title: Clinical Decision Support Tools for Selecting Interventions for Patients with Disabling Musculoskeletal Disorders: A Scoping Review.
abstract: Purpose We aimed to identify and inventory clinical decision support (CDS) tools for helping front-line staff select interventions for patients with musculoskeletal (MSK) disorders. Methods We used Arksey and O'Malley's scoping review framework which progresses through five stages: (1) identifying the research question; (2) identifying relevant studies; (3) selecting studies for analysis; (4) charting the data; and (5) collating, summarizing and reporting results. We considered computer-based, and other available tools, such as algorithms, care pathways, rules and models. Since this research crosses multiple disciplines, we searched health care, computing science and business databases. Results Our search resulted in 4605 manuscripts. Titles and abstracts were screened for relevance. The reliability of the screening process was high with an average percentage of agreement of 92.3 %. Of the located articles, 123 were considered relevant. Within this literature, there were 43 CDS tools located. These were classified into 3 main areas: computer-based tools/questionnaires (n = 8, 19 %), treatment algorithms/models (n = 14, 33 %), and clinical prediction rules/classification systems (n = 21, 49 %). Each of these areas and the associated evidence are described. The state of evidentiary support for CDS tools is still preliminary and lacks external validation, head-to-head comparisons, or evidence of generalizability across different populations and settings. Conclusions CDS tools, especially those employing rapidly advancing computer technologies, are under development and of potential interest to health care providers, case management organizations and funders of care. Based on the results of this scoping review, we conclude that these tools, models and systems should be subjected to further validation before they can be recommended for large-scale implementation for managing patients with MSK disorders.
authors.affiliation: Department of Physical Therapy, University of Alberta, 2-50 Corbett Hall, Edmonton, AB, T6G 2G4, Canada. dgross@ualberta.ca.
authors.forename: Douglas P
authors.initials: DP
authors.lastname: Gross
authors.affiliation: Faculty of Rehabilitation Medicine, University of Alberta, 3-62 Corbett Hall, Edmonton, AB, T6G 2G4, Canada.
authors.forename: Susan
authors.initials: S
authors.lastname: Armijo-Olivo
authors.affiliation: Liberty Mutual Research Institute for Safety, 71 Frankland Road, Hopkinton, MA, 01748, USA.
authors.forename: William S
authors.initials: WS
authors.lastname: Shaw
authors.affiliation: University of Lethbridge, Calgary Campus, Suite S6032, 345 - 6th Avenue SE, Calgary, AB, T2G 4V1, Canada.
authors.forename: Kelly
authors.initials: K
authors.lastname: Williams-Whitt
authors.affiliation: Algoma University, 1520 Queen Street East, CC 303, Sault Ste. Marie, ON, P2A 2G4, Canada.
authors.forename: Nicola T
authors.initials: NT
authors.lastname: Shaw
authors.affiliation: University of Southern Denmark, Odense, Denmark.|Center for Muscle and Joint Health, Nordic Institute of Chiropractic and Clinical Biomechanics, Campusvej 55, 5230, Odense M, Denmark.
authors.forename: Jan
authors.initials: J
authors.lastname: Hartvigsen
authors.affiliation: Faculty of Rehabilitation Medicine, University of Alberta, 3-62 Corbett Hall, Edmonton, AB, T6G 2G4, Canada.
authors.forename: Ziling
authors.initials: Z
authors.lastname: Qin
authors.affiliation: Faculty of Rehabilitation Medicine, University of Alberta, 3-62 Corbett Hall, Edmonton, AB, T6G 2G4, Canada.
authors.forename: Christine
authors.initials: C
authors.lastname: Ha
authors.affiliation: Department of Physical Therapy, University of Alberta, 2-50 Corbett Hall, Edmonton, AB, T6G 2G4, Canada.
authors.forename: Linda J
authors.initials: LJ
authors.lastname: Woodhouse
authors.affiliation: Institute for Work & Health, 481 University Avenue, Suite 800, Toronto, ON, M5G 2E9, Canada.
authors.forename: Ivan A
authors.initials: IA
authors.lastname: Steenstra
mesh_terms: D020000:Decision Support Systems, Clinical; D004185:Disability Evaluation; D006233:Persons with Disabilities; D006801:Humans; D009140:Musculoskeletal Diseases / Q000175:diagnosis / Q000503:physiopathology / Q000534:rehabilitation*; D062707:Return to Work
keywords: Back pain; Decision support techniques; Decision-making; Musculoskeletal; Return to work; Sick leave