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Diagnostic validity and triage concordance of a physiotherapist compared to physicians’ diagnoses for common knee disorders

Overview of attention for article published in BMC Musculoskeletal Disorders, November 2017
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  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (89th percentile)
  • High Attention Score compared to outputs of the same age and source (95th percentile)

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32 X users
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98 Mendeley
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Title
Diagnostic validity and triage concordance of a physiotherapist compared to physicians’ diagnoses for common knee disorders
Published in
BMC Musculoskeletal Disorders, November 2017
DOI 10.1186/s12891-017-1799-3
Pubmed ID
Authors

S. Décary, M. Fallaha, B. Pelletier, P. Frémont, J. Martel-Pelletier, J.-P. Pelletier, D. E. Feldman, M.-P. Sylvestre, P.-A. Vendittoli, F. Desmeules

Abstract

Emergence of more autonomous roles for physiotherapists warrants more evidence regarding their diagnostic capabilities. Therefore, we aimed to evaluate diagnostic and surgical triage concordance between a physiotherapist and expert physicians and to assess the diagnostic validity of the physiotherapist's musculoskeletal examination (ME) without imaging. This is a prospective diagnostic study where 179 consecutive participants consulting for any knee complaint were independently diagnosed and triaged by two evaluators: a physiotherapist and one expert physician (orthopaedic surgeons or sport medicine physicians). The physiotherapist completed only a ME, while the physicians also had access to imaging to make their diagnosis. Raw agreement proportions and Cohen's kappa (k) were calculated to assess inter-rater agreement. Sensitivity (Se) and specificity (Sp), as well as positive and negative likelihood ratios (LR+/-) were calculated to assess the validity of the ME compared to the physicians' composite diagnosis. Primary knee diagnoses included anterior cruciate ligament injury (n = 8), meniscal injury (n = 36), patellofemoral pain (n = 45) and osteoarthritis (n = 79). Diagnostic inter-rater agreement between the physiotherapist and physicians was high (k = 0.89; 95% CI:0.83-0.94). Inter-rater agreement for triage recommendations of surgical candidates was good (k = 0.73; 95% CI:0.60-0.86). Se and Sp of the physiotherapist's ME ranged from 82.0 to 100.0% and 96.0 to 100.0% respectively and LR+/- ranged from 23.2 to 30.5 and from 0.03 to 0.09 respectively. There was high diagnostic agreement and good triage concordance between the physiotherapist and physicians. The ME without imaging may be sufficient to diagnose or exclude common knee disorders for a large proportion of patients. Replication in a larger study will be required as well as further assessment of innovative multidisciplinary care trajectories to improve care of patients with common musculoskeletal disorders.

X Demographics

X Demographics

The data shown below were collected from the profiles of 32 X users who shared this research output. Click here to find out more about how the information was compiled.
Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 98 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 98 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 22 22%
Student > Bachelor 14 14%
Student > Doctoral Student 7 7%
Student > Ph. D. Student 4 4%
Other 3 3%
Other 13 13%
Unknown 35 36%
Readers by discipline Count As %
Medicine and Dentistry 22 22%
Nursing and Health Professions 18 18%
Sports and Recreations 5 5%
Business, Management and Accounting 2 2%
Philosophy 1 1%
Other 10 10%
Unknown 40 41%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 21. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 11 November 2022.
All research outputs
#1,620,947
of 23,859,750 outputs
Outputs from BMC Musculoskeletal Disorders
#306
of 4,215 outputs
Outputs of similar age
#33,119
of 328,488 outputs
Outputs of similar age from BMC Musculoskeletal Disorders
#5
of 87 outputs
Altmetric has tracked 23,859,750 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 93rd percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 4,215 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 7.3. This one has done particularly well, scoring higher than 92% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 328,488 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 89% of its contemporaries.
We're also able to compare this research output to 87 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 95% of its contemporaries.