Clinical Prediction Rules

We have recently had several controversial posts regarding not limiting ourselves to the findings of higher level studies. One of the outputs of that research has been the development of clinical prediction rules (CPR's). Matthew Barton recently wrote a very interesting piece on the topic of CPR's regarding the definition, developmental process, and impact on our practice. With sufficient research and development, CPR's may possibly play a larger role in our care. However it should be known that most of the CPR's have not been validated and studied sufficiently to impact our practice significantly at this point. For example, in the newest JOSPT publication, Dr. Rabin and his colleagues found that the clinical prediction rule for Lumbar Stabilization Exercises was not valid. Additionally, we must be careful that we do not only choose an intervention based on when the CPR would instruct us to do so. Remember to treat underlying impairments!