Application of a diagnosis-based clinical decision guide in patients with neck pain
Background Neck pain (NP) is a common cause of disability. Accurate and efficacious methods of diagnosis and treatment have been elusive. A diagnosis-based clinical decision guide (DBCDG; previously referred to as a diagnosis-based clinical decision rule) has been proposed which attempts to provide...
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| Autor*in: |
Murphy, Donald R [verfasserIn] |
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| Format: |
E-Artikel |
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| Sprache: |
Englisch |
| Erschienen: |
2011 |
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| Schlagwörter: |
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| Anmerkung: |
© Murphy and Hurwitz; licensee BioMed Central Ltd. 2011 |
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| Übergeordnetes Werk: |
Enthalten in: Chiropractic & osteopathy - London : BioMed Central, 2005, 19(2011), 1 vom: 27. Aug. |
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| Übergeordnetes Werk: |
volume:19 ; year:2011 ; number:1 ; day:27 ; month:08 |
| Links: |
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| DOI / URN: |
10.1186/2045-709X-19-19 |
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SPR029356202 |
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| 520 | |a Background Neck pain (NP) is a common cause of disability. Accurate and efficacious methods of diagnosis and treatment have been elusive. A diagnosis-based clinical decision guide (DBCDG; previously referred to as a diagnosis-based clinical decision rule) has been proposed which attempts to provide the clinician with a systematic, evidence-based guide in applying the biopsychosocial model of care. The approach is based on three questions of diagnosis. The purpose of this study is to present the prevalence of findings using the DBCDG in consecutive patients with NP. Methods Demographic, diagnostic and baseline outcome measure data were gathered on a cohort of NP patients examined by one of three examiners trained in the application of the DBCDG. Results Data were gathered on 95 patients. Signs of visceral disease or potentially serious illness were found in 1%. Centralization signs were found in 27%, segmental pain provocation signs were found in 69% and radicular signs were found in 19%. Clinically relevant myofascial signs were found in 22%. Dynamic instability was found in 40%, oculomotor dysfunction in 11.6%, fear beliefs in 31.6%, central pain hypersensitivity in 4%, passive coping in 5% and depression in 2%. Conclusion The DBCDG can be applied in a busy private practice environment. Further studies are needed to investigate clinically relevant means to identify central pain hypersensitivity, oculomotor dysfunction, poor coping and depression, correlations and patterns among the diagnostic components of the DBCDG as well as inter-examiner reliability, validity and efficacy of treatment based on the DBCDG. | ||
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10.1186/2045-709X-19-19 doi (DE-627)SPR029356202 (SPR)2045-709X-19-19-e DE-627 ger DE-627 rakwb eng Murphy, Donald R verfasserin aut Application of a diagnosis-based clinical decision guide in patients with neck pain 2011 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Murphy and Hurwitz; licensee BioMed Central Ltd. 2011 Background Neck pain (NP) is a common cause of disability. Accurate and efficacious methods of diagnosis and treatment have been elusive. A diagnosis-based clinical decision guide (DBCDG; previously referred to as a diagnosis-based clinical decision rule) has been proposed which attempts to provide the clinician with a systematic, evidence-based guide in applying the biopsychosocial model of care. The approach is based on three questions of diagnosis. The purpose of this study is to present the prevalence of findings using the DBCDG in consecutive patients with NP. Methods Demographic, diagnostic and baseline outcome measure data were gathered on a cohort of NP patients examined by one of three examiners trained in the application of the DBCDG. Results Data were gathered on 95 patients. Signs of visceral disease or potentially serious illness were found in 1%. Centralization signs were found in 27%, segmental pain provocation signs were found in 69% and radicular signs were found in 19%. Clinically relevant myofascial signs were found in 22%. Dynamic instability was found in 40%, oculomotor dysfunction in 11.6%, fear beliefs in 31.6%, central pain hypersensitivity in 4%, passive coping in 5% and depression in 2%. Conclusion The DBCDG can be applied in a busy private practice environment. Further studies are needed to investigate clinically relevant means to identify central pain hypersensitivity, oculomotor dysfunction, poor coping and depression, correlations and patterns among the diagnostic components of the DBCDG as well as inter-examiner reliability, validity and efficacy of treatment based on the DBCDG. Comparative Effectiveness Research (dpeaa)DE-He213 Passive Coping (dpeaa)DE-He213 Cervical Radiculopathy (dpeaa)DE-He213 Chronic Neck Pain (dpeaa)DE-He213 Taut Band (dpeaa)DE-He213 Hurwitz, Eric L aut Enthalten in Chiropractic & osteopathy London : BioMed Central, 2005 19(2011), 1 vom: 27. Aug. (DE-627)484836161 (DE-600)2185661-8 1746-1340 nnns volume:19 year:2011 number:1 day:27 month:08 https://dx.doi.org/10.1186/2045-709X-19-19 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA AR 19 2011 1 27 08 |
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10.1186/2045-709X-19-19 doi (DE-627)SPR029356202 (SPR)2045-709X-19-19-e DE-627 ger DE-627 rakwb eng Murphy, Donald R verfasserin aut Application of a diagnosis-based clinical decision guide in patients with neck pain 2011 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Murphy and Hurwitz; licensee BioMed Central Ltd. 2011 Background Neck pain (NP) is a common cause of disability. Accurate and efficacious methods of diagnosis and treatment have been elusive. A diagnosis-based clinical decision guide (DBCDG; previously referred to as a diagnosis-based clinical decision rule) has been proposed which attempts to provide the clinician with a systematic, evidence-based guide in applying the biopsychosocial model of care. The approach is based on three questions of diagnosis. The purpose of this study is to present the prevalence of findings using the DBCDG in consecutive patients with NP. Methods Demographic, diagnostic and baseline outcome measure data were gathered on a cohort of NP patients examined by one of three examiners trained in the application of the DBCDG. Results Data were gathered on 95 patients. Signs of visceral disease or potentially serious illness were found in 1%. Centralization signs were found in 27%, segmental pain provocation signs were found in 69% and radicular signs were found in 19%. Clinically relevant myofascial signs were found in 22%. Dynamic instability was found in 40%, oculomotor dysfunction in 11.6%, fear beliefs in 31.6%, central pain hypersensitivity in 4%, passive coping in 5% and depression in 2%. Conclusion The DBCDG can be applied in a busy private practice environment. Further studies are needed to investigate clinically relevant means to identify central pain hypersensitivity, oculomotor dysfunction, poor coping and depression, correlations and patterns among the diagnostic components of the DBCDG as well as inter-examiner reliability, validity and efficacy of treatment based on the DBCDG. Comparative Effectiveness Research (dpeaa)DE-He213 Passive Coping (dpeaa)DE-He213 Cervical Radiculopathy (dpeaa)DE-He213 Chronic Neck Pain (dpeaa)DE-He213 Taut Band (dpeaa)DE-He213 Hurwitz, Eric L aut Enthalten in Chiropractic & osteopathy London : BioMed Central, 2005 19(2011), 1 vom: 27. Aug. (DE-627)484836161 (DE-600)2185661-8 1746-1340 nnns volume:19 year:2011 number:1 day:27 month:08 https://dx.doi.org/10.1186/2045-709X-19-19 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA AR 19 2011 1 27 08 |
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10.1186/2045-709X-19-19 doi (DE-627)SPR029356202 (SPR)2045-709X-19-19-e DE-627 ger DE-627 rakwb eng Murphy, Donald R verfasserin aut Application of a diagnosis-based clinical decision guide in patients with neck pain 2011 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Murphy and Hurwitz; licensee BioMed Central Ltd. 2011 Background Neck pain (NP) is a common cause of disability. Accurate and efficacious methods of diagnosis and treatment have been elusive. A diagnosis-based clinical decision guide (DBCDG; previously referred to as a diagnosis-based clinical decision rule) has been proposed which attempts to provide the clinician with a systematic, evidence-based guide in applying the biopsychosocial model of care. The approach is based on three questions of diagnosis. The purpose of this study is to present the prevalence of findings using the DBCDG in consecutive patients with NP. Methods Demographic, diagnostic and baseline outcome measure data were gathered on a cohort of NP patients examined by one of three examiners trained in the application of the DBCDG. Results Data were gathered on 95 patients. Signs of visceral disease or potentially serious illness were found in 1%. Centralization signs were found in 27%, segmental pain provocation signs were found in 69% and radicular signs were found in 19%. Clinically relevant myofascial signs were found in 22%. Dynamic instability was found in 40%, oculomotor dysfunction in 11.6%, fear beliefs in 31.6%, central pain hypersensitivity in 4%, passive coping in 5% and depression in 2%. Conclusion The DBCDG can be applied in a busy private practice environment. Further studies are needed to investigate clinically relevant means to identify central pain hypersensitivity, oculomotor dysfunction, poor coping and depression, correlations and patterns among the diagnostic components of the DBCDG as well as inter-examiner reliability, validity and efficacy of treatment based on the DBCDG. Comparative Effectiveness Research (dpeaa)DE-He213 Passive Coping (dpeaa)DE-He213 Cervical Radiculopathy (dpeaa)DE-He213 Chronic Neck Pain (dpeaa)DE-He213 Taut Band (dpeaa)DE-He213 Hurwitz, Eric L aut Enthalten in Chiropractic & osteopathy London : BioMed Central, 2005 19(2011), 1 vom: 27. Aug. (DE-627)484836161 (DE-600)2185661-8 1746-1340 nnns volume:19 year:2011 number:1 day:27 month:08 https://dx.doi.org/10.1186/2045-709X-19-19 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA AR 19 2011 1 27 08 |
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10.1186/2045-709X-19-19 doi (DE-627)SPR029356202 (SPR)2045-709X-19-19-e DE-627 ger DE-627 rakwb eng Murphy, Donald R verfasserin aut Application of a diagnosis-based clinical decision guide in patients with neck pain 2011 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Murphy and Hurwitz; licensee BioMed Central Ltd. 2011 Background Neck pain (NP) is a common cause of disability. Accurate and efficacious methods of diagnosis and treatment have been elusive. A diagnosis-based clinical decision guide (DBCDG; previously referred to as a diagnosis-based clinical decision rule) has been proposed which attempts to provide the clinician with a systematic, evidence-based guide in applying the biopsychosocial model of care. The approach is based on three questions of diagnosis. The purpose of this study is to present the prevalence of findings using the DBCDG in consecutive patients with NP. Methods Demographic, diagnostic and baseline outcome measure data were gathered on a cohort of NP patients examined by one of three examiners trained in the application of the DBCDG. Results Data were gathered on 95 patients. Signs of visceral disease or potentially serious illness were found in 1%. Centralization signs were found in 27%, segmental pain provocation signs were found in 69% and radicular signs were found in 19%. Clinically relevant myofascial signs were found in 22%. Dynamic instability was found in 40%, oculomotor dysfunction in 11.6%, fear beliefs in 31.6%, central pain hypersensitivity in 4%, passive coping in 5% and depression in 2%. Conclusion The DBCDG can be applied in a busy private practice environment. Further studies are needed to investigate clinically relevant means to identify central pain hypersensitivity, oculomotor dysfunction, poor coping and depression, correlations and patterns among the diagnostic components of the DBCDG as well as inter-examiner reliability, validity and efficacy of treatment based on the DBCDG. Comparative Effectiveness Research (dpeaa)DE-He213 Passive Coping (dpeaa)DE-He213 Cervical Radiculopathy (dpeaa)DE-He213 Chronic Neck Pain (dpeaa)DE-He213 Taut Band (dpeaa)DE-He213 Hurwitz, Eric L aut Enthalten in Chiropractic & osteopathy London : BioMed Central, 2005 19(2011), 1 vom: 27. Aug. (DE-627)484836161 (DE-600)2185661-8 1746-1340 nnns volume:19 year:2011 number:1 day:27 month:08 https://dx.doi.org/10.1186/2045-709X-19-19 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA AR 19 2011 1 27 08 |
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10.1186/2045-709X-19-19 doi (DE-627)SPR029356202 (SPR)2045-709X-19-19-e DE-627 ger DE-627 rakwb eng Murphy, Donald R verfasserin aut Application of a diagnosis-based clinical decision guide in patients with neck pain 2011 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Murphy and Hurwitz; licensee BioMed Central Ltd. 2011 Background Neck pain (NP) is a common cause of disability. Accurate and efficacious methods of diagnosis and treatment have been elusive. A diagnosis-based clinical decision guide (DBCDG; previously referred to as a diagnosis-based clinical decision rule) has been proposed which attempts to provide the clinician with a systematic, evidence-based guide in applying the biopsychosocial model of care. The approach is based on three questions of diagnosis. The purpose of this study is to present the prevalence of findings using the DBCDG in consecutive patients with NP. Methods Demographic, diagnostic and baseline outcome measure data were gathered on a cohort of NP patients examined by one of three examiners trained in the application of the DBCDG. Results Data were gathered on 95 patients. Signs of visceral disease or potentially serious illness were found in 1%. Centralization signs were found in 27%, segmental pain provocation signs were found in 69% and radicular signs were found in 19%. Clinically relevant myofascial signs were found in 22%. Dynamic instability was found in 40%, oculomotor dysfunction in 11.6%, fear beliefs in 31.6%, central pain hypersensitivity in 4%, passive coping in 5% and depression in 2%. Conclusion The DBCDG can be applied in a busy private practice environment. Further studies are needed to investigate clinically relevant means to identify central pain hypersensitivity, oculomotor dysfunction, poor coping and depression, correlations and patterns among the diagnostic components of the DBCDG as well as inter-examiner reliability, validity and efficacy of treatment based on the DBCDG. Comparative Effectiveness Research (dpeaa)DE-He213 Passive Coping (dpeaa)DE-He213 Cervical Radiculopathy (dpeaa)DE-He213 Chronic Neck Pain (dpeaa)DE-He213 Taut Band (dpeaa)DE-He213 Hurwitz, Eric L aut Enthalten in Chiropractic & osteopathy London : BioMed Central, 2005 19(2011), 1 vom: 27. Aug. (DE-627)484836161 (DE-600)2185661-8 1746-1340 nnns volume:19 year:2011 number:1 day:27 month:08 https://dx.doi.org/10.1186/2045-709X-19-19 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA AR 19 2011 1 27 08 |
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Accurate and efficacious methods of diagnosis and treatment have been elusive. A diagnosis-based clinical decision guide (DBCDG; previously referred to as a diagnosis-based clinical decision rule) has been proposed which attempts to provide the clinician with a systematic, evidence-based guide in applying the biopsychosocial model of care. The approach is based on three questions of diagnosis. The purpose of this study is to present the prevalence of findings using the DBCDG in consecutive patients with NP. Methods Demographic, diagnostic and baseline outcome measure data were gathered on a cohort of NP patients examined by one of three examiners trained in the application of the DBCDG. Results Data were gathered on 95 patients. Signs of visceral disease or potentially serious illness were found in 1%. Centralization signs were found in 27%, segmental pain provocation signs were found in 69% and radicular signs were found in 19%. Clinically relevant myofascial signs were found in 22%. Dynamic instability was found in 40%, oculomotor dysfunction in 11.6%, fear beliefs in 31.6%, central pain hypersensitivity in 4%, passive coping in 5% and depression in 2%. Conclusion The DBCDG can be applied in a busy private practice environment. 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Application of a diagnosis-based clinical decision guide in patients with neck pain |
| abstract |
Background Neck pain (NP) is a common cause of disability. Accurate and efficacious methods of diagnosis and treatment have been elusive. A diagnosis-based clinical decision guide (DBCDG; previously referred to as a diagnosis-based clinical decision rule) has been proposed which attempts to provide the clinician with a systematic, evidence-based guide in applying the biopsychosocial model of care. The approach is based on three questions of diagnosis. The purpose of this study is to present the prevalence of findings using the DBCDG in consecutive patients with NP. Methods Demographic, diagnostic and baseline outcome measure data were gathered on a cohort of NP patients examined by one of three examiners trained in the application of the DBCDG. Results Data were gathered on 95 patients. Signs of visceral disease or potentially serious illness were found in 1%. Centralization signs were found in 27%, segmental pain provocation signs were found in 69% and radicular signs were found in 19%. Clinically relevant myofascial signs were found in 22%. Dynamic instability was found in 40%, oculomotor dysfunction in 11.6%, fear beliefs in 31.6%, central pain hypersensitivity in 4%, passive coping in 5% and depression in 2%. Conclusion The DBCDG can be applied in a busy private practice environment. Further studies are needed to investigate clinically relevant means to identify central pain hypersensitivity, oculomotor dysfunction, poor coping and depression, correlations and patterns among the diagnostic components of the DBCDG as well as inter-examiner reliability, validity and efficacy of treatment based on the DBCDG. © Murphy and Hurwitz; licensee BioMed Central Ltd. 2011 |
| abstractGer |
Background Neck pain (NP) is a common cause of disability. Accurate and efficacious methods of diagnosis and treatment have been elusive. A diagnosis-based clinical decision guide (DBCDG; previously referred to as a diagnosis-based clinical decision rule) has been proposed which attempts to provide the clinician with a systematic, evidence-based guide in applying the biopsychosocial model of care. The approach is based on three questions of diagnosis. The purpose of this study is to present the prevalence of findings using the DBCDG in consecutive patients with NP. Methods Demographic, diagnostic and baseline outcome measure data were gathered on a cohort of NP patients examined by one of three examiners trained in the application of the DBCDG. Results Data were gathered on 95 patients. Signs of visceral disease or potentially serious illness were found in 1%. Centralization signs were found in 27%, segmental pain provocation signs were found in 69% and radicular signs were found in 19%. Clinically relevant myofascial signs were found in 22%. Dynamic instability was found in 40%, oculomotor dysfunction in 11.6%, fear beliefs in 31.6%, central pain hypersensitivity in 4%, passive coping in 5% and depression in 2%. Conclusion The DBCDG can be applied in a busy private practice environment. Further studies are needed to investigate clinically relevant means to identify central pain hypersensitivity, oculomotor dysfunction, poor coping and depression, correlations and patterns among the diagnostic components of the DBCDG as well as inter-examiner reliability, validity and efficacy of treatment based on the DBCDG. © Murphy and Hurwitz; licensee BioMed Central Ltd. 2011 |
| abstract_unstemmed |
Background Neck pain (NP) is a common cause of disability. Accurate and efficacious methods of diagnosis and treatment have been elusive. A diagnosis-based clinical decision guide (DBCDG; previously referred to as a diagnosis-based clinical decision rule) has been proposed which attempts to provide the clinician with a systematic, evidence-based guide in applying the biopsychosocial model of care. The approach is based on three questions of diagnosis. The purpose of this study is to present the prevalence of findings using the DBCDG in consecutive patients with NP. Methods Demographic, diagnostic and baseline outcome measure data were gathered on a cohort of NP patients examined by one of three examiners trained in the application of the DBCDG. Results Data were gathered on 95 patients. Signs of visceral disease or potentially serious illness were found in 1%. Centralization signs were found in 27%, segmental pain provocation signs were found in 69% and radicular signs were found in 19%. Clinically relevant myofascial signs were found in 22%. Dynamic instability was found in 40%, oculomotor dysfunction in 11.6%, fear beliefs in 31.6%, central pain hypersensitivity in 4%, passive coping in 5% and depression in 2%. Conclusion The DBCDG can be applied in a busy private practice environment. Further studies are needed to investigate clinically relevant means to identify central pain hypersensitivity, oculomotor dysfunction, poor coping and depression, correlations and patterns among the diagnostic components of the DBCDG as well as inter-examiner reliability, validity and efficacy of treatment based on the DBCDG. © Murphy and Hurwitz; licensee BioMed Central Ltd. 2011 |
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Application of a diagnosis-based clinical decision guide in patients with neck pain |
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