Background
Methods
Literature search and study identification
Data extraction and quality assessment
Study selection
Methodological quality appraisal tools
Data analysis
Results
Overall description of included studies
Authors | Study design | Setting | APP Role | Population | n* | Outcome measures | Main results by outcome measures |
---|---|---|---|---|---|---|---|
Trompeter et al., 2010 | Retrospective Diagnostic validity | Orthopaedic clinic (United Kingdom) | Triage of patients for orthopaedic consultation | Knee soft tissue or sports injuries | 100 | 1- Comparison of diagnostic accuracy to arthroscopy for: | 1- Sensitivity |
a. 68.1% | |||||||
b. 90.7% | |||||||
a. APP | Specificity | ||||||
b. Orthopeadic surgeon | a. 66.6% | ||||||
b. 71.4% | |||||||
Comparison in number of incorrect diagnosis: | |||||||
17/50 for APP compared to 9/50 for surgeon (p < 0.07) | |||||||
2- Identification of surgical candidates | 2- Number of correctly selected surgical candidates | ||||||
a. APP | a. 47/50 | ||||||
b. Orthopeadic surgeon | b. 43/50 | ||||||
No significant differences between providers (p = 0.20) | |||||||
MacKay, et al., 2009 | Inter-rater agreement | Orthopaedic clinic (Canada) | Triage of patients for orthopaedic consultation and treatment recommendations (rehabilitation interventions) | Hip and knee arthritis | 62 | Agreement between APPs and Orthopaedic surgeons: | |
1- Appropriateness to be seen by surgeon | 1- Level of agreement κ = 0.69 | ||||||
Observed agreement 91.8% | |||||||
2- Identification of TJA surgical candidates | 2- Level of agreement κ = 0.70 | ||||||
Observed agreement 85.5% | |||||||
Aiken et al., 2008 | Inter-rater agreement | Orthopaedic clinic (Canada) | Triage of surgical candidates for TJA and treatment recommendations (rehabilitation, medication, ordering tests, referral to other providers) | Hip and knee arthritis** | 38 | Agreement between an APP and an Orthopaedic surgeon: | |
1- Identification of TJA surgical candidates | 1- Observed agreement 100% | ||||||
2- Surgical urgency using the WCWL-HKPT tool | 2- Observed agreement 64% | ||||||
3- Treatment recommendations | 3- Level of agreement κ = 0.68 | ||||||
Aiken and McColl, 2008 | Diagnostic validity/Inter-rater agreement | Orthopaedic clinic (Canada) | Diagnosis and treatment recommendations (rehabilitation, medication, ordering tests, referral to other providers, and to surgery) | Shoulder or knee musculoskeletal impairments | 24 | Agreement between an APP and an Orthopaedic surgeon: | |
1- Diagnostic agreement | 1- Level of agreement for knee impairments κ = 0.69 | ||||||
Observed agreement for knee and shoulder impairments 90% | |||||||
2- Treatment recommendations | 2- Level of agreement κ = 0.52–0.87 | ||||||
Observed agreement 90% | |||||||
Diagnostic accuracy of APP compared to MRI: | |||||||
3- Diagnostic agreement | 3- APP accuracy to MRI 75% | ||||||
Orthopedic surgeon accuracy to MRI 75% | |||||||
O’Donoghue and Hurley-Osing, 2007 | Diagnostic validity | Physiotherapy hospital department (Ireland) | Diagnosis of new patients referred by the emergency department | Acute knee injury, of less than three weeks duration | 42 | Diagnostic accuracy of an APP compared to MRI | |
All knee derangements, PPV = 73,2 | |||||||
ACL tear, PPV = 90,4 | |||||||
Meniscal tear PPV = 55.5 | |||||||
Moore, J. H., 2005 | Retrospective Diagnostic validity | Military hospital clinic (United States) | Primary care practitioner (rehabilitation, medication, ordering tests, referral to other providers and to surgery) | Musculoskeletal complaints of the spine or extremities | 560 | Comparison of diagnostic accuracy to MRI for: | Observed diagnostic accuracy: |
a. 74.5% (108/145) | |||||||
b. 80.8% (139/172) | |||||||
a. APPs | c. 35.4% (86/243) | ||||||
b. Orthopeadic surgeons | Difference in diagnostic accuracy between groups: | ||||||
c. Other healthcare providers†
| a better than c (P = 0.001) | ||||||
b better than c (P = 0.001) | |||||||
No differences between a and b (P > 0.05) | |||||||
Dickens, et al., 2003 | Diagnostic validity/inter-rater agreement | Orthopaedic clinic (United Kingdom) | Diagnosis and triage of surgical candidates for arthroscopy | Knee impairments excluding severe osteoarthritis | 50 | Agreement between APPs and an Orthopaedic surgeon: | 1- Observed agreement 76.5% |
1- Diagnostic agreement | 2- Diagnostic accuracy to arthroscopy: | ||||||
Sensitivity (range depending on pathology) | |||||||
2- Diagnostic accuracy to arthroscopy for: | a. 43–93% | ||||||
b. 40–100% | |||||||
a. APPs | Specificity | ||||||
b. Orthopeadic surgeons | a. 92–98% | ||||||
b. 98–100% | |||||||
Sephton et al., 2010 | Prospective observational cohort | Outpatient musculoskeletal clinic (United Kingdom) | Triage of patients for orthopaedic, rheumatology or pain clinic consultations (ordering tests, referral to other providers and to surgery) | Various musculoskeletal conditions | 217 | Treatment outcomes for patients triaged by APP at 3 months and 12 months following care (no control group): | Mean improvement in scores and 95%CI from baseline to 3 and 12 months: |
1- Pain VAS(/10) | 1- 3 m: −0.72 (−1.15 to −0.29) | ||||||
12 m: −0.80 (−1.31 to −0.29) | |||||||
2- EQ-5D questionnaire (/1) | 2- 3 m: 0.044 (0.001 to 0.086) | ||||||
12 m: 0.048 (0.003 to 0.093) | |||||||
3- SF-36 questionnaire (%) | 3- 3 m: −0.9% (−6.3 to 4.4) | ||||||
12 m: −4.9%(−9.9 to 0.1) | |||||||
4- Perceived improvement-PIVAS scale (%) | 4- 3 m : 33% (28 to 38) | ||||||
12 m: 46% (40 to 51) | |||||||
5- Deyo and Diehl Satisfaction Questionnaire (%) | |||||||
Proportion of patients satisfied with care: | |||||||
5- 94% | |||||||
Taylor et al., 2010 | Prospective non-randomised controlled trial | Three emergency departments—ED (Australia) | Primary care practitioner (rehabilitation, medication and ordering tests) | Peripheral musculoskeletal injury | 315 | Comparison between first line APP care and usual medical care followed by physiotherapy care for ED consultation: | Differences and 95%CI between APP care and usual care: |
Time reduction with APP care: | |||||||
1- Length of stay (min) | 1- 59.5 (38.4 to 80.6) min. | ||||||
2- Wait time (min) | 2- 25.0 (12.1 to 38.0) min. | ||||||
3- Treatment time (min) | 3- 34.9 (16.2 to 53.6) min. | ||||||
Relative Risks (APP relative to usual care): | |||||||
4- Proportion of re-presentation to ED at 1 month follow up | 4- RR : 1.02 (0.51 to 2.05) | ||||||
5- Proportion of diagnostic imaging referrals | 5- RR : 0.89 (0.78 to 1.02) | ||||||
Proportion of patient satisfied and relative risk (APP relative to usual care): | |||||||
6- APP care : 85% | |||||||
Usual care: 82% | |||||||
6- Patient satisfaction | RR: 1.03 (0.94 to 1.15) | ||||||
Ball and Walton, 2007 | Retrospective observational cohort | Emergency department (United Kingdom) | Primary care practitioner (rehabilitation, medication and ordering tests) | Closed musculoskeletal injuries to the upper or lower extremities, including fractures | 643 | Comparison between APPs, nurse practitioners and physicians (senior house officers, middle grade doctors and consultants): | |
1- No differences between providers (p = 0.17) | |||||||
2- No differences between providers (p = 0.99) | |||||||
1- Proportion of ordered X-rays | |||||||
3- APP gave more advice (p < 0.007) | |||||||
2- Proportion of positive X-rays | APP prescribed fewer assistive devices (p < 0.001) | ||||||
APP referred more patients to physiotherapy (p < 0.001) | |||||||
3- Soft tissues injury treatment recommendations | Physicians prescribed more medication than other providers (p < 0.001) | ||||||
McClellan et al., 2006 | Prospective quasi- experimental cohort | Emergency department (United Kingdom) | Primary care practitioner (rehabilitation, medication and ordering tests) | Patients with peripheral soft tissue injuries and associated fractures | 102‡
| Comparison between APPs, nurse practitioners (NP) and physicians on treatment outcomes for patients with ankle injuries only at 4 or 16 weeks: | |
784°
| Mean Wait and consultation times comparisons: | ||||||
1- Mean wait time for consultation (min.) | 1- APPs: 43 min., NPs: 55 min., Physicians: 80 min. | ||||||
APP significantly shorter wait time than NP and physicians (p < 0.05) | |||||||
2- Mean consultation time (min.) | 2- APPs: 25 min., NPs: 15 min., Physicians: 20 min. | ||||||
No significant differences in consultation time (p > 0.05) | |||||||
3- Pain VAS (/10) | Outcome of treatment for patients with ankle injuries only at 4 weeks: | ||||||
4- Function VAS (/10) | 3- No significant differences between providers (p > 0.05) | ||||||
5- SF-36 (%) | 4- No significant differences between providers(p > 0.05) | ||||||
Comparison between APPs, nurse practitioners and physicians care for all patients and type of injuries: | 5- No significant differences between providers (p > 0.05) | ||||||
6- Patient satisfaction (%) | Proportions of patient satisfied with care (patient who strongly agreed to question: Overall I was satisfied with the treatment received): | ||||||
6- APPs: 54.5% NPs: 38.9%, Physicians: 35.6% (p = 0.048) | |||||||
Richardson et al. 2005 | RCT and cost consequence analysis | Emergency department (United Kingdom) | Primary care practitioner (rehabilitation, medication and ordering tests) | Patients with semi or non-urgent musculoskeletal conditions | 766 | Comparison between APP care and usual care by emergency physician on treatment outcomes at 6 months: | |
Difference and 95%CI for days to return to usual activities or work: | |||||||
1- Return to usual activities (days) | 1- 12.5 added days for APP care. APP care marginally longer than usual care (p = 0.07) | ||||||
2- Return to work (days) | 2- 1 added day for APP care (−3.0 to 1.0). No differences between providers (p > 0.05) | ||||||
Difference in proportions of patient satisfied with care and 95%CI: | |||||||
3- Satisfaction with care | 3- 74% for usual care and 89% for APP care : 15% difference (9 to 21%) | ||||||
Economic analysis | |||||||
4- Direct costs to healthcare system | 4- No differences in costs between the two types of care (p > 0.05) | ||||||
5- Direct costs to patients | 5- No differences in costs between the two types of care (p > 0.05) | ||||||
6- Indirect costs (productivity loss) | 6- No differences in costs between the two types of care (p > 0.05) | ||||||
Daker-White et al., 1999 | RCT and cost minimisation analysis | Orthopaedic clinic (United Kingdom) | Primary care practitioner (rehabilitation, medication, ordering tests, referral to other providers and to surgery) | Patients with musculoskeletal complaints | 481 | Comparison between APP care and usual care by orthopeadic surgeons in training (UK junior doctors): | |
Treatment outcomes at a mean 5.6 months follow-up: | |||||||
No significant differences between providers for outcomes 1 to 8 (p > 0.05) | |||||||
Treatment outcomes at a mean 5.6 months follow-up: | |||||||
1- Pain VAS (/10) | Use of health services: | ||||||
2- Oswestry Disability Index (%) | |||||||
3- St-Michael's (48-0) | 9- Significant difference in the proportion of patients with no test ordered (p < 0.01): 14.7% for surgeons and 47.5% for APP | ||||||
4- WOMAC (0–96) | |||||||
5- Perceived handicap (DRP) | |||||||
6- SF-36 (%) | |||||||
7- Psychological status (HADS) | Significant difference in the proportion of patients with X-rays ordered (p < 0.01): 41.4% for surgeons and 13% for APP | ||||||
8- Self-efficacy | |||||||
Use of health services | 10- Significant difference in the proportion of patients who received advice and reassurance (p < 0.01): 32.5% for surgeons and 58.9% for APP | ||||||
9- Use of diagnostic tests for consult | |||||||
10- Treatment recommendations | |||||||
Satisfaction with care | Significant difference in the proportion of patients who received Intra-muscular injections (p < 0.01): 3.9% for surgeons and 0.5% for APP | ||||||
11- Patients | |||||||
12- Referring general practitioners | |||||||
Economic analysis | Significant difference in the proportion of patients who were referred for surgery (p < 0.01): 17% for surgeons and 7.1% for APP | ||||||
13- Direct costs to patients | |||||||
14- Direct costs to healthcare system (NHS) | |||||||
Satisfaction with care for patients and referring GP | |||||||
11- Satisfaction scores and 95%CI: | |||||||
Staff communication/attitudes (scale from 19–95) 4.6 points significant difference (2.2 to 6.8) favoring APP care | |||||||
Perceived treatment quality (scale from 13–65) 3.0 points significant difference (1.3 to 4.9) favoring APP care. | |||||||
Facilities (scale from 5–25) 0.9 point significant difference (0.3 to 1.7) favoring APP care. | |||||||
12- No significant differences between providers (p > 0.05) | |||||||
Direct costs differences | |||||||
13- No differences in costs between the two types of care (p > 0.05) | |||||||
14- Significant difference in direct hospital costs (p < 0.01): | |||||||
£498.38 for surgeon care and £255.55 for APP care. | |||||||
Hockin and Bannister, 1994 | Retrospective observational cohort | Orthopaedic clinic (United Kingdom) | Primary care practitioner (rehabilitation, orthotic, injection, ordering tests, referral to other providers and to surgery) | Patients with musculoskeletal complaints | 189 | Patient self reported global perception of improvement (%): | |
1- At the end of treatments by APP | 1- 71% of patients improved by more than 40% on scale of improvement. | ||||||
2- Comparison of type of APP treatment and proportion of patients who improved: | 2- More patients reported improvement with orthotics or injections than with advice and physiotherapy or surgery and referrals to other medical providers. (p < 0.05) | ||||||
Kennedy et al., 2010 | Cross-sectional observational study | Orthopaedic clinic (Canada) | Follow-up care after hip and knee arthroplasty | Hip and knee arthroplasty patients | 123 | Comparison of patients satisfaction measured by the modified VSQ-9 questionnaire: | |
Satisfaction score | |||||||
a. APP led follow-up clinic | a. 89.8% | ||||||
b. Orthopaedic surgeon led follow-up clinic | b. 87.6% | ||||||
No significant differences between providers (p = 0.34) | |||||||
Campos Ayling et al. 2002 | Cross-sectional observational study | Paediatric rheumatology clinic (Canada) | Review and manage independently pre-selected patients and refer to rheumatologist when tests and medication are needed | Pediatric patients with Juvenile Idiopathic Arthritis | 358 | Comparison of patients satisfaction measured by the modified GHAA questionnaire | |
Summary satisfaction score (5 point scale): | |||||||
a. APPs led clinic | a. 4.0 ±0.7 | ||||||
b. Rheumatologists led clinic | b. 4.0 ±0.7 | ||||||
No significant differences between care models (P > 0.05) |
Methodological quality of included studies and inter-rater agreement
Study | MacKay et al. 2009 | O'Donoghue and Hurley-Osing 2007 | Dickens et al. 2003 | Moore, J. H. 2005 | Trompeteret al. 2010 | Aiken and McColl 2008 | Aiken et al. 2008 |
---|---|---|---|---|---|---|---|
Item Evaluation Criteria
| |||||||
(maximum = 1; minimum = 0)* | |||||||
1. Independent, blind comparison with a reference standard test | 1 | 1 | 1 | 0 | 0 | 1 | 1 |
2. Reference standard/true diagnosis selected is a recognized gold standard or reasonable alternative | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
3. Reference standard applied to all patients | 1 | 0 | 0 | 1 | 1 | 0 | 0 |
4. Actual cases include an appropriate spectrum of severity | 1 | 1 | 1 | 1 | 1 | 1 | 0 |
5. Non-cases patients are patients who might reasonably present for differential diagnosis | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
6. Non-cases include an appropriate spectrum of patients with alternate diagnoses | 1 | 1 | 1 | 1 | 1 | 1 | 0 |
7. Justified sample size or not less than 40 participants | 0 | 1 | 1 | 1 | 0 | 0 | 0 |
8. Test manoeuvre described in sufficient detail to permit replication | 1 | 1 | 1 | 1 | 1 | 0 | 0 |
9. Exact criteria for interpreting the test results provided | 0 | 0 | 0 | 0 | 0 | 0 | N/A |
10. The reliability of the test procedures documented | 0 | 1 | 0 | 0 | 0 | 0 | N/A |
11. Number of positive and negative results reported for both cases and non-cases | 1 | 0 | 0 | 0 | 0 | 1 | 1 |
12. Appropriate statistics presented (sensitivity, specificity, positive/negative predictive value or likelihood ratios) | 0 | 0 | 1 | 0 | 0 | 0 | 0 |
13. The qualifications and skills of the examiner described if the test required an element of examiner interpretation | 1 | 1 | 1 | 1 | 1 | 0 | 0 |
14. Training, skills and experience of the examiner found to be appropriate for test interpretation | 1 | 1 | 1 | 1 | 1 | 0 | 0 |
Total score (%)
| 71% | 71% | 71% | 64% | 57% | 42% | 33% |
Rank
| 1 | 1 | 1 | 2 | 3 | 4 | 5 |
Study | Taylor et al. 2010 | Richardson et al. 2005 | Daker-White et al. 1999 | Sephton et al. 2010 | McClellan et al. 2006 | Hockinet al. 1994 | Ballet al. 2007 |
---|---|---|---|---|---|---|---|
Item Evaluation Criteria
| |||||||
(maximum = 2; minimum = 0)* | |||||||
1. Relevant background cited to establish a foundation for research question | 2 | 0 | 2 | 2 | 2 | 2 | 2 |
2. Comparison group used | 2 | 2 | 2 | 0 | 1 | 0 | 1 |
3. Patient status considered at more than one time point | 0 | 2 | 2 | 2 | 2 | 1 | 0 |
4. Data collection performed prospectively | 2 | 2 | 2 | 2 | 2 | 2 | 1 |
5. Randomization | 0 | 2 | 2 | 0 | 0 | 0 | 0 |
6. Patients blinding | 1 | 0 | 0 | 0 | 0 | 1 | 0 |
7. Treatment providers blinding | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
8. Independent evaluator of outcome measures | 2 | 2 | 2 | 2 | 2 | 0 | 0 |
9. Sampling procedures minimized biases | 2 | 2 | 1 | 1 | 0 | 1 | 0 |
10. Inclusion/exclusion criteria well-defined | 2 | 2 | 2 | 2 | 1 | 1 | 1 |
11. Enrolment obtained to attain adequate statistical power | 2 | 2 | 2 | 0 | 0 | 0 | 0 |
12. Appropriate retention/follow-up (>90% = 2, >70% = 1, ≤ 70% = 0) | N/A | 1 | 1 | 0 | 0 | 0 | N/A |
13. Intervention applied according to established principles | 2 | 1 | 1 | 1 | 1 | 1 | 0 |
14. Biases due to the treatment provider minimized | 1 | 1 | 1 | 1 | 1 | 1 | 0 |
15. Intervention compared to an appropriate comparator | 2 | 2 | 2 | 0 | 1 | 0 | 1 |
16. Appropriate validated primary outcome | 2 | 1 | 0 | 1 | 1 | 1 | 0 |
17. Appropriate validated secondary outcomes | 2 | 2 | 2 | 2 | 2 | 0 | 1 |
18. Appropriate follow-up | N/A | 2 | 2 | 2 | 2 | 1 | 0 |
19. Appropriate statistical testing | 2 | 1 | 2 | 2 | 2 | 1 | 2 |
20. Adequate power to identify treatment effects | 2 | 1 | 1 | 1 | 0 | 1 | 0 |
21. Size and significance of treatment effect reported | 2 | 2 | 2 | 2 | 1 | 1 | 0 |
22. Missing data accounted for and considered in analyses | 1 | 2 | 0 | 2 | 0 | 0 | 0 |
23. Clinical and practical significance considered in interpretation of results | 2 | 1 | 1 | 2 | 1 | 1 | 1 |
24. Conclusions and recommendations supported by the study objectives, analysis and results | 2 | 1 | 2 | 2 | 2 | 1 | 1 |
Total score (%)
| 81% | 73% | 73% | 63% | 52% | 38% | 25% |
Rank
| 1 | 2 | 2 | 3 | 4 | 5 | 6 |
Study | Daker-White et al. 1999 | Richardson et al. 2005 |
---|---|---|
Item Evaluation Criteria (maximum = 1; minimum = 0)* | ||
1. Well-defined question posed | 0 | 1 |
2. Comprehensive description of the competing alternatives | 0 | 0 |
3. Evidence that the programme would be effective | 1 | 1 |
4a. Identification of all important and relevant resource use and health outcome consequences for each alternative | 1 | 0 |
4b. Resources measured accurately in appropriate units (hours of treatments, numbers of visits, etc.) | 0 | 0 |
4c. Resources valued credibly | 0 | 0 |
5. Resource use and health outcomes consequences adjusted for different times at which they occurred (discounting) | 1 | 1 |
6. Incremental analysis of the consequences and costs of alternatives performed | 1 | 0 |
7. Adequate sensitivity analysis performed | 0 | 1 |
8. Discussion of the results includes issues that are required to inform a purchasing decision | 0 | 0 |
9. Conclusions of the evaluation justified by the evidence presented | 1 | 0 |
10. Applicability of results to local setting | 1 | 1 |
Total score (%)
| 50% | 42% |
Study | Kennedy et al. 2010 | Taylor et al. 2010 | Daker-White et al. 1999 | Sephton et al. 2010 | Campos-Ayling et al. 2002 | McClellan et al. 2006 | Richardson et al. 2005 |
---|---|---|---|---|---|---|---|
Item Evaluation Criteria (maximum = 1; mimimum = 0)*‡ | |||||||
1. Relevant background cited to establish a foundation for research question | 1 | 1 | 1 | 1 | 0 | 1 | 0 |
2. Adequate description of the study setting and patients characteristics | 1 | 1 | 1 | 1 | 1 | 0 | 1 |
3. Inception cohort sampled | 1 | 1 | 1 | 1 | 1 | 1 | 1 |
4. Data collection process administered by independent evaluators | 1 | 0 | 1 | 1 | 1 | 0 | 1 |
5. Respondents informed that their results are anonymous or not shared with treatment providers | 1 | 0 | 0 | 0 | 0 | 0 | 0 |
6. Standardized satisfaction tool/measure used with known validity and reliability; Item | 1 | 0 | 0 | 1 | 1 | 0 | 0 |
7. Timing of data collection sufficiently close to care treatment/encounter as to minimise recall bias; | 0 | 1 | 0 | 1 | 0 | 1 | 1 |
8. Accounted for missing data; | 1 | 0 | 0 | 0 | 0 | 0 | 0 |
9. ≥ 80% of eligible patients sampled | 1 | 1 | 1 | 0 | 0 | 0 | 0 |
10. Clearly defined measurements of components of satisfaction: | |||||||
a. Affability/Patients centeredness and interpersonal interactions with providers | 1 | 1 | 1 | 1 | 1 | 1 | 0 |
b. Process (accessibility, availability, efficiency of care) | 1 | N/A | 1 | N/A | 1 | N/A | 0 |
c. Perceived competency of professionals | 1 | 1 | 1 | 1 | 1 | 1 | 0 |
d. Satisfaction with outcomes | 1 | 1 | 0 | N/A | 1 | 1 | N/A |
11. Appropriate statistical test(s) performed; | 1 | 1 | 1 | 0 | 1 | 1 | 1 |
12. Conclusions and clinical recommendations supported by the study objectives, analysis and results | 1 | 1 | 1 | 1 | 1 | 1 | 0 |
Total score (%)
| 93% | 71% | 71% | 69% | 67% | 57% | 36% |
Rank
| 1 | 2 | 2 | 3 | 4 | 5 | 6 |
Medical diagnostic, triage and clinical recommendations agreement studies
Studies on the effectiveness of treatment for APP care
Economic evaluations of treatments provided by physiotherapists in APP
Patients’ satisfaction of services provided by physiotherapists in APP
Discussion
Main findings
Comparison with previous reviews
Methodological quality and implication for future research
Strengths and limitations of the present review
Conclusions
Appendix
1- Search terms used to identify resources relevant to musculoskeletal disorders
| |
Musculoskeletal diseases
M(exp)
|
Musculoskeletal disease
E(exp)
|
Musculoskeletal system
M(exp), E(exp)
|
Back pain
M(exp)
|
Low back pain
E
| |
2- Search terms used to identiffy resources relevant to diagnostic, prescribing and primary care
| |
Diagnosis
M, E
|
Decision Making
M,E
|
Diagnosis, Differential
M, E
|
Magnetic resonance imaging
M, E
|
Diagnos* - diagnos(is/es/tic/tics/tician) |
Primary health care
M, E,C
|
Diagnosis, musculoskeletal
C
|
Prescriptive autority
C
|
Disability Evaluation
M
| |
3- Search terms used to identify resources relevant to advanced practice
| |
advanc* ADJ4 practi*
|
professional role
M
|
clinical specialist*
|
professional standards
E
|
consultant*
|
profession* boundar*
|
consultants
M,C
|
reprofessionali?ation
|
cross boundar*
|
prompt access
|
current role*
|
role* boundar*
|
direct access*
|
role* ADJ1 chang* - role(s) chang(ed/es/ing) |
direct access
C
|
role change
C,E
|
early ADJ1 access
|
role* ADJ1 collaborati* - role(s) collaborati(ve/on) |
emerging role*
|
role* ADJ1 cross* - role(s) cross(ing/over(s)) |
enhan* ADJ4 practice* - enhan(ced/cing/sion(s)) practice(s) |
role* ADJ1 defin* - role(s) defin(e/ed/ing/ition(s)) |
enhan* ADJ4 scope* - enhanc(ed/ing/ement(s)) scope(s) |
role* demarcation*
|
existing role*
|
role* ADJ1 develop*
|
existing scope*
|
role* ADJ4 enhan* - role(s) enhanc(ed/ing/ement(s)) |
expan* ADJ4 practice* - expan(ded/ding/sion(s)) practice(s) |
role* ADJ4 expan* - role(s) expan(ded/ding/sion(s)) |
expan* ADJ4 scope* - expan(ed/ing/sion(s)) scope(s) |
role* ADJ4 exten* - role(s) exten(ded/ding/sion(s)) |
ext* ADJ4 scope* - extra / exten(ded/ding/sion(s)) scope(s) |
role* ADJ4 interdisciplin* - role(s) interdisciplin(e/ary) |
exten*ADJ4 practice* - exten(ded/ding/sion(s)) practice(s) |
role* ADJ1 interprofessional*
|
initial ADJ1 assessment
|
role* ADJ4 modern* - role(s) modern(ise(d)/ising/isation) |
int??disciplinary competenc* - (intra/inter)disciplinary c |
role* ADJ4 overlap* - role(s) overlap(s/ped/ping) |
int??disciplinary practice* - (intra/inter)disciplinary p |
role* ADJ1 professional*
|
interdisciplinary collaboration
|
role* ADJ 4 redefin* - role(s) redefin(e/ed/ing/ition(s)) |
interprofessional relations
M
|
role* ADJ1 shar* - role(s) shar(ed/es/ing) |
interprofessional relation*
|
role* ADJ1 shift* - role(s) shift(s/ed/ing) |
joint practice*
|
scope of practice
|
led ADJ4 clinic*
|
scope of practice
C
|
led ADJ4 service*
|
shar* ADJ4 competenc* - shar(ed/ing competenc(e/y/ies) |
multi* task*
|
shift* ADJ4 boundar*
|
new role*
|
skill* ADJ4 interdisciplin*
|
new scope*
|
skill* ADJ4 overlap* - skill(s) overlap(s/ped/ping) |
physician exten*
|
skill* ADJ4 shar*
|
physician* assist*
|
specialist practitioner*
|
physiotherap* practitioner*
|
traditional role*
|
physical therap* practitioner*
|
transdisciplinary practice*
|
primary contact
|
triage
M, E
|
profession* ADJ4 autonomy
|
triage
|
professional autonomy
M
| |
4- Search terms used to identify resources relevant to emergency service
| |
Emergency Service, Hospital
M, E
| |
Emergency Service
C
| |
5- Search terms used to identify resources relevant to physiotherapy
| |
exercise therap* - exercise therap(y/ies/ist(s)) |
physical therapy service
C
|
exercise therapy
M(exp)
|
physical therapy (specialty)
M
|
kinesiotherap* - kinesiotherap(y/ist(s)) |
physical therapy modalities
M(exp)
|
kinesiotherapy
E(exp)
|
physio
|
manual therap*
|
physios
|
manual therapy
C(exp)
|
physiotherap*
|
physical therap*- physical therap(y/ist(s)/ies) |
physiotherapist
E
|
physical therapists
C
|
physiotherapy
, E(exp)
|
physical therapy
C(exp)
|
physiotherapy practice
E
|