Optimizing referral of patients with neuromuscular disorders to allied health care.
OBJECTIVE
To report the predictive validity of the perceived limitations in activities and need questionnaire (PLAN-Q), a screening instrument to support neurologists to select patients with neuromuscular disorders (NMD) for referral for a one-off consultation by occupational therapist (OT), physical therapist (PT) and speech therapist (ST).


METHODS
In a cross-sectional validation study, 102 patients with various NMD participated. Patients received a one-off consultation by an expert OT, PT and ST and filled out the PLAN-Q. Therapists rated the appropriateness of the one-off consultations based on need, available treatment and patient's motivation. Receiver Operation Characteristic analysis and multivariate logistic regression analysis were used to obtain a PLAN-Q based prediction model for the appropriateness of the one-off consultations.


RESULTS
Probability for a one-off OT consultation increased from 64% to 78% (95% CI: 69-85%). Prior test probability for a one-off ST consultation increased from 44% to 61% (95% CI: 48-73%). Prior test probability for one-off PT consultation could not be increased.


CONCLUSIONS
Screening patients with NMD using the PLAN-Q may assist neurologists in selecting the appropriate patients for a one-off consultation by OT and ST. Unlike our expectations the screening did not guide referral for a one-off consultation by PT.
Pieterse
A J
AJ
Research Centre for Allied Health Sciences, Institute for Neurology, Radboud University, NijmegenMedical Centre, The Netherlands. a.pieterse@pmd.umcn.nl
Cup
E H C
EH
Akkermans
R P
RP
Hendricks
H T
HT
van Engelen
B G M
BG
van der Wilt
G J
GJ
Oostendorp
R A B
RA
D016390:Allied Health Occupations; D019540:Area Under Curve; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009468:Neuromuscular Diseases / Q000534:rehabilitation*; D012372:ROC Curve; D012017:Referral and Consultation; D011795:Surveys and Questionnaires