Abstract
Aims
The aim of this study was to investigate the agreement of physician assistants (PAs) in the triaging of patients with Low Back Pain (LBP) based on self-reported data.
Patients and methods
A cross sectional vignette study among four PAs was carried out. Vignettes (cases) were constructed including 26 factors that can be self-reported, identified in literature that have predictive value in treatment outcomes (for example red flags indicating serious underlying conditions and yellow flags indicating psychosocial factors). All vignettes were randomly assigned to the PAs who should determine what intervention would be most optimal to the patient (rehabilitation, injections, medications, surgery, primary care psychology, primary care physical therapy). PAs were allowed to advise more than one intervention. Per vignette, 3 PAs were assigned randomly to advise on intervention. Fleish kappas were calculated to determine the interrater reliability.
Results
Twenty-five vignettes were judged by 3 of the 4 PAs. Per advise, Fleish kappa values varied between k=0.65 for surgery and medication to k=0.77 for rehabilitation, which can be interpreted as substantial agreement.
Conclusion
Based on self-reported data provided by patients, PAs can triage patients with substantial agreement. Adding more information based on history, physical examination and imaging, may influence these outcomes. This study adds to the merit of using questionnaires for guiding clinicians in their triaging process.
No conflicts of interest
No funding obtained
