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Picture

Great resource on Clinical Prediction Rules!

8/16/2013

2 Comments

 
Picture
While relatively new to the field of Physical Therapy, Clinical Prediction Rules have been used in medicine for a very long time (for example the Deep Vein Thrombosis CPR). These rules have been designed to improve clinical decision making and assist the practitioner in diagnosis, prognosis, and intervention planning. Childs and Cleland point out that "CPRs provide practitioners with powerful diagnostic information from the history and physical examination that may serve as an accurate decision-making surrogate for more expensive diagnostic tests." Not only can CPR's help curb the rising costs of healthcare, using this high level of evidence is especially important in the direct access setting where more extensive diagnostic testing has not been performed. In addition to diagnosis, other CPRs can aide in the classification and subgrouping of patients to guide you in intervention planning. 

Now that you know CPRs are important, what are these clinical prediction rules and where can you access them? Fortunately John Synder at the Orthopedic Manual Therapist recently compiled a list of them. Check them out HERE! 

References:
Childs J and Cleland J. (2006). Development and Application of Clinical Prediction Rules to improve decision making in Physical Therapist Practice. PHYS THER. 2006. Jan;86(1):122-131. Web. 13 Aug 2013.
2 Comments
MARCOS F LOPEZ
8/19/2013 05:24:17 am

It is important to note that not all of these CPRs have been validated. A lot of these CPRs are in the first stage of validation, being that they have been proposed in the literature by a study but they need to be followed up with further reserach (ie RCTs) to become validated.

Although it is a good practice to start using CPRs, we want to use them in a manner that is appropriate and of course, specific to our patients. These should also not be used exclusively. If you are taking a patient history and you are inclined to believe it is "impingement syndrome" of the shoulder, do not just perform the CPR for impingement syndrome and believe that is enough to rule in/rule out this pathology. These should be used as adjuncts to our evaluation, used in a manner that is specific to our patients.

Reply
Jim Heafner
8/20/2013 02:08:41 pm

Marcos,
I completely agree with what you said. It is very important for young professionals like myself to understand that as well. As the profession becomes better at subgrouping, the use of clinical prediction rules will play a much larger role in diagnosis and treatment selection. Thank you for the comment!

Reply



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  • Home
  • About Us
  • Insider Access
    • About Insider Access
  • Online Courses
    • Hooper's Knee
    • Physical Therapist Entrepreneur Course
    • Physical Therapist Consultant Course
    • Orthopedic Management of the Cervical Spine
    • Return to Sport Essentials Course
  • Resources
    • Newsletter
    • Business Minded Sports Physio Podcast
    • Day in the Life of a Sports PT
    • Residency Corner
    • Special Tests >
      • Cervical Spine >
        • Alar Ligament Test
        • Bakody's Sign
        • Cervical Distraction Test
        • Cervical Rotation Lateral Flexion Test
        • Craniocervical Flexion Test (CCFT)
        • Deep Neck Flexor Endurance Test
        • Posterior-Anterior Segmental Mobility
        • Segmental Mobility
        • Sharp-Purser Test
        • Spurling's Maneuver
        • Transverse Ligament Test
        • ULNT - Median
        • ULNT - Radial
        • ULNT - Ulnar
        • Vertebral Artery Test
      • Thoracic Spine >
        • Adam's Forward Bend Test
        • Passive Neck Flexion Test
        • Thoracic Compression Test
        • Thoracic Distraction Test
        • Thoracic Foraminal Closure Test
      • Lumbar Spine/Sacroiliac Joint >
        • Active Sit-Up Test
        • Alternate Gillet Test
        • Crossed Straight Leg Raise Test
        • Extensor Endurance Test
        • FABER Test
        • Fortin's Sign
        • Gaenslen Test
        • Gillet Test
        • Gower's Sign
        • Lumbar Quadrant Test
        • POSH Test
        • Posteroanterior Mobility
        • Prone Knee Bend Test
        • Prone Instability Test
        • Resisted Abduction Test
        • Sacral Clearing Test
        • Seated Forward Flexion Test
        • SIJ Compression/Distraction Test
        • Slump Test
        • Sphinx Test
        • Spine Rotators & Multifidus Test
        • Squish Test
        • Standing Forward Flexion Test
        • Straight Leg Raise Test
        • Supine to Long Sit Test
      • Shoulder >
        • Active Compression Test
        • Anterior Apprehension
        • Biceps Load Test II
        • Drop Arm Sign
        • External Rotation Lag Sign
        • Hawkins-Kennedy Impingement Sign
        • Horizontal Adduction Test
        • Internal Rotation Lag Sign
        • Jobe Test
        • Ludington's Test
        • Neer Test
        • Painful Arc Sign
        • Pronated Load Test
        • Resisted Supination External Rotation Test
        • Speed's Test
        • Posterior Apprehension
        • Sulcus Sign
        • Thoracic Outlet Tests >
          • Adson's Test
          • Costoclavicular Brace
          • Hyperabduction Test
          • Roos (EAST)
        • Yergason's Test
      • Elbow >
        • Biceps Squeeze Test
        • Chair Sign
        • Cozen's Test
        • Elbow Extension Test
        • Medial Epicondylalgia Test
        • Mill's Test
        • Moving Valgus Stress Test
        • Push-up Sign
        • Ulnar Nerve Compression Test
        • Valgus Stress Test
        • Varus Stress Test
      • Wrist/Hand >
        • Allen's Test
        • Carpal Compression Test
        • Finkelstein Test
        • Phalen's Test
        • Reverse Phalen's Test
      • Hip >
        • Craig's Test
        • Dial Test
        • FABER Test
        • FAIR Test
        • Fitzgerald's Test
        • Hip Quadrant Test
        • Hop Test
        • Labral Anterior Impingement Test
        • Labral Posterior Impingement Test
        • Long-Axis Femoral Distraction Test
        • Noble Compression Test
        • Percussion Test
        • Sign of the Buttock
        • Trendelenburg Test
      • Knee >
        • Anterior Drawer Test
        • Dial Test (Tibial Rotation Test)
        • Joint Line Tenderness
        • Lachman Test
        • McMurray Test
        • Noble Compression Test
        • Pivot-Shift Test
        • Posterior Drawer Test
        • Posterior Sag Sign
        • Quad Active Test
        • Thessaly Test
        • Valgus Stress Test
        • Varus Stress Test
      • Foot/Ankle >
        • Anterior Drawer
        • Calf Squeeze Test
        • External Rotation Test
        • Fracture Screening Tests
        • Impingement Sign
        • Navicular Drop Test
        • Squeeze Test
        • Talar Tilt
        • Tarsal Tunnel Syndrome Test
        • Test for Interdigital Neuroma
        • Windlass Test