Reliability of ‘ACAPN’ Clinical Assessment Tool for Differential Diagnoses of Pathologies in Clinical Physiotherapy

Abstract

The standardization of assessment procedures is to ensure high quality clinical care. Considering variations in clinical training backgrounds of physiotherapists, there may be inconsistency in methods of documentation. The aims of this study were to develop a standard assessment tool and also determine its internal consistency (reliability). The tool was developed using the guidelines of University College London Guide. The tool was divided into 7 sections: sociodemographic data, history, vital signs, physical diagnostic tests, problem lists, differential diagnoses and therapeutic interventions. Ninety-five physiotherapists from purposively selected government hospitals participated in the cross-sectional survey study. They chose the level of agreement for each section of the developed tool on a 5 points likert scale (scored as 1 – 5). The same questionnaire was re-administered to same respondents with test-retest interval of 2 weeks. Cumulative agreement score was computed to have global scores for days 1 and 2. Descriptive Statistics of mean, frequency and percentages were used to summarize the data. Cronbach alpha was used to determine the internal consistency of the assessment tool. Spearman Rho was used to determine the relationship between the agreement scores of the two days. Alpha level was set at P<0.05. The mean age of the respondent was 33.62 ± 10.26 years while years of experience was 10.36 ± 6.22 years. The Cronbach Alpha obtained for the tool was 0.9 while that of individual sections ranged from 0.53 to 0.86. The mean global agreement score for day 1 was 169.44 ± 13.78 and after test-retest, it was 169.20 ± 13.61 (day 2). The result of the Spearman's rho showed that there was significant correlation between global agreement score for days 1 and 2 (r = 0.99, p = 0.001). There was also significant correlation between the age and experience of the respondent (r = 0.77, p = 0.01). In conclusion, the developed assessment tool has internal consistency and it was found to be reliable as a means of documentation for evaluating patients.