Development and Validation of the Sorting Non-trauMatIc adoLescent knEe Pain (SMILE) Tool – a Development and Validation Study

Abstract Background: Despite the commonality of adolescent knee pain, there are no tools to support medical doctors to correctly diagnose knee pain. Aim: This study aimed to develop and evaluate a support tool for diagnosing the most common types of non-traumatic adolescent knee pain.Design and setting: Development and validation study in participants recruited from the general community. Method: A systematic search on Medline identified the literature on clinical tests and diagnoses of adolescent knee pain. The search was supplemented by textbooks and transformed into a diagnostic flowchart based on onset, symptoms, and pain localisation. This tool was revised based on feedback from general practitioners and experts in sports medicine. The tool was evaluated on two separate days with blinded assessors. Overall, 27 participants (aged 10-17 years) with non-traumatic knee pain were included. All participants were diagnosed by medical doctors or medical students, without and with the use of the tool. Diagnoses were compared to a golden standard (expert clinician). An interview to inform optimisations of the tool was performed with the assessors. Percentage agreement with the golden standard, and Kappa statistic for interrater reliability were calculated.Results: The final tool improved diagnostic agreement with the golden standard from 22.7% (95% CI 10.3-35.1) to 77.3% (95% CI 64.9-89.7). Inter-rater reliability increased from poor agreement k=-0.04 (95% CI, -0.12-0.04) moderate agreement k=0.56 (95% CI, 0.40-0.72).Conclusion: This simple diagnostic tool is quick to use and may assist doctors in diagnosing non-traumatic knee pain in adolescents.Trial registration: Not applicable.

Download Full-text

Development and validation of the Sorting non-trauMatIc adoLescent knEe pain (SMILE) tool – a development and initial validation study

Pediatric Rheumatology ◽

10.1186/s12969-021-00591-5 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Clara Guldhammer ◽

Sinead Holden ◽

Marina Elmelund Sørensen ◽

Jens Lykkegaard Olesen ◽

Martin Bach Jensen ◽

...

Keyword(s):

Knee Pain ◽

Gold Standard ◽

Sports Medicine ◽

Kappa Statistic ◽

Medical Doctors ◽

Clinical Tests ◽

Support Tool ◽

Expert Clinician ◽

Diagnostic Flowchart ◽

Development And Validation

Abstract Background Despite the commonality of adolescent knee pain, there are no tools to support medical doctors to correctly diagnose knee pain. This study aimed to develop and evaluate a support tool for diagnosing the most common types of non-traumatic adolescent knee pain. Method A systematic search on Medline identified the literature on clinical tests and diagnoses of adolescent knee pain. The search was supplemented by textbooks and transformed into a diagnostic flowchart based on onset, symptoms, and pain localisation. This tool was revised based on feedback from general practitioners and experts in sports medicine. The tool was evaluated on two separate days with blinded assessors. Overall, 27 participants (aged 10–17 years) with non-traumatic knee pain were included. All participants were diagnosed by medical doctors or medical students, without and with the use of the tool. Diagnoses were compared to a gold standard (expert clinician). An interview to inform optimisations of the tool was performed with the assessors. Percentage agreement with the gold standard, and Kappa statistic for interrater reliability were calculated. Results The final tool improved diagnostic agreement with the gold standard from 22.7% (95% CI 10.3–35.1) to 77.3% (95% CI 64.9–89.7). Inter-rater reliability increased from poor agreement k = − 0.04 (95% CI, − 0.12-0.04) to moderate agreement k = 0.56 (95% CI, 0.40–0.72). Conclusion This simple diagnostic tool is quick to use and may assist doctors in diagnosing non-traumatic knee pain in adolescents.

Download Full-text

Development and validation of the Sorting non-trauMatIc adoLescent knEe pain (SMILE) tool – a development and initial validation study

10.21203/rs.3.rs-52554/v2 ◽

2020 ◽

Author(s):

Clara Guldhammer ◽

Sinead Holden ◽

Marina Elmelund Sørensen ◽

Jens Lykkegaard Olesen ◽

Martin Bach Jensen ◽

...

Keyword(s):

Knee Pain ◽

Gold Standard ◽

Sports Medicine ◽

Kappa Statistic ◽

Medical Doctors ◽

Clinical Tests ◽

Support Tool ◽

Expert Clinician ◽

Diagnostic Flowchart ◽

Development And Validation

Abstract Background: Despite the commonality of adolescent knee pain, there are no tools to support medical doctors to correctly diagnose knee pain. This study aimed to develop and evaluate a support tool for diagnosing the most common types of non-traumatic adolescent knee pain.Method: A systematic search on Medline identified the literature on clinical tests and diagnoses of adolescent knee pain. The search was supplemented by textbooks and transformed into a diagnostic flowchart based on onset, symptoms, and pain localisation. This tool was revised based on feedback from general practitioners and experts in sports medicine. The tool was evaluated on two separate days with blinded assessors. Overall, 27 participants (aged 10-17 years) with non-traumatic knee pain were included. All participants were diagnosed by medical doctors or medical students, without and with the use of the tool. Diagnoses were compared to a gold standard (expert clinician). An interview to inform optimisations of the tool was performed with the assessors. Percentage agreement with the gold standard, and Kappa statistic for interrater reliability were calculated.Results: The final tool improved diagnostic agreement with the gold standard from 22.7% (95% CI 10.3-35.1) to 77.3% (95% CI 64.9-89.7). Inter-rater reliability increased from poor agreement k=-0.04 (95% CI, -0.12-0.04) to moderate agreement k=0.56 (95% CI, 0.40-0.72).Conclusion: This simple diagnostic tool is quick to use and may assist doctors in diagnosing non-traumatic knee pain in adolescents.

Download Full-text

Development and Validation Study for Yonsei-Cambridge Mindreading Face Battery for Children/Adolescent (YCAM-C/A)

THE KOREAN JOURNAL OF PSYCHOLOGY GENERAL ◽

10.22257/kjp.2020.6.39.2.249 ◽

2020 ◽

Vol 39 (2) ◽

pp. 249-282

Author(s):

Kyong-Mee Chung ◽

Heewon Kim

Keyword(s):

Validation Study ◽

Development And Validation

Download Full-text

Using Telemedicine to Pre-Screen Sports Medicine Patients in the Ambulatory Setting Reduces Wait Times and Maximizes Provider-Patient Interaction

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967119s00417 ◽

2019 ◽

Vol 7 (7_suppl5) ◽

pp. 2325967119S0041

Author(s):

Alfred Atanda ◽

Kathryn Leyden ◽

Medical Student

Keyword(s):

Patient Satisfaction ◽

Knee Pain ◽

Sports Medicine ◽

Clinic Visit ◽

Background Information ◽

Full Time ◽

Visit Time ◽

Medicine Clinic ◽

Exam Room ◽

Room Time

Objectives: Gathering of background information during a clinic visit can be time-consuming. Some medical specialties have workflows that pre-screen patients ahead of time to minimize delays. Having background information ahead of time may decrease delays and ensure that the visit is focused on physical examination, diagnosis, and treatment. We have used telemedicine to treat established patients to reduce cost and resource utilization, while maintaining high levels of patient satisfaction. It is conceivable that telemedicine could also be used to pre-screen new patients prior to their in-person clinic visit. The goal of the current study was to evaluate whether utilizing telemedicine to pre-screen new patients to our sports medicine clinic would reduce time in the exam room waiting and being seen, and overall clinic times. Methods: From June 2018 through August 2018, we utilized videoconferencing telemedicine to pre-screen all new patients to a pediatric sports medicine clinic with a chief diagnosis of knee pain. Visits were performed by full-time telemedicine pediatricians who were provided appropriate training and an intake form describing which questions should be asked. All visits utilized the American Well software platform (Boston, USA) and were performed on the patient’s personal device. During the subsequent in-person visit, the overall timing of the visit was recorded including: time checked in, time waiting in waiting room, time waiting in exam room, time spent with provider, and time-checked out, were all recorded. Similar time points were recorded for matched control patients that did not undergo telemedicine pre-screening and were seen in the traditional manner. Inclusion criteria included: being brand new to the practice and unilateral knee pain. Results: There were eight pre-screened patients and ten control patients in this cohort. Compared to controls, pre-screened patients spent less time in the exam room (19 min vs. 31 min), higher percentage of the exam room time with the provider (58% vs. 34%), higher percentage of the overall visit time with the provider (29% vs. 19.5%), and less time for the overall visit (39 min vs. 52 min). Conclusion: Pre-screening patients to obtain background information can decrease exam room waiting time and overall visit time and maximize time during the visit spent with the provider. In addition, it could potentially be used to increase throughput through the clinic and improve patient satisfaction scores.

Download Full-text