Dear Giovanni,

We are not only interested in the outcomes but more specifically in the process of clinical reasoning and decision in physiotherapy practice based on routinely collected data.

We are interested in the experience of.colleagues on which way they have analysed a set of routinely collected data. We cannot find any publication in different search systems. Do you have an idea?

Thanks in advance and kind regards,

Rob Oostendor

Hi Rob

We teach our students to clinically reason towards an hypothesis on what the pain driver is in a patient. For me it would make sense to organise the data in this way:

After the interview [and therefore the info of the interview must inform this] they must know

- what are the underlying and possibly referring structures to the area of symptoms

- any red flags or specific precautions

- mechanical behaviour? [scale]

- sensitisation? [scale] including irritability, symptoms of inflammation, non-mechanical nature

- these all to decide between nociceptive [somatic, neural and visceral], neuropathic and nociplastic pain

- contributing factors [psychosocial barriers, work place, sport etc]

Here is a nice way to organise information: https://www.musculoskeletalframework.net/

Here is a picture of the summary of this framework: http://www.pain-ed.com/blog/2018/05/16/musculoskeletal-clinical-translation-framework-from-knowing-to-doing/

Hi Rob

We teach our students to clinically reason towards an hypothesis on what the pain driver is in a patient. For me it would make sense to organise the data in this way:

After the interview [and therefore the info of the interview must inform this] they must know

- what are the underlying and possibly referring structures to the area of symptoms

- any red flags or specific precautions

- mechanical behaviour? [scale]

- sensitisation? [scale] including irritability, symptoms of inflammation, non-mechanical nature

- these all to decide between nociceptive [somatic, neural and visceral], neuropathic and nociplastic pain

- contributing factors [psychosocial barriers, work place, sport etc]

Here is a nice way to organise information: https://www.musculoskeletalframework.net/

Here is a picture of the summary of this framework: http://www.pain-ed.com/blog/2018/05/16/musculoskeletal-clinical-translation-framework-from-knowing-to-doing/

Hi Rob

We teach our students to clinically reason towards an hypothesis on what the pain driver is in a patient. For me it would make sense to organise the data in this way: After the interview [and therefore the info of the interview must inform this] they must know

- what are the underlying and possibly referring structures to the area of symptoms

- any red flags or specific precautions

- mechanical behaviour? [scale]

- sensitisation? [scale] including irritability, symptoms of inflammation, non-mechanical nature

- these all to decide between nociceptive [somatic, neural and visceral], neuropathic and nociplastic pain

- contributing factors [psychosocial barriers, work place, sport etc]

Here is a nice way to organise information: https://www.musculoskeletalframework.net/

Here is a picture of the summary of this framework: http://www.pain-ed.com/blog/2018/05/16/musculoskeletal-clinical-translation-framework-from-knowing-to-doing/

Dear,

an interesting paper on 'statistical significance' and what does it actually mean.

Moving to a World Beyond “p < 0.05” https://doi.org/10.1080/00031305.2019.1583913

Kind regards,

Dear Ina,

Hope you are doing well.

Thanks for your valuable reponse. Our routinely collected data are fully organized according to the steps of clinical reasoning and decision making, Roughly on the same way you teach your students..

An example illustrates the embedding of the clinical reasoning process in patients with Whiplash-Associated Disorder.

A flowchart illustrating the steps of the clinical reasoning process in patients with Whiplash-Associated Disorders (WAD) is as supplmentary available in ReserachGate (Supplementary data: Quality indicators for physiotherapy care process of patients with Whiplash-Associated Disorders (WAD). Flowchart of steps of clinical reasoning Related to the article: Has the quality of physiotherapy care in patients with Whiplash-Associated disorders (WAD) improved over time? A retrospective study using routinely collected data and quality indicators. Published in: Patient Preference and Adherence 2018:12;2291-2308).

In the second supplementary, you will find an overview of variables as recorded in the patient files.

Supplementary data - Steps of Clinical Reasoning Process and overview of variables of quality indicators for the physiotherapy care process in patients with Whiplash-Associated Disorders (WAD) related to article: Has the quality of physiotherapy care in patients with Whiplash-Associated disorders (WAD) improved over time? A retrospective study using routinely collected data and quality indicators. Published in: Patient Preference and Adherence 2018:12;2291-2308.

Hopefully this information gives you insight in the way we have collected the clinical data. You can find the artile including the supplementaries in ResearchGate,

Agian thanks for your valuable answer and all the best.

If you have any question, please don't hesitate to contact me.

Best wishes,

Rob Oostendorp

Dear Sarah,

Many thanks for the reference. I know this discussion about statistical signifance very well in collaboration with my statistician. Clinical significance and relevance is our toppriority.

Thanks again. Please, don't hesitate to contact me.

Best wishes,

Rob Oostendorp.

Dear Huub,

Thank you for your response. The paper is welcome. We have gonished the first analysis, together with Hans Elvers and Emiel van Trijffel. A manuscript is in preparation.

Hope you are doing eell.

Best wishes,

Also on behalf of Hans and Emiel,

Rob O.