"I understand about indecision
But I don't care if I get behind
People livin in competition
All I want is to have my peace of mind."
Evaluation of a Treatment-Based Classification Algorithm for Low Back Pain: A Cross-Sectional Study published in the April 2011 Physical Therapy Journal helps quantify where algorithmic decision making tools leave off in physical therapists' practice.
Algorithms are new in physical therapy - Australian physical therapists have an average of only 1.2 years of experience with algorithms while American physical therapists have 7.6 years of experience with algorithms.
What did we use before we had algorithms? Intuition.
This study clarifies where algorithms leave blanks that physical therapists need to fill in with intuition.
The treatment based classification algorithms explained the majority of the patients studied. Forty nine percent (49%) belonged to one sub-group and twenty five (25%) belonged to more than one treatment group. Twenty five percent (25%) of the 250 study subjects did not belong to any treatment group (eg: manipulation, traction, etc).
Is is possible that every physical therapy patient will belong to one and only one treatment group? Have we described all of the groups? If not, how much our our practice is left to intuition?
Algorithms are important because they allow physical therapists to create sub-categories of patient that respond well to our interventions. These sub-categories can be analyzed for long-term outcomes.
High quality outcome studies based on well-defined sub-categories will surely show larger treatment effects than current studies. Better outcomes will prove physical therapists' worth in the reformed, more competitive healthcare system.
