Article

OBJECTIVE: To validate clinical vignettes as a measure of physiotherapists'
activity and work recommendations given to patients with non-specific low back pain. DESIGN: Validation study comparing two methods for measuring aspects of
health providers' clinical management: Clinical vignettes and unannounced visits
of standardized patients (the gold standard). SETTING: Outpatient physiotherapy clinics. SUBJECTS: Physiotherapists
(N = 59) who consented to see unannounced
standardized patients in their clinical practice. MAIN MEASURES: Clinical
vignettes were used to initially measure physiotherapists' self-reported activity
and work recommendations. Subsequently, actors performing as standardized
patients visited physiotherapists in their clinical practice and rated the advice
given by the physiotherapist regarding activity and work.
A total of 23
standardized patients were randomly scheduled to physiotherapists.
Physiotherapists were blinded towards the standardized patients. To test whether
standardized patients were detected, physiotherapists reported if they suspected
that they had treated an actor. RESULTS: The 23 standardized patients visited 22
different physiotherapists. Physiotherapists detected 12 out of 23 unannounced
standardized patients (detection rate: 52%). The estimated agreement between the
two measures was poor, for both activity and work recommendations (weighted kappa
coefficients: 0.29 resp. -0.21). CONCLUSION: The poor concordance between
clinical vignettes and standardized patients indicates the potentially limited
validity of clinical vignettes as a measure of health providers' activity and
work recommendations in low back pain practice.
CI - (c) The Author(s) 2015.

Langue : ANGLAIS