TY - JOUR
T1 - Agreement between physical therapists and radiologists of stratifying patients with shoulder pain into new treatment related categories using ultrasound; an exploratory study
AU - Thoomes-de Graaf, M.
AU - Ottenheijm, R. P. G.
AU - Verhagen, A. P.
AU - Duijn, E.
AU - Karel, Y. H. J. M.
AU - van den Borne, M. P. J.
AU - Beumer, A.
AU - van Broekhoven, J.
AU - Dinant, G. J.
AU - Tetteroo, E.
AU - Lucas, C.
AU - Koes, B. W.
AU - Scholten-Peeters, G. G. M.
PY - 2019/4
Y1 - 2019/4
N2 - Study design: A systematic overview of the literature and an agreement study.Objectives: The aim of this study is to explore the inter-professional agreement of diagnostic musculoskeletal ultrasound (DMUS) between physical therapists (PT) and radiologists, using a new classification strategy based upon the therapeutic consequences in patients with shoulder pain.Background: DMUS is frequently used by PTs, although the agreement regarding traditional diagnostic labels between PTs and radiologists is only fair. Nevertheless, DMUS could be useful when used as a stratifying-tool.Methods: First, a systematic overview of current evidence was performed to assess which traditional diagnostic labels could be recoded into new treatment related categories (referral to secondary care, corticosteroid injections, physical therapy, watchful waiting). Next, kappa values were calculated for these categories between PTs and radiologists.Results: Only three categories were extracted, as none of the traditional diagnostic labels were classified into the 'corticosteroid injection' category. Overall, we found moderate agreement to stratify patients into treatment related categories and substantial agreement for the category 'referral to secondary care'. Both categories 'watchful waiting' and 'indication for physical therapy' showed moderate agreement between the two professions.Conclusion: Our results indicate that the agreement between radiologists and PTs is moderate to substantial when labelling is based on treatment consequences. DMUS might be able to help the PT to guide treatment, especially for the category 'referral to secondary care' as this showed the highest agreement. However, as this is just an explorative study, more research is needed, to validate and assess the consequences of this stratification classification for clinical care.
AB - Study design: A systematic overview of the literature and an agreement study.Objectives: The aim of this study is to explore the inter-professional agreement of diagnostic musculoskeletal ultrasound (DMUS) between physical therapists (PT) and radiologists, using a new classification strategy based upon the therapeutic consequences in patients with shoulder pain.Background: DMUS is frequently used by PTs, although the agreement regarding traditional diagnostic labels between PTs and radiologists is only fair. Nevertheless, DMUS could be useful when used as a stratifying-tool.Methods: First, a systematic overview of current evidence was performed to assess which traditional diagnostic labels could be recoded into new treatment related categories (referral to secondary care, corticosteroid injections, physical therapy, watchful waiting). Next, kappa values were calculated for these categories between PTs and radiologists.Results: Only three categories were extracted, as none of the traditional diagnostic labels were classified into the 'corticosteroid injection' category. Overall, we found moderate agreement to stratify patients into treatment related categories and substantial agreement for the category 'referral to secondary care'. Both categories 'watchful waiting' and 'indication for physical therapy' showed moderate agreement between the two professions.Conclusion: Our results indicate that the agreement between radiologists and PTs is moderate to substantial when labelling is based on treatment consequences. DMUS might be able to help the PT to guide treatment, especially for the category 'referral to secondary care' as this showed the highest agreement. However, as this is just an explorative study, more research is needed, to validate and assess the consequences of this stratification classification for clinical care.
KW - ROTATOR CUFF TENDINOPATHY
KW - SUBACROMIAL IMPINGEMENT SYNDROME
KW - LOW-BACK-PAIN
KW - LONG HEAD
KW - PRIMARY-CARE
KW - ACROMIOCLAVICULAR JOINT
KW - OBSERVER AGREEMENT
KW - SURGICAL-TREATMENT
KW - MANAGEMENT
KW - TEARS
U2 - 10.1016/j.msksp.2019.01.005
DO - 10.1016/j.msksp.2019.01.005
M3 - Article
C2 - 30660988
SN - 2468-7812
VL - 40
SP - 1
EP - 9
JO - Musculoskeletal science and practice
JF - Musculoskeletal science and practice
ER -