers with no evidence of musculoskeletal pathologies and no back pain. All 173 subjects were examined three times by the diagnostic part of the Computer Kinesiology method. Groups 1 and 2 were treated after every diagnostics. Group 3 was not treated. The effect was evaluated by H score. Improvements after therapy were defined by reducing the H score by at least 1 point. In Group 1, the H score decreased by at least 1 point in 87.3% (95% CI: 75.5-94.7) and in Group 2 in 78.4% (95% CI: 64.7-88.7). There was no change of distribution of H Score grade in Group 3. The improvement neither depended on gender, age, and BMI nor was it influenced by the length of the therapy. This study demonstrated a high therapeutic efficacy of the Computer Kinesiology system in patients with back pain (Group 1) and in persons without back pain (Group 2) who used the Computer Kinesiology system for primary and secondary prevention of back pain.
Collapse
|
3
|
Baillie L, Bacon CJ, Hewitt CM, Moran RW. Predictors of functional improvement in people with chronic low back pain following a graded Pilates-based exercise programme. J Bodyw Mov Ther 2019; 23:211-218. [PMID: 30691755 DOI: 10.1016/j.jbmt.2018.06.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Revised: 03/31/2018] [Accepted: 05/13/2018] [Indexed: 11/28/2022]
Abstract
BACKGROUND Several studies have investigated subgroups of patients with low back pain (LBP) most likely to benefit from Pilates or movement control exercises, but none have determined prognostic factors specifically for chronic LBP. This prospective cohort study aimed to determine predictors of change in disability in people with chronic LBP following a Pilates-based exercise programme and reports summarised integrated prediction statistics to aid clinical utility for determination of subgroups likely to benefit or not benefit from treatment. METHODS Healthy adults (n = 55) with non-specific chronic LBP undertook a graded 6-week programme involving two 1-hour Pilates sessions/week (1 mat and 1 equipment-based) led in small groups by a trained Pilates instructor. Predictors of change in Patient-Specific Functional Scale (PSFS) were identified through regression analysis and used to develop clinical prediction statistics. RESULTS Clinically important improvement (n = 14 of 48 analysed) was predicted by four variables: gradual rather than sudden onset of LBP, PSFS <3.7 points, absence of aberrant motions on forward bending, and body mass index >24.5 kg/m2. Presence of ≥3 improved probability of success from 29% to 73%. Failure to improve (n = 18) was predicted by three variables: sudden onset of low back pain, patient-specific functional score ≥3.7, and difference between left and right active straight leg raise >7°. Presence of all three increased probability of failure from 38% to 80%. CONCLUSIONS A combination of five, easily measured variables were able to predict disability outcome following a graded programme of Pilates-based exercises in people with chronic LBP. Two common movement deficits were inversely related to positive changes in function which may call into question the structural mechanism of improvements observed. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry: ACTRN12616001588482.
Collapse
Affiliation(s)
- Leyla Baillie
- Osteopathy, Unitec Institute of Technology, Auckland, New Zealand
| | | | - Claire M Hewitt
- Osteopathy, Unitec Institute of Technology, Auckland, New Zealand
| | - Robert W Moran
- Osteopathy, Unitec Institute of Technology, Auckland, New Zealand
| |
Collapse
|
4
|
Khan Y. The STarT back tool in chiropractic practice: a narrative review. Chiropr Man Therap 2017; 25:11. [PMID: 28439405 PMCID: PMC5399842 DOI: 10.1186/s12998-017-0142-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2016] [Accepted: 04/12/2017] [Indexed: 11/10/2022] Open
Abstract
Background The Keele STarT Back Tool was designed for primary care medical physicians in the UK to determine the risk for persistent disabling pain in patients with musculoskeletal pain and to tailor treatments accordingly. In medical and physical therapy settings, STarT Back Tool’s tailored care plans improved patients’ low back pain outcomes and lowered costs. Objective Review studies using the STarT Back Tool in chiropractic patient populations. Methods PubMed, The Cochrane Library, Index to Chiropractic Literature, and Science Direct databases were searched. Articles written in English, published in peer-reviewed journals, that studied the STarT Back Tool in patients seeking chiropractic care were included. Results Seven articles were selected based on inclusion and exclusion criteria. The STarT Back Tool was feasibly incorporated into 19 chiropractic clinics in Denmark. Total STarT Back 5-item score correlated moderately with total Bournemouth Questionnaire score. Two studies reported that the STarT Back Tool’s predictive ability was poor, while another reported that the tool predicted outcomes in patients scoring in the medium and high risk categories who completed the STarT Back 2 days after their initial visit. A study examining Danish chiropractic, medical and physical therapy settings revealed that only baseline episode duration affected STarT Back’s prognostic ability across all care settings. The tool predicted pain and disability in chiropractic patients whose episode duration was at least 2 weeks, but not in patients with an episode duration <2 weeks. Conclusion While the STarT Back Tool can be incorporated into chiropractic settings and correlates with some elements of the Bournemouth Questionnaire, its prognostic ability is sometimes limited by the shorter low back pain episodes with which chiropractic patients often present. It may be a better predictor in patients whose episode duration is at least 2 weeks. Studies examining outcomes of stratified care in chiropractic patients are needed.
Collapse
Affiliation(s)
- Yasmeen Khan
- Palmer College of Chiropractic Center for Chiropractic Research, 741 Brady Street, Davenport, IA 52803 USA
| |
Collapse
|
5
|
Gross DP, Armijo-Olivo S, Shaw WS, Williams-Whitt K, Shaw NT, Hartvigsen J, Qin Z, Ha C, Woodhouse LJ, Steenstra IA. Clinical Decision Support Tools for Selecting Interventions for Patients with Disabling Musculoskeletal Disorders: A Scoping Review. JOURNAL OF OCCUPATIONAL REHABILITATION 2016; 26:286-318. [PMID: 26667939 PMCID: PMC4967425 DOI: 10.1007/s10926-015-9614-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Purpose We aimed to identify and inventory clinical decision support (CDS) tools for helping front-line staff select interventions for patients with musculoskeletal (MSK) disorders. Methods We used Arksey and O'Malley's scoping review framework which progresses through five stages: (1) identifying the research question; (2) identifying relevant studies; (3) selecting studies for analysis; (4) charting the data; and (5) collating, summarizing and reporting results. We considered computer-based, and other available tools, such as algorithms, care pathways, rules and models. Since this research crosses multiple disciplines, we searched health care, computing science and business databases. Results Our search resulted in 4605 manuscripts. Titles and abstracts were screened for relevance. The reliability of the screening process was high with an average percentage of agreement of 92.3 %. Of the located articles, 123 were considered relevant. Within this literature, there were 43 CDS tools located. These were classified into 3 main areas: computer-based tools/questionnaires (n = 8, 19 %), treatment algorithms/models (n = 14, 33 %), and clinical prediction rules/classification systems (n = 21, 49 %). Each of these areas and the associated evidence are described. The state of evidentiary support for CDS tools is still preliminary and lacks external validation, head-to-head comparisons, or evidence of generalizability across different populations and settings. Conclusions CDS tools, especially those employing rapidly advancing computer technologies, are under development and of potential interest to health care providers, case management organizations and funders of care. Based on the results of this scoping review, we conclude that these tools, models and systems should be subjected to further validation before they can be recommended for large-scale implementation for managing patients with MSK disorders.
Collapse
Affiliation(s)
- Douglas P. Gross
- Department of Physical Therapy, University of Alberta, 2-50 Corbett Hall, Edmonton, AB T6G 2G4 Canada
| | - Susan Armijo-Olivo
- Faculty of Rehabilitation Medicine, University of Alberta, 3-62 Corbett Hall, Edmonton, AB T6G 2G4 Canada
| | - William S. Shaw
- Liberty Mutual Research Institute for Safety, 71 Frankland Road, Hopkinton, MA 01748 USA
| | - Kelly Williams-Whitt
- University of Lethbridge, Calgary Campus, Suite S6032, 345 - 6th Avenue SE, Calgary, AB T2G 4V1 Canada
| | - Nicola T. Shaw
- Algoma University, 1520 Queen Street East, CC 303, Sault Ste. Marie, ON P2A 2G4 Canada
| | - Jan Hartvigsen
- University of Southern Denmark, Odense, Denmark
- Center for Muscle and Joint Health, Nordic Institute of Chiropractic and Clinical Biomechanics, Campusvej 55, 5230 Odense M, Denmark
| | - Ziling Qin
- Faculty of Rehabilitation Medicine, University of Alberta, 3-62 Corbett Hall, Edmonton, AB T6G 2G4 Canada
| | - Christine Ha
- Faculty of Rehabilitation Medicine, University of Alberta, 3-62 Corbett Hall, Edmonton, AB T6G 2G4 Canada
| | - Linda J. Woodhouse
- Department of Physical Therapy, University of Alberta, 2-50 Corbett Hall, Edmonton, AB T6G 2G4 Canada
| | - Ivan A. Steenstra
- Institute for Work & Health, 481 University Avenue, Suite 800, Toronto, ON M5G 2E9 Canada
| |
Collapse
|
6
|
Widerström B, Olofsson N, Boström C, Rasmussen-Barr E. Feasibility of the subgroup criteria included in the treatment-strategy-based (TREST) classification system (CS) for patients with non-specific low back pain (NSLBP). ACTA ACUST UNITED AC 2016; 23:90-7. [DOI: 10.1016/j.math.2016.01.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Revised: 12/14/2015] [Accepted: 01/03/2016] [Indexed: 02/06/2023]
|
7
|
Hegedus EJ, Cook C, Lewis J, Wright A, Park JY. Combining orthopedic special tests to improve diagnosis of shoulder pathology. Phys Ther Sport 2015; 16:87-92. [DOI: 10.1016/j.ptsp.2014.08.001] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Revised: 07/05/2014] [Accepted: 08/01/2014] [Indexed: 10/24/2022]
|
8
|
Na X, Martin AJ, Sethi S, Kyne L, Garey KW, Flores SW, Hu M, Shah DN, Shields K, Leffler DA, Kelly CP. A Multi-Center Prospective Derivation and Validation of a Clinical Prediction Tool for Severe Clostridium difficile Infection. PLoS One 2015; 10:e0123405. [PMID: 25906284 PMCID: PMC4408056 DOI: 10.1371/journal.pone.0123405] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Accepted: 02/18/2015] [Indexed: 12/18/2022] Open
Abstract
Background and Aims Prediction of severe clinical outcomes in Clostridium difficile infection (CDI) is important to inform management decisions for optimum patient care. Currently, treatment recommendations for CDI vary based on disease severity but validated methods to predict severe disease are lacking. The aim of the study was to derive and validate a clinical prediction tool for severe outcomes in CDI. Methods A cohort totaling 638 patients with CDI was prospectively studied at three tertiary care clinical sites (Boston, Dublin and Houston). The clinical prediction rule (CPR) was developed by multivariate logistic regression analysis using the Boston cohort and the performance of this model was then evaluated in the combined Houston and Dublin cohorts. Results The CPR included the following three binary variables: age ≥ 65 years, peak serum creatinine ≥2 mg/dL and peak peripheral blood leukocyte count of ≥20,000 cells/μL. The Clostridium difficile severity score (CDSS) correctly classified 76.5% (95% CI: 70.87-81.31) and 72.5% (95% CI: 67.52-76.91) of patients in the derivation and validation cohorts, respectively. In the validation cohort, CDSS scores of 0, 1, 2 or 3 were associated with severe clinical outcomes of CDI in 4.7%, 13.8%, 33.3% and 40.0% of cases respectively. Conclusions We prospectively derived and validated a clinical prediction rule for severe CDI that is simple, reliable and accurate and can be used to identify high-risk patients most likely to benefit from measures to prevent complications of CDI.
Collapse
Affiliation(s)
- Xi Na
- Division of Gastroenterology, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, United States of America
| | - Alan J. Martin
- Department of Medicine for the Older Person, Mater Misericordiae University Hospital and University College Dublin, Dublin, Ireland
| | - Saurabh Sethi
- Division of Gastroenterology, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, United States of America
| | - Lorraine Kyne
- Department of Medicine for the Older Person, Mater Misericordiae University Hospital and University College Dublin, Dublin, Ireland
| | - Kevin W. Garey
- University of Houston College of Pharmacy, Houston, Texas, United States of America
| | - Sarah W. Flores
- Division of Gastroenterology, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, United States of America
| | - Mary Hu
- Division of Gastroenterology, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, United States of America
| | - Dhara N. Shah
- University of Houston College of Pharmacy, Houston, Texas, United States of America
| | - Kelsey Shields
- Division of Gastroenterology, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, United States of America
| | - Daniel A. Leffler
- Division of Gastroenterology, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, United States of America
| | - Ciarán P. Kelly
- Division of Gastroenterology, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts, United States of America
- * E-mail:
| |
Collapse
|
9
|
Haskins R, Osmotherly PG, Southgate E, Rivett DA. Australian physiotherapists’ priorities for the development of clinical prediction rules for low back pain: A qualitative study. Physiotherapy 2015; 101:44-9. [DOI: 10.1016/j.physio.2014.04.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Accepted: 04/21/2014] [Indexed: 10/25/2022]
|
10
|
Haskins R, Osmotherly PG, Rivett DA. Validation and impact analysis of prognostic clinical prediction rules for low back pain is needed: a systematic review. J Clin Epidemiol 2015; 68:821-32. [PMID: 25804336 DOI: 10.1016/j.jclinepi.2015.02.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Revised: 01/05/2015] [Accepted: 02/09/2015] [Indexed: 02/06/2023]
Abstract
OBJECTIVES To identify prognostic forms of clinical prediction rules (CPRs) related to the nonsurgical management of adults with low back pain (LBP) and to evaluate their current stage of development. STUDY DESIGN AND SETTING Systematic review using a sensitive search strategy across seven databases with hand searching and citation tracking. RESULTS A total of 10,005 records were screened for eligibility with 35 studies included in the review. The included studies report on the development of 30 prognostic LBP CPRs. Most of the identified CPRs are in their initial phase of development. Three CPRs were found to have undergone validation--the Cassandra rule for predicting long-term significant functional limitations and the five-item and two-item Flynn manipulation CPRs for predicting a favorable functional prognosis in patients being treated with lumbopelvic manipulation. No studies were identified that investigated whether the implementation of a CPR resulted in beneficial patient outcomes or improved resource efficiencies. CONCLUSION Most of the identified prognostic CPRs for LBP are in the initial phase of development and are consequently not recommended for direct application in clinical practice at this time. The body of evidence provides emergent confidence in the limited predictive performance of the Cassandra rule and the five-item Flynn manipulation CPR in comparable clinical settings and patient populations.
Collapse
Affiliation(s)
- Robin Haskins
- School of Health Sciences, University of Newcastle, University Drive, Callaghan, New South Wales 2308, Australia.
| | - Peter G Osmotherly
- School of Health Sciences, University of Newcastle, University Drive, Callaghan, New South Wales 2308, Australia
| | - Darren A Rivett
- School of Health Sciences, University of Newcastle, University Drive, Callaghan, New South Wales 2308, Australia
| |
Collapse
|
11
|
Diagnostic clinical prediction rules for specific subtypes of low back pain: a systematic review. J Orthop Sports Phys Ther 2015; 45:61-76, A1-4. [PMID: 25573009 DOI: 10.2519/jospt.2015.5723] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
STUDY DESIGN Systematic review. OBJECTIVES To identify diagnostic clinical prediction rules (CPRs) for low back pain (LBP) and to assess their readiness for clinical application. BACKGROUND Significant research has been invested into the development of CPRs that may assist in the meaningful subgrouping of patients with LBP. To date, very little is known about diagnostic forms of CPRs for LBP, which relate to the present status or classification of an individual, and whether they have been developed sufficiently to enable their application in clinical practice. METHODS A sensitive electronic search strategy using 7 databases was combined with hand searching and citation tracking to identify eligible studies. Two independent reviewers identified relevant studies for inclusion using a 2-stage selection process. The quality appraisal of included studies was conducted by 2 independent raters using the Quality Assessment of Diagnostic Accuracy Studies-2 and checklists composed of accepted methodological standards for the development of CPRs. RESULTS Of 10 014 studies screened for eligibility, the search identified that 13 diagnostic CPRs for LBP have been derived. Among those, 1 tool for identifying lumbar spinal stenosis and 2 tools for identifying inflammatory back pain have undergone validation. No impact analysis studies were identified. CONCLUSION Most diagnostic CPRs for LBP are in their initial development phase and cannot be recommended for use in clinical practice at this time. Validation and impact analysis of the diagnostic CPRs identified in this review are warranted, particularly for those tools that meet an identified unmet need of clinicians who manage patients with LBP. LEVEL OF EVIDENCE Diagnosis, level 2a-.
Collapse
|
12
|
van Trijffel E, Lindeboom R, Bossuyt PMM, Schmitt MA, Lucas C, Koes BW, Oostendorp RAB. Indicating spinal joint mobilisations or manipulations in patients with neck or low-back pain: protocol of an inter-examiner reliability study among manual therapists. Chiropr Man Therap 2014; 22:22. [PMID: 24982754 PMCID: PMC4074830 DOI: 10.1186/2045-709x-22-22] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2014] [Accepted: 05/14/2014] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Manual spinal joint mobilisations and manipulations are widely used treatments in patients with neck and low-back pain. Inter-examiner reliability of passive intervertebral motion assessment of the cervical and lumbar spine, perceived as important for indicating these interventions, is poor within a univariable approach. The diagnostic process as a whole in daily practice in manual therapy has a multivariable character, however, in which the use and interpretation of passive intervertebral motion assessment depend on earlier results from the diagnostic process. To date, the inter-examiner reliability among manual therapists of a multivariable diagnostic decision-making process in patients with neck or low-back pain is unknown. METHODS This study will be conducted as a repeated-measures design in which 14 pairs of manual therapists independently examine a consecutive series of a planned total of 165 patients with neck or low-back pain presenting in primary care physiotherapy. Primary outcome measure is therapists' decision about whether or not manual spinal joint mobilisations or manipulations, or both, are indicated in each patient, alone or as part of a multimodal treatment. Therapists will largely be free to conduct the full diagnostic process based on their formulated examination objectives. For each pair of therapists, 2×2 tables will be constructed and reliability for the dichotomous decision will be expressed using Cohen's kappa. In addition, observed agreement, prevalence of positive decisions, prevalence index, bias index, and specific agreement in positive and negative decisions will be calculated. Univariable logistic regression analysis of concordant decisions will be performed to explore which demographic, professional, or clinical factors contributed to reliability. DISCUSSION This study will provide an estimate of the inter-examiner reliability among manual therapists of indicating spinal joint mobilisations or manipulations in patients with neck or low-back pain based on a multivariable diagnostic reasoning and decision-making process, as opposed to reliability of individual tests. As such, it is proposed as an initial step toward the development of an alternative approach to current classification systems and prediction rules for identifying those patients with spinal disorders that may show a better response to manual therapy which can be incorporated in randomised clinical trials. Potential methodological limitations of this study are discussed.
Collapse
Affiliation(s)
- Emiel van Trijffel
- Department of Clinical Epidemiology, Biostatistics & Bioinformatics, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands
- Institute for Master Education in Musculoskeletal Therapy, Amersfoort, the Netherlands
| | - Robert Lindeboom
- Department of Clinical Epidemiology, Biostatistics & Bioinformatics, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands
| | - Patrick MM Bossuyt
- Department of Clinical Epidemiology, Biostatistics & Bioinformatics, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands
| | - Maarten A Schmitt
- Institute for Master Education in Musculoskeletal Therapy, Amersfoort, the Netherlands
| | - Cees Lucas
- Department of Clinical Epidemiology, Biostatistics & Bioinformatics, Academic Medical Centre, University of Amsterdam, Amsterdam, the Netherlands
| | - Bart W Koes
- Department of General Practice, Erasmus MC University Medical Centre, Rotterdam, the Netherlands
| | - Rob AB Oostendorp
- Scientific Institute for Quality of Healthcare, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands
- Department of Rehabilitation, Physiotherapy and Manual Therapy, Faculty of Medicine and Pharmacology, Free University of Brussels, Brussels, Belgium
| |
Collapse
|
13
|
Bruno P. The use of "stabilization exercises" to affect neuromuscular control in the lumbopelvic region: a narrative review. THE JOURNAL OF THE CANADIAN CHIROPRACTIC ASSOCIATION 2014; 58:119-130. [PMID: 24932016 PMCID: PMC4025082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
It is well-established that the coordination of muscular activity in the lumbopelvic region is vital to the generation of mechanical spinal stability. Several models illustrating mechanisms by which dysfunctional neuromuscular control strategies may serve as a cause and/or effect of low back pain have been described in the literature. The term "core stability" is variously used by clinicians and researchers, and this variety has led to several rehabilitative approaches suggested to affect the neuromuscular control strategies of the lumbopelvic region (e.g. "stabilization exercise", "motor control exercise"). This narrative review will highlight: 1) the ongoing debate in the clinical and research communities regarding the terms "core stability" and "stabilization exercise", 2) the importance of sub-grouping in identifying those patients most likely to benefit from such therapeutic interventions, and 3) two protocols that can assist clinicians in this process.
Collapse
Affiliation(s)
- Paul Bruno
- Assistant Professor and CCRF Research Chair in Neuromusculoskeletal Health, Faculty of Kinesiology and Health Studies, University of Regina
| |
Collapse
|
14
|
Haskins R, Osmotherly PG, Southgate E, Rivett DA. Physiotherapists' knowledge, attitudes and practices regarding clinical prediction rules for low back pain. ACTA ACUST UNITED AC 2014; 19:142-51. [DOI: 10.1016/j.math.2013.09.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2013] [Revised: 08/23/2013] [Accepted: 09/23/2013] [Indexed: 12/27/2022]
|
15
|
Abstract
Stratified care for back pain involves targeting treatment to subgroups of patients based on their key characteristics such as prognostic factors, likely response to treatment and underlying mechanisms. It aims to tailor therapeutic decisions in ways that maximise treatment benefit, reduce harm and increase health-care efficiency by offering the right treatment to the right patient at the right time. From being called the 'Holy Grail' of back pain research over a decade ago, stratified care is becoming the zeitgeist in research and clinical practice. In this chapter, we introduce and evaluate the quality and underpinning evidence for three examples of stratified care for back pain to highlight their general principles, research design issues and clinical practice implications. We include consideration of their merits for implementation in practice. We conclude with a set of remaining, key research questions.
Collapse
|
16
|
Macdermid JC, Miller J, Gross AR. Knowledge Translation Tools are Emerging to Move Neck Pain Research into Practice. Open Orthop J 2013; 7:582-93. [PMID: 24155807 PMCID: PMC3805983 DOI: 10.2174/1874325001307010582] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Revised: 08/23/2013] [Accepted: 08/23/2013] [Indexed: 12/20/2022] Open
Abstract
Development or synthesis of the best clinical research is in itself insufficient to change practice. Knowledge translation (KT) is an emerging field focused on moving knowledge into practice, which is a non-linear, dynamic process that involves knowledge synthesis, transfer, adoption, implementation, and sustained use. Successful implementation requires using KT strategies based on theory, evidence, and best practice, including tools and processes that engage knowledge developers and knowledge users. Tools can provide instrumental help in implementing evidence. A variety of theoretical frameworks underlie KT and provide guidance on how tools should be developed or implemented. A taxonomy that outlines different purposes for engaging in KT and target audiences can also be useful in developing or implementing tools. Theoretical frameworks that underlie KT typically take different perspectives on KT with differential focus on the characteristics of the knowledge, knowledge users, context/environment, or the cognitive and social processes that are involved in change. Knowledge users include consumers, clinicians, and policymakers. A variety of KT tools have supporting evidence, including: clinical practice guidelines, patient decision aids, and evidence summaries or toolkits. Exemplars are provided of two KT tools to implement best practice in management of neck pain—a clinician implementation guide (toolkit) and a patient decision aid. KT frameworks, taxonomies, clinical expertise, and evidence must be integrated to develop clinical tools that implement best evidence in the management of neck pain.
Collapse
Affiliation(s)
- Joy C Macdermid
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario and Hand and Upper Limb Centre Clinical Research Laboratory, St. Joseph's Health Centre, 268 Grosvenor St., London, Ontario, N6A 3A8, Canada
| | | | | |
Collapse
|
17
|
Systematic review of randomized controlled trials of clinical prediction rules for physical therapy in low back pain. Spine (Phila Pa 1976) 2013; 38:762-9. [PMID: 23132535 DOI: 10.1097/brs.0b013e31827b158f] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Systematic review. OBJECTIVE To evaluate randomized controlled trials validating the effects of a clinical prediction rule for patients with non-specific low back pain (LBP). The outcomes of interest were any back pain or pain-related measures. SUMMARY OF BACKGROUND DATA LBP is a common and costly condition. Interventions for back pain seem to have, at best, small to moderate mean beneficial effects. Identifying subgroups of patients who may respond better to certain treatments may help to improve clinical outcomes in back pain. The development of clinical prediction rules is an attempt to determine who will respond best to certain treatments. METHODS We conducted electronic searches of MEDLINE (1980-2009), EMBASE (1980-2009), PsycINFO (1980-2009), Allied and Complementary Medicine (1980-2009), PubMed (1980-2009), ISI Web of Knowledge (1980-2009), and the Cochrane Library (1980-2009). The reference lists of relevant articles were searched for further references. RESULTS We identified 1821 potential citations; 3 articles were included. The results from the available data do not support the use of clinical prediction rules in the management of non-specific LBP. CONCLUSION There is a lack of good quality randomized controlled trials validating the effects of a clinical prediction rule for LBP. Furthermore, there is no agreement on appropriate methodology for the validation and impact analysis. The evidence for, and development of, the existing prediction rules is generally weak.
Collapse
|
18
|
Schenk R, Dionne C, Simon C, Johnson R. Effectiveness of mechanical diagnosis and therapy in patients with back pain who meet a clinical prediction rule for spinal manipulation. J Man Manip Ther 2013; 20:43-9. [PMID: 23372393 DOI: 10.1179/2042618611y.0000000017] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Recently a clinical prediction rule (CPR) for lumbar regional spinal thrust manipulation (STM) has shown predictive success in patients with back pain who met specific selection criteria. The purpose of this study was to compare the effectiveness of STM and mechanical diagnosis and therapy (MDT) in patients who are positive for the STM CPR. Following initial examination, 31 participants were randomized to the STM group (n = 16) and to the MDT group (n = 15). Two weeks following initial examination, four participants chose to cross over from the STM group to the MDT group. The Oswestry Disability Index (ODI), Fear-Avoidance Beliefs Questionnaire work subscale (FABQw), and the Numerical Pain Rating Scale (NPRS) were administered initially, and at 2-weeks and 4 week follow-up (discharge). Data were analyzed to determine changes in ODI and NPRS scores from initial examination through one month. Of the 31 participants, one patient who met only three of five selection criteria and four others who chose to switch groups were removed from the analysis. Both groups exhibited statistically significant improvements in ODI and NPRS scores from baseline to final visit but there was no significant difference in scores between groups at 4 weeks. In this sample of patients, the selection criteria for this CPR were not exclusive for lumbopelvic STM. Mechanical diagnosis and therapy was an equally viable choice for these patients.
Collapse
|
19
|
Learman K, Showalter C, Cook C. Does the use of a prescriptive clinical prediction rule increase the likelihood of applying inappropriate treatments? A survey using clinical vignettes. ACTA ACUST UNITED AC 2012; 17:538-43. [DOI: 10.1016/j.math.2012.05.011] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2011] [Revised: 05/16/2012] [Accepted: 05/23/2012] [Indexed: 12/12/2022]
|
20
|
Preliminary state of development of prediction models for primary care physical therapy: a systematic review. J Clin Epidemiol 2012; 65:1257-66. [PMID: 22959592 DOI: 10.1016/j.jclinepi.2012.05.007] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2011] [Revised: 05/17/2012] [Accepted: 05/22/2012] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To summarize the methodological quality and developmental stage of prediction models for musculoskeletal complaints that are relevant for physical therapists in primary care. STUDY DESIGN AND SETTING A systematic literature search was carried out in the databases of Medline, Embase, and Cinahl. Studies on prediction models for musculoskeletal complaints that can be used by primary care physical therapists were included. Methodological quality of the studies was assessed and relevant study characteristics were extracted. RESULTS The search retrieved 4,702 references of which 29 studies were included in this review. The study quality of the included studies showed substantial variation. The studied populations consisted mostly of back (n=10) and neck pain (n=6) patients, and patients with knee complaints (n=4). Most studies (n=22) used "perceived recovery" as primary outcome. Most prediction models (n=18) were at the derivation level of development. CONCLUSIONS Many prediction models are available for a wide range of patient populations. The developmental stage of most models is preliminary and the study quality is often moderate. We do not recommend physiotherapist to use these models yet. All models reviewed here are in the developmental stage and need validation and impact evaluation before using them in daily practice.
Collapse
|
21
|
A survey of the McKenzie Classification System in the Extremities: prevalence of mechanical syndromes and preferred loading strategies. Phys Ther 2012; 92:1175-86. [PMID: 22628582 DOI: 10.2522/ptj.20110371] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
BACKGROUND Classification of patients with extremity problems is commonly based on patho-anatomical diagnoses, but problems exist regarding reliability and validity of the tests and diagnostic criteria used. Alternatively, a classification system based on patient response to repeated loading strategies can be used to classify and direct management. OBJECTIVE The purpose of this study was to investigate the prevalence of McKenzie's classification categories among patients with extremity problems and the loading strategies used in their management. DESIGN This was a prospective, observational study. METHODS Thirty therapists among 138 invited (response rate=22%) with a Diploma in Mechanical Diagnosis and Therapy (MDT) were identified from the McKenzie Institute International registry and recruited worldwide to complete an e-mailed questionnaire. They provided data about their age, years qualified, years since gaining a diploma, and practice, and prospectively provided data on anatomical site and categorization for 15 consecutive patients with extremity problems. RESULTS Data were gathered on 388 patients; classification categories were as follows: derangement (37%); contractile dysfunction (17%); articular dysfunction (10%); and "other" (36%), of which 20% were postsurgery or posttrauma. Exercise management strategies and syndrome application varied considerably among anatomical sites. Classification categories remained consistent in 85.8% of patients over the treatment episode. LIMITATIONS These findings are not generalizable to therapists who are not experienced with use of MDT in the extremities. CONCLUSIONS This study demonstrates that trained clinicians can classify patients with extremity problems into MDT classifications and that these classifications remain stable during the treatment episode. Further work is needed to test the efficacy of this system compared with other approaches, but if derangements are as common as this survey suggests, the findings have important prognostic implications because this syndrome is defined by its rapid response to repeated movements.
Collapse
|
22
|
Abou Chakra CN, Pepin J, Valiquette L. Prediction tools for unfavourable outcomes in Clostridium difficile infection: a systematic review. PLoS One 2012; 7:e30258. [PMID: 22291926 PMCID: PMC3265469 DOI: 10.1371/journal.pone.0030258] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2011] [Accepted: 12/12/2011] [Indexed: 11/19/2022] Open
Abstract
CONTEXT Identifying patients at risk for adverse outcomes of Clostridium difficile infection (CDI), including recurrence and death, will become increasingly important as novel therapies emerge, which are more effective than traditional approaches but very expensive. Clinical prediction rules (CPRs) can improve the accuracy of medical decision-making. Several CPRs have been developed for CDI, but none has gained a widespread acceptance. METHODS We systematically reviewed studies describing the derivation or validation of CPRs for unfavourable outcomes of CDI, in medical databases (Medline, Embase, PubMed, Web of Science and Cochrane) and abstracts of conferences. RESULTS Of 2945 titles and abstracts screened, 13 studies on the derivation of a CPR were identified: two on recurrences, five on complications (including mortality), five on mortality alone and one on response to treatment. Two studies on the validation of different severity indices were also retrieved. Most CPRs were developed as secondary analyses using cohorts assembled for other purposes. CPRs presented several methodological limitations that could explain their limited use in clinical practice. Except for leukocytosis, albumin and age, there was much heterogeneity in the variables used, and most studies were limited by small sample sizes. Eight models used a retrospective design. Only four studies reported the incidence of the outcome of interest, even if this is essential to evaluate the potential usefulness of a model in other populations. Only five studies performed multivariate analyses to adjust for confounders. CONCLUSIONS The lack of weighing variables, of validation, calibration and measures of reproducibility, the weak validities and performances when assessed, and the absence of sensitivity analyses, all led to suboptimal quality and debatable utility of those CPRs. Evidence-based tools developed through appropriate prospective cohorts would be more valuable for clinicians than empirically-developed CPRs.
Collapse
Affiliation(s)
- Claire Nour Abou Chakra
- Department of Microbiology and Infectious Diseases, University of Sherbrooke, Quebec, Canada
| | - Jacques Pepin
- Department of Microbiology and Infectious Diseases, University of Sherbrooke, Quebec, Canada
| | - Louis Valiquette
- Department of Microbiology and Infectious Diseases, University of Sherbrooke, Quebec, Canada
| |
Collapse
|
23
|
Haskins R, Rivett DA, Osmotherly PG. Clinical prediction rules in the physiotherapy management of low back pain: a systematic review. ACTA ACUST UNITED AC 2011; 17:9-21. [PMID: 21641849 DOI: 10.1016/j.math.2011.05.001] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2011] [Revised: 04/28/2011] [Accepted: 05/09/2011] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To identify, appraise and determine the clinical readiness of diagnostic, prescriptive and prognostic Clinical Prediction Rules (CPRs) in the physiotherapy management of Low Back Pain (LBP). DATA SOURCES MEDLINE, EMBASE, CINAHL, AMED and the Cochrane Database of Systematic Reviews were searched from 1990 to January 2010 using sensitive search strategies for identifying CPR and LBP studies. Citation tracking and hand-searching of relevant journals were used as supplemental strategies. STUDY SELECTION Two independent reviewers used a two-phase selection procedure to identify studies that explicitly aimed to develop one or more CPRs involving the physiotherapy management of LBP. Diagnostic, prescriptive and prognostic studies investigating CPRs at any stage of their development, derivation, validation, or impact-analysis, were considered for inclusion using a priori criteria. 7453 unique records were screened with 23 studies composing the final included sample. DATA EXTRACTION Two reviewers independently extracted relevant data into evidence tables using a standardised instrument. DATA SYNTHESIS Identified studies were qualitatively synthesized. No attempt was made to statistically pool the results of individual studies. The 23 scientifically admissible studies described the development of 25 unique CPRs, including 15 diagnostic, 7 prescriptive and 3 prognostic rules. The majority (65%) of studies described the initial derivation of one or more CPRs. No studies investigating the impact phase of rule development were identified. CONCLUSIONS The current body of evidence does not enable confident direct clinical application of any of the identified CPRs. Further validation studies utilizing appropriate research designs and rigorous methodology are required to determine the performance and generalizability of the derived CPRs to other patient populations, clinicians and clinical settings.
Collapse
Affiliation(s)
- Robin Haskins
- School of Health Sciences, The University of Newcastle, NSW 2308, Australia
| | | | | |
Collapse
|
24
|
Nee RJ, Coppieters MW. Interpreting research on clinical prediction rules for physiotherapy treatments. ACTA ACUST UNITED AC 2010; 16:105-8. [PMID: 21074480 DOI: 10.1016/j.math.2010.10.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2010] [Accepted: 10/08/2010] [Indexed: 11/17/2022]
|
25
|
Ammer K. Veränderung der Hauttemperatur nach Manipulation des Wirbelsäulensegments L5. MANUELLE MEDIZIN 2010. [DOI: 10.1007/s00337-010-0787-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
26
|
Foster NE, Hill JC, Hay EM. Subgrouping patients with low back pain in primary care: are we getting any better at it? ACTA ACUST UNITED AC 2010; 16:3-8. [PMID: 20580595 DOI: 10.1016/j.math.2010.05.013] [Citation(s) in RCA: 100] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2010] [Revised: 05/21/2010] [Accepted: 05/27/2010] [Indexed: 11/16/2022]
Abstract
Low back pain is a common, disabling condition with high personal and economic costs. Despite clinical guidelines, there have not been tangible reductions in the population prevalence of back pain or its serious long-term consequences. One reason for this might be that the 'one-size fits all approach' advocated by many guidelines fails to target treatments at patients who might benefit the most, thus diluting their potential benefits. Identifying subgroups of patients for whom different treatments are superior has been referred to as the 'Holy Grail' of low back pain research. Maximising the potential for targeted interventions is predicated on better understanding of the prognostic factors that are causally related to clinical outcome and identifying which are a) most predictive of outcome and b) most likely to be modifiable. Systematic identification of key obstacles to recovery in primary care back pain patients from high quality epidemiological studies can inform the development of early, targeted interventions. Only then can closer matching of treatments to patient characteristics be a clinical reality. This paper critically reviews progress in subgrouping for targeted treatment for patients with low back pain, identifies the key arguments for and against subgrouping and highlights the attributes of robust approaches in this field.
Collapse
Affiliation(s)
- Nadine E Foster
- Arthritis Research UK Primary Care Centre, Primary Care Sciences, Keele University, Keele, Staffordshire ST5 5BG, UK.
| | | | | |
Collapse
|
27
|
Critical appraisal of clinical prediction rules that aim to optimize treatment selection for musculoskeletal conditions. Phys Ther 2010; 90:843-54. [PMID: 20413577 DOI: 10.2522/ptj.20090233] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Clinical prediction rules (CPRs) for treatment selection in musculoskeletal conditions have become increasingly popular. PURPOSE The purposes of this review are: (1) to critically appraise studies evaluating CPRs and (2) to consider the clinical utility and stage of development of each CPR. DATA SOURCES Pertinent databases were searched up to April 2009. Studies aiming to develop or evaluate a CPR for treatment response in musculoskeletal conditions were included. Two independent reviewers assessed eligibility and extracted methodological data, stage of development, and effect size information. STUDY SELECTION/DATA EXTRACTION AND SYNTHESIS: Eighteen studies, evaluating 15 separate CPRs, were included. Fourteen CPRs were at the derivation stage, and all CPRs had been evaluated using a single-arm trial design, thus it is not possible to determine whether the CPRs identify prognosis (regardless of treatment) or specifically response to treatment. The CPR at the validation stage investigated spinal manipulative therapy (SMT) for low back pain and had been evaluated in 2 separate well-conducted randomized controlled trials. The first trial demonstrated a clinically meaningful effect of the SMT CPR; the additional effect from SMT in patients "positive-on-the-rule" was 15 Oswestry disability units at week 1 and 9 units at week 4. The second trial showed that the CPR did not generalize to a different clinical setting, including a modified treatment. LIMITATIONS Due to differences in methods of reporting and journal publication restraints (eg, word count restrictions), some quality assessment items may have been completed in the included studies, but not captured in this review. CONCLUSIONS There is, at present, little evidence that CPRs can be used to predict effects of treatment for musculoskeletal conditions. The principal problem is that most studies use designs that cannot differentiate between predictors of response to treatment and general predictors of outcome. Only 1 CPR has been evaluated within an RCT designed to predict response to treatment. Validation of these rules is imperative to allow clinical application.
Collapse
|
28
|
Hegedus EJ. Studies of quality and impact in clinical diagnosis and decision-making. J Man Manip Ther 2010; 18:5-6. [PMID: 21655417 DOI: 10.1179/106698110x12640740713012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
|
29
|
Cook C, Brismée JM, Courtney C, Hancock M, May S. Publishing a scientific manuscript on manual therapy. J Man Manip Ther 2010; 17:141-7. [PMID: 20046620 DOI: 10.1179/jmt.2009.17.3.141] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Publication in peer-reviewed journals is the way to introduce new information that has clinical implications. However, clinicians may be reluctant to embark on the publication process because of lack of confidence or uncertainty about the process. The aim of this paper is to summarize the requirements of that process and to provide tips for successful publication to encourage potential clinical authors of manual therapy articles. In general, articles should contribute knowledge, corroborate or contradict previous knowledge, or summarize existing knowledge. Articles should be clearly structured, with abstract, introduction, methods, discussion, conclusion, and references; and often include tables and figures. The content of each of these sections is described. The use of standardized checklists is encouraged and the format should adhere to each journal's author guidelines. Submission is electronic and typically first the editor or deputy editor reviews for suitability, adherence to journal format, and quality of writing. If deemed suitable, the article is then sent out for blinded review by two reviewers with expertise in that area. Review typically takes 6-8 weeks, and all communication is via the editor. A decision is made then to either accept, accept with amendments to be made, reject but with advice to resubmit, or reject outright. In any re-submissions, the review teams' comments should be diligently addressed, either making the recommended changes or justifying why they have not been adopted. Common reasons for rejection of articles are given. Finally, the authors provide some tips for publication to help readers with successful submission of articles.
Collapse
|
30
|
Development of a Quality Checklist Using Delphi Methods for Prescriptive Clinical Prediction Rules: The QUADCPR. J Manipulative Physiol Ther 2010; 33:29-41. [DOI: 10.1016/j.jmpt.2009.11.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2009] [Revised: 07/28/2009] [Indexed: 11/17/2022]
|