Examining Diagnostic Tests: An Evidence-Based Perspective

Abstract Diagnosis is an important aspect of physical therapist practice. Selecting tests that will provide the most accurate information and evaluating the results appropriately are important clinical skills. Most of the discussion in physical therapy to date has centered on defining diagnosis, with considerably less attention paid to elucidating the diagnostic process. Determining the best diagnostic tests for use in clinical situations requires an ability to appraise evidence in the literature that describes the accuracy and interpretation of the results of testing. Important issues for judging studies of diagnostic tests are not widely disseminated or adhered to in the literature. Lack of awareness of these issues may lead to misinterpretation of the results. The application of evidence to clinical practice also requires an understanding of evidence and its use in decision making. The purpose of this article is to present an evidence-based perspective on the diagnostic process in physical therapy. Issues relevant to the appraisal of evidence regarding diagnostic tests and integration of the evidence into patient management are presented.

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The Hypothesis-Oriented Algorithm for Clinicians II (HOAC II): A Guide for Patient Management

Physical Therapy ◽

10.1093/ptj/83.5.455 ◽

2003 ◽

Vol 83 (5) ◽

pp. 455-470 ◽

Cited By ~ 73

Author(s):

Jules M Rothstein ◽

John L Echternach ◽

Daniel L Riddle

Keyword(s):

Health Care ◽

Decision Making ◽

Clinical Practice ◽

Physical Therapy ◽

Patient Management ◽

Physical Therapists ◽

Physical Therapist ◽

Functional Deficits ◽

Original Algorithm ◽

Contemporary Practice

Abstract In this era of health care accountability, a need exists for a new decision-making and documentation guide in physical therapy. The original Hypothesis-Oriented Algorithm for Clinicians (HOAC) provided clinicians and students with a framework for science-based clinical practice and focused on the remediation of functional deficits and how changes in impairments related to these deficits. The HOAC II was designed to address shortcomings in the original HOAC and be more compatible with contemporary practice, including the Guide to Physical Therapist Practice. Disablement terminology is used in the HOAC II to guide clinicians and students when documenting patient care and incorporating evidence into practice. The HOAC II, like the HOAC, can be applied to a patient regardless of age or disorder and allows for identification of problems by physical therapists when patients are not able to communicate their problems. A feature of the HOAC II that was lacking in the original algorithm is the concept of prevention and how to justify and document interventions directed at prevention.

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A Knowledge Translation Framework for Optimizing Physical Therapy in Patients With Heart Failure

Physical Therapy ◽

10.1093/ptj/pzab079 ◽

2021 ◽

Author(s):

Konrad J Dias ◽

Michael J Shoemaker ◽

Kristin M Lefebvre ◽

John D Heick

Keyword(s):

Heart Failure ◽

Clinical Practice ◽

Physical Therapy ◽

Knowledge Translation ◽

Cardiorespiratory Fitness ◽

Practice Guideline ◽

Physical Therapist ◽

Evidence Based ◽

Patients With Heart Failure ◽

The Continuum

Abstract The American Physical Therapy Association (APTA) has supported the development of clinical practice guidelines to promote and support evidence-based practice and reduce unwarranted practice variation. Essential to the success of this effort is the generation of knowledge translation—a concept that emphasizes the translation of global knowledge to an application that can be effectively integrated into clinical practice. The Physical Therapy Clinical Practice Guideline for the Management of Individuals with Heart Failure published in the Physical Therapy Journal in January 2020 provides a broad base of knowledge related to evidence-based treatment interventions for patients with heart failure. However, the application and integration of this knowledge in clinical practice need further elucidation. Therefore, this perspective paper aims to serve as a complementary knowledge translation resource to the recently published practice guideline to maximize the utilization of contemporary evidence in clinical practice. This resource provides the physical therapist with practical guidance in the management of patients with heart failure by placing research findings in the context of other knowledge and practice norms that can be applied at the point of care and across the continuum of care. We propose a novel ABCDE (Assessment, Behavior, Cardiorespiratory Fitness, Dosage, and Education) practical framework. This clinical paradigm is grounded in ongoing physical therapist assessment throughout the episode of care, along with behavior modification, assessment of cardiorespiratory fitness, appropriate selection and dosing of interventions and patient education. Examples highlighting the use of this model in patients with heart failure across the continuum of care are provided for application in clinical care.

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Evidence-Based Decision-Making 4: Development and Limitations of Clinical Practice Guidelines

Methods in Molecular Biology - Clinical Epidemiology ◽

10.1007/978-1-4939-2428-8_26 ◽

2015 ◽

pp. 443-453 ◽

Cited By ~ 2

Author(s):

Bruce Culleton

Keyword(s):

Decision Making ◽

Clinical Practice ◽

Clinical Practice Guidelines ◽

Practice Guidelines ◽

Evidence Based ◽

Evidence Based Decision Making

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Integrated Clinical Experiences in a Campus Onsite Clinic: A Self-Contained Model of Physical Therapy Clinical Education

Internet Journal of Allied Health Sciences and Practice ◽

10.46743/1540-580x/2014.1493 ◽

2014 ◽

Author(s):

Ann Wilson

Keyword(s):

Physical Therapy ◽

Physical Therapist ◽

Clinical Performance ◽

Clinical Skills ◽

Learning Experiences ◽

Academic Program ◽

Full Time ◽

Clinical Experiences ◽

Wellness Program ◽

Academic Knowledge

Purpose: This paper describes a self-contained model of integrated clinical experiences (ICEs) that take place during the academic portion of an entry-level physical therapist education program in a campus onsite clinic. Description of Model: Students participate in ICEs for three consecutive semesters. Students provide pro bono physical therapy services to individuals with impairments, functional limitations, or changes in physical function resulting from a variety of health conditions. In addition, students participate in an exercise/wellness program for individuals who wish to improve or maintain their current levels of fitness. The first ICE consists of second-year students observing/assisting third-year students in the onsite clinic with basic patient care skills and participation in an exercise/wellness program. Students in the second and third ICEs provide ongoing one-on-one skilled therapy for individuals with neurological or musculoskeletal diagnoses. Results: Feedback obtained from onsite clinical instructors, core academic faculty, students, and patients receiving care in the onsite clinic through group debriefings, questionnaires, and interviews is used to assess students’ readiness for full-time internships and effectiveness of the ICEs. The feedback reveals that the ICEs are meeting their intended goals. Category ratings in the “red flag” areas of the Clinical Performance Instrument (CPI) are consistently above expected levels for students completing their first full-time clinical internship. In addition, patients receiving care in the onsite clinic report a high level of satisfaction with the care provided. Conclusion/Possible Recommendations: This model provides students with an opportunity to gain clinical confidence in a realistic setting while reinforcing concepts presented in academic coursework. Providing ICEs on campus decreases reliance on clinical facilities and allows for academic program oversight of the quality of the learning experiences and early identification of students who have deficits in clinical skills and/or academic knowledge. The learning experiences provided in the onsite clinic give students a transitional experience that helps them benefit more fully from full-time internships. A potential challenge to this model is finding the space and financial resources needed to make it viable.

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Current Status of Clinical Practice with Dental Implants: An Evidence-Based Decision Making Overview

Decision Making in Dental Implantology: Atlas of Surgical and Restorative Approaches ◽

10.1002/9781119225973.ch1 ◽

2017 ◽

pp. 1-22

Keyword(s):

Decision Making ◽

Clinical Practice ◽

Dental Implants ◽

Current Status ◽

Evidence Based ◽

Evidence Based Decision Making

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Awareness and Perception of Physical Therapy Education, Role in Patient Management and Health Promotion Held by Senior Medical Practitioners

Asian Journal of Allied Health Sciences (AJAHS) ◽

10.52229/ajahs.v2i3.299 ◽

2020 ◽

pp. 13-17

Author(s):

OJS Admin

Keyword(s):

Health Promotion ◽

Physical Therapy ◽

Patient Management ◽

Physical Therapists ◽

Physical Therapist ◽

Well Being ◽

Physical Therapy Education ◽

Health Providers ◽

Medical Practitioners ◽

Therapy Education

Physical therapists are integral part of health care system. In collaboration with other health providers, physical therapist can play an effective role in patient handling and well-being of individuals. The awareness and perception of senior medical practitioners is less known regarding physical therapy education, role in patient management and health promotion.

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