Methods

The design was a prospective cohort study in the Australian Capital Territory (ACT), Australia and a fault based compensation system. The subjects were people with mild to moderate musculoskeletal injuries who presented to the emergency department within 7 days of an RTC. Outcome Measures were Physical Component Score (PCS) and Mental Component Score (MCS) of the Short Form 36 (SF-36) health status measure; Hospital Anxiety and Depression Scale (HADS); and the Functional Rating Index (FRI). These measures were recorded immediately RTC, and at 6 and 12 months.

Methods and results

A cross-disciplinary group of healthcare providers (the indicatorgroup) prioritized nine evidensbased indicators and standards in a systematic consensus process.

A pilot test including 206 low-back-pain patients was carried out in eight chiropractic clinics.

An audit meeting with the test-clinics was conducted after the test-period, and the indicatorgroup designed the final set of indicators.

The indicator domains were: Anamnesis, test for discogenic back pain, neurology, radiology, classification, exercise therapy, outcome assessment (process and result) and re-evaluation.

Two indicators: outcome assessment as a process-indicator (standard ≥ 95 %, standard reached (95% CI): 95.8 % (91.6 – 98.3)) and outcome assessment as a result-indicator (standard ≥ 50 %, standard reached: 67.7 % (59.9 – 74.8)) met the standards set by the indicatorgroup.

After evaluating the test-results the indicatorgroup decided to maintain all nine indicators, however, lowering the standards on anamnesis, discogenic back pain and classification.