DOS 2018

DOS Kongressen 2018 · 267 Effect of extended scope physiotherapists assessments in orthopaedic diagnostic setting: a systematic review Jeanette Trøstrup, Carsten Bogh Juhl, Lone Ramer Mikkelsen Forskningsenheden, Center for Planlagt Kirurgi, Regionshospitalet Silkeborg, Hospitalsenhed Midt; Muskuloskeletal Funktion og Fysioterapi (FoF) Institut for Idræt og Biomekanik, SDU Background: Patients with musculoskeletal diseases referred to an outpatient orthopaedic clinic can potentially be assessed by an extended scope physio- therapist (ESP) instead of an orthopaedic surgeon (OS). Purpose / Aim of Study: To evaluate the diagnostic accuracy, cost and patient satisfaction of the musculoskeletal assessment performed by ESP compared to OS. Materials and Methods: MEDLINE, Cochrane Central Register of Controlled Trials, EMBASE, CINAHL, PEDro and reference lists of included studies and pre- vious reviews were searched in November 2015. Studies were included if they 1) evaluated adults with a musculoskeletal disease referred to an outpatient or- thopaedic clinic where a diagnostic assessment had been conducted by an ESP and 2) evaluated one of our primary (diagnostic agreement, costs and satisfac- tion) or secondary outcomes (wait time and relevant referrals). Data were ex- tracted using a customised data extraction sheet. Two reviewers independently evaluated the methodological quality using checklists, and classified risk of bias in high, moderate and low. Findings / Results: We included one randomised controlled trial and 31 ob- servational studies. Diagnostic agreement between ESPs and OSs ranged from 65 to 100% across studies. Health care cost savings for diagnostic assessments performed by ESPs were between 27 and 49% compared to OSs. Overall, be- tween 77 and 100% of the patients were satisfied with the ESP assessment. Conclusions: Diagnostic assessments performed by ESP may be at least as beneficial than assessment performed by OSs in terms diagnostic agreement, costs and satisfaction. However, the methodological quality of included studies was generally too low to determine the clear effectiveness of ESP assessment, and more high quality studies are needed. 208.