Australian physiotherapists’ priorities for the development of clinical prediction rules for low back pain: A qualitative study

Abstract

ObjectiveTo identify the types of clinical prediction rules (CPRs) for low back pain (LBP) that Australian physiotherapists wish to see developed and the characteristics of LBP CPRs that physiotherapists believe are important. DesignQualitative study using semi-structured focus groups. SettingMetropolitan and regional areas of New South Wales, Australia. ParticipantsTwenty-six physiotherapists who manage patients with LBP (77% male, 81% private practice). ResultsParticipants welcomed the development of prognostic forms of LBP CPRs. Tools that assist in identifying serious spinal pathology, likely responders to interventions, patients who are likely to experience an adverse outcome, and patients not requiring physiotherapy management were also considered useful. Participants thought that LBP CPRs should be uncomplicated, easy to remember, easy to apply, accurate and precise, and well-supported by research evidence. They should not contain an excessive number of variables, use complicated statistics, or contain variables that have no clear logical relationship to the dependent outcome. It was considered by participants that LBP CPRs need to be compatible with traditional clinical reasoning and decision-making processes, and sufficiently inclusive of a broad range of management approaches and common clinical assessment techniques. ConclusionThere were several identified areas of perceived need for LBP CPR development and a range of characteristics such tools need to encompass to be considered clinically meaningful and useful by physiotherapists in this study. Targeting and incorporating the needs and preferences of physiotherapists is likely to result in the development of tools for LBP with the greatest potential to positively impact clinical practice.