Diagnostic accuracy of knee pathologies by a telephone based Advanced Level Physiotherapy service

Abstract

Purpose: Advanced Level Physiotherapist (ALP) posts have long been established in the physiotherapy profession in an effort to provide management for individuals presenting with orthopaedic or musculoskeletal problems. ALP's utilise extended scope practices including radiology requests, and advanced clinical reasoning, to triage and manage complex presentations, directing to appropriate conservative management or escalation for potential orthopaedic review. Extensive clinical and cost effectiveness research suggests strong reproducibility between diagnostic accuracy of similar face to face services against orthopaedic surgeons, demonstrating 66–88% diagnostic accuracy for knee pathologies. The diagnostic accuracy of telephone based physiotherapy services, including ALP triage services, have not previously been investigated. Telephone based ALP services provide patients with rapid access to specialist musculoskeletal advice and management, and avoid prolonged waiting times for diagnosis. The aim of this study was to audit and examine the diagnostic accuracy of radiology investigations performed for knee pain, by a telephone based ALP triage service.