title: Evaluation of the usefulness of 2 prediction models of clinical prediction models in physical therapy: a qualitative process evaluation.
abstract: OBJECTIVE
  The purposes of this study were to (1) evaluate the usefulness of 2 prediction models by assessing the actual use and advantages/disadvantages of application in daily clinical practice and (2) propose recommendations to enhance their implementation.
  
  
  METHODS
  Physical therapists working in 283 practices in the area of Breda (the Netherlands) were invited to participate in this study. Two prediction models were presented: (1) to predict persistent shoulder pain and (2) to predict the preferable treatment in nonspecific neck pain. Participants were asked to apply both models in practice. After 2 months, their opinions about the usefulness of both models were gathered during a focus group meeting or by using an online questionnaire in order to identify the most important advantages/disadvantages of each prediction model.
  
  
  RESULTS
  In total, 46 physical therapists (13.8%) of 39 practices participated. Evaluative data were available from 32 participants who used the shoulder model 102 times and the neck model 126 times. For the shoulder model, the most frequent advantage (mentioned 14 times) was that it enabled physical therapists to estimate a motivated prognosis, that is, a prognosis based on the score of the model. The most frequent mentioned disadvantage was that participants expressed their doubts about the validity of the model because the model initially was developed for usage in a general practice setting. For the neck model, the most frequently mentioned advantage (29 times) was that the model was easy to interpret. The most important disadvantage (mentioned 14 times) was that the model only takes a few treatment options into account.
  
  
  CONCLUSIONS
  The physical therapists participating in this study reported that both models evaluated in this study were not easy to use in daily practice. Based on the findings of this study, we recommend that these models are modified to meet the practical needs of the therapist, before assessing their impact on daily clinical care and patient outcomes.
authors.affiliation: Instructor, Department of physical therapy, AVANS University of Applied Sciences, Breda, the Netherlands. Electronic address: l.vanoort@avans.nl.
authors.forename: Lieke
authors.initials: L
authors.lastname: van Oort
authors.affiliation: Associate professor, Department of physical therapy, AVANS University of Applied Sciences, Breda, the Netherlands; Associate professor, Department of General Practice, Erasmus MC, Rotterdam, the Netherlands.
authors.forename: Arianne
authors.initials: A
authors.lastname: Verhagen
authors.affiliation: Professor, Department of General Practice, Erasmus MC, Rotterdam, the Netherlands.
authors.forename: Bart
authors.initials: B
authors.lastname: Koes
authors.affiliation: Professor, Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, the Netherlands.
authors.forename: Riekie
authors.initials: R
authors.lastname: de Vet
authors.affiliation: Assistant professor, Department of Public and Occupational Health, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, the Netherlands.
authors.forename: Han
authors.initials: H
authors.lastname: Anema
authors.affiliation: Professor, Faculty of Earth and Life Sciences, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, the Netherlands; Assistant professor, Department of Epidemiology and Biostatistics, EMGO Institute for Health and Care Research, VU University Medical Centre, Amsterdam, the Netherlands.
authors.forename: Martijn
authors.initials: M
authors.lastname: Heymans
mesh_terms: D000328:Adult; D005260:Female; D017144:Focus Groups; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D019547:Neck Pain / Q000628:therapy; D026741:Physical Therapy Modalities; D026761:Physical Therapy Specialty; D011320:Primary Health Care; D018570:Risk Assessment; D020069:Shoulder Pain / Q000628:therapy; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Musculoskeletal Diseases; Physical Therapy Specialty; Prognosis