INTERRATER RELIABILITY OF TRIAGING PATIENTS WITH LOW BACK PAIN TO INTERVENTION BASED ON SELF-REPORTS ONLY

P Stegeman, L.G.N. Speijer, J.L.C. Hamelink, M.W. Sterken, Remko Soer, A.P. Wolff, H.R. Schiphorst Preuper, M.F. Reneman, Wendy Oude Nijeweme - d'Hollosy

    Research output: Contribution to conferencePaperpeer-review

    Abstract

    Aims
    The aim of this study was to investigate the agreement of physician assistants (PAs) in the triaging of patients with Low Back Pain (LBP) based on self-reported data.

    Patients and methods
    A cross sectional vignette study among four PAs was carried out. Vignettes (cases) were constructed including 26 factors that can be self-reported, identified in literature that have predictive value in treatment outcomes (for example red flags indicating serious underlying conditions and yellow flags indicating psychosocial factors). All vignettes were randomly assigned to the PAs who should determine what intervention would be most optimal to the patient (rehabilitation, injections, medications, surgery, primary care psychology, primary care physical therapy). PAs were allowed to advise more than one intervention. Per vignette, 3 PAs were assigned randomly to advise on intervention. Fleish kappas were calculated to determine the interrater reliability.

    Results
    Twenty-five vignettes were judged by 3 of the 4 PAs. Per advise, Fleish kappa values varied between k=0.65 for surgery and medication to k=0.77 for rehabilitation, which can be interpreted as substantial agreement.

    Conclusion
    Based on self-reported data provided by patients, PAs can triage patients with substantial agreement. Adding more information based on history, physical examination and imaging, may influence these outcomes. This study adds to the merit of using questionnaires for guiding clinicians in their triaging process.


    Original languageEnglish
    Publication statusPublished - 15 Nov 2018
    EventSBPR 2018: Understanding the mechanisms of back pain: work, rest and play - University Medical Centre , Groningen, Netherlands
    Duration: 15 Nov 201816 Nov 2018

    Conference

    ConferenceSBPR 2018
    Abbreviated titleSBPR
    Country/TerritoryNetherlands
    CityGroningen
    Period15/11/1816/11/18

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