The diagnostic accuracy of spinal pathologies referred for by a telephone based advanced level physiotherapy triage service

Abstract

Purpose: Advanced Level Physiotherapy (ALP) is a term used to describe a level of practice for a physiotherapist to be working at. It includes utilising a combination of advanced skills, knowledge and clinical reasoning to successfully and safely manage patients, recognising where a clinical presentation is outside an individual's scope, and taking appropriate action. Utilising advanced clinical reasoning and making appropriate radiology referrals enables physiotherapists to exclude serious pathology and determine the appropriate pathway for a patient. Being able to safely triage and direct patients to conservative management or escalate to an orthopaedic review where suitable is the cornerstone of a clinically-effective service, and highlights the benefits of having experienced physiotherapists on hand to guide patients appropriately. Many studies have looked at whether the diagnostic accuracy of physiotherapists is comparable to orthopaedic consultants, but the diagnostic accuracy of a telephone based ALP triage service has not previously been investigated. The aim of this study was to audit the diagnostic accuracy of radiology investigations performed for spinal pain (cervical, thoracic, lumbar and sacroiliac) by a telephone based ALP triage service.