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 conferencePaperAcademicpeer-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
CountryNetherlands
CityGroningen
Period15/11/1816/11/18

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Physician Assistants
Low Back Pain
Self Report
Primary Health Care
Rehabilitation
Psychology
Triage
Physical Examination
Cross-Sectional Studies
History
Injections

Cite this

Stegeman, P., Speijer, L. G. N., Hamelink, J. L. C., Sterken, M. W., Soer, R., Wolff, A. P., ... Oude Nijeweme - d'Hollosy, W. (2018). INTERRATER RELIABILITY OF TRIAGING PATIENTS WITH LOW BACK PAIN TO INTERVENTION BASED ON SELF-REPORTS ONLY. Paper presented at SBPR 2018, Groningen, Netherlands.
Stegeman, P ; Speijer, L.G.N. ; Hamelink, J.L.C. ; Sterken, M.W. ; Soer, Remko ; Wolff, A.P. ; Schiphorst Preuper, H.R. ; Reneman, M.F. ; Oude Nijeweme - d'Hollosy, Wendy. / INTERRATER RELIABILITY OF TRIAGING PATIENTS WITH LOW BACK PAIN TO INTERVENTION BASED ON SELF-REPORTS ONLY. Paper presented at SBPR 2018, Groningen, Netherlands.
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title = "INTERRATER RELIABILITY OF TRIAGING PATIENTS WITH LOW BACK PAIN TO INTERVENTION BASED ON SELF-REPORTS ONLY",
abstract = "AimsThe 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 methodsA 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. ResultsTwenty-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. ConclusionBased 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.",
author = "P Stegeman and L.G.N. Speijer and J.L.C. Hamelink and M.W. Sterken and Remko Soer and A.P. Wolff and {Schiphorst Preuper}, H.R. and M.F. Reneman and {Oude Nijeweme - d'Hollosy}, Wendy",
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language = "English",
note = "SBPR 2018 : Understanding the mechanisms of back pain: work, rest and play, SBPR ; Conference date: 15-11-2018 Through 16-11-2018",

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Stegeman, P, Speijer, LGN, Hamelink, JLC, Sterken, MW, Soer, R, Wolff, AP, Schiphorst Preuper, HR, Reneman, MF & Oude Nijeweme - d'Hollosy, W 2018, 'INTERRATER RELIABILITY OF TRIAGING PATIENTS WITH LOW BACK PAIN TO INTERVENTION BASED ON SELF-REPORTS ONLY' Paper presented at SBPR 2018, Groningen, Netherlands, 15/11/18 - 16/11/18, .

INTERRATER RELIABILITY OF TRIAGING PATIENTS WITH LOW BACK PAIN TO INTERVENTION BASED ON SELF-REPORTS ONLY. / Stegeman, P; Speijer, L.G.N.; Hamelink, J.L.C.; Sterken, M.W.; Soer, Remko; Wolff, A.P.; Schiphorst Preuper, H.R.; Reneman, M.F.; Oude Nijeweme - d'Hollosy, Wendy.

2018. Paper presented at SBPR 2018, Groningen, Netherlands.

Research output: Contribution to conferencePaperAcademicpeer-review

TY - CONF

T1 - INTERRATER RELIABILITY OF TRIAGING PATIENTS WITH LOW BACK PAIN TO INTERVENTION BASED ON SELF-REPORTS ONLY

AU - Stegeman, P

AU - Speijer, L.G.N.

AU - Hamelink, J.L.C.

AU - Sterken, M.W.

AU - Soer, Remko

AU - Wolff, A.P.

AU - Schiphorst Preuper, H.R.

AU - Reneman, M.F.

AU - Oude Nijeweme - d'Hollosy, Wendy

PY - 2018/11/15

Y1 - 2018/11/15

N2 - AimsThe 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 methodsA 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. ResultsTwenty-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. ConclusionBased 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.

AB - AimsThe 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 methodsA 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. ResultsTwenty-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. ConclusionBased 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.

UR - https://wencke4.housing.rug.nl/Cursuswinkel/public/Brochure/SBPR_program%20with%20abstracts.pdf

M3 - Paper

ER -

Stegeman P, Speijer LGN, Hamelink JLC, Sterken MW, Soer R, Wolff AP et al. INTERRATER RELIABILITY OF TRIAGING PATIENTS WITH LOW BACK PAIN TO INTERVENTION BASED ON SELF-REPORTS ONLY. 2018. Paper presented at SBPR 2018, Groningen, Netherlands.