PMID- 32941698
OWN - NLM
STAT- MEDLINE
DCOM- 20211027
LR  - 20211027
IS  - 1365-2753 (Electronic)
IS  - 1356-1294 (Linking)
VI  - 27
IP  - 5
DP  - 2021 Oct
TI  - Clinical decision-making for shoulder surgery referral: An art or a science?
PG  - 1159-1163
LID - 10.1111/jep.13473 [doi]
AB  - RATIONALE: Decision-making in musculoskeletal health care is complex, with 
      discrepancy among clinical providers and variation in the per cent of referrals 
      for specialist care. To date, there is an increased focus on specialist 
      referrals, risking overuse of expensive testing and contributing to unnecessary 
      treatment. AIMS AND OBJECTIVES: This report will considerer the difficulties of 
      primary care musculoskeletal decision-making using shoulder injuries as an 
      example, presenting a solution based on multi-criteria decision-making analysis 
      with online software. The associated issues involved in clinical decision-making 
      are complex. Contributing to the components of complexity are; the multifaceted 
      aetiology of shoulders, the experience and knowledge of providers, and the burden 
      of patient demands. Notwithstanding, funding considerations, resource allocation 
      availability and other associated issues around clinical decision-making. 
      Considering the many facets and complexities of clinical decision-making, this is 
      an area where multi-criteria decision-making analysis (MCDM) may be appropriate. 
      The MCDM analysis approach is increasingly being used in health care and can 
      assist in the organizing and weighting of identified key clinical factors. MCDM 
      could be applied to the challenges of musculoskeletal care with the potential to 
      decrease decision-making variability. Furthermore, the significance of each key 
      clinical factor that musculoskeletal decision-making is based on are to date 
      unclear. CONCLUSION: Therefore, this preliminary report offers a start towards 
      clarifying key factors and an approach for implementing improved shoulder 
      clinical care decision-making which could then be adapted and applied to other 
      body sites.
CI  - (c) 2020 John Wiley & Sons Ltd.
FAU - Taylor, Karen
AU  - Taylor K
AUID- ORCID: 0000-0002-7183-8033
AD  - Centre for Health, Activity, and Rehabilitation Research, School of 
      Physiotherapy, University of Otago, Dunedin, New Zealand.
FAU - Baxter, George D
AU  - Baxter GD
AD  - Centre for Health, Activity, and Rehabilitation Research, School of 
      Physiotherapy, University of Otago, Dunedin, New Zealand.
FAU - Tumilty, Steve
AU  - Tumilty S
AD  - Centre for Health, Activity, and Rehabilitation Research, School of 
      Physiotherapy, University of Otago, Dunedin, New Zealand.
LA  - eng
PT  - Journal Article
DEP - 20200917
PL  - England
TA  - J Eval Clin Pract
JT  - Journal of evaluation in clinical practice
JID - 9609066
SB  - IM
MH  - Clinical Decision-Making
MH  - *Decision Making
MH  - Humans
MH  - Primary Health Care
MH  - Referral and Consultation
MH  - *Shoulder/surgery
OTO - NOTNLM
OT  - health economics
OT  - healthcare
OT  - practical reasoning
EDAT- 2020/09/18 06:00
MHDA- 2021/10/28 06:00
CRDT- 2020/09/17 17:19
PHST- 2020/07/31 00:00 [revised]
PHST- 2020/03/24 00:00 [received]
PHST- 2020/08/04 00:00 [accepted]
PHST- 2020/09/18 06:00 [pubmed]
PHST- 2021/10/28 06:00 [medline]
PHST- 2020/09/17 17:19 [entrez]
AID - 10.1111/jep.13473 [doi]
PST - ppublish
SO  - J Eval Clin Pract. 2021 Oct;27(5):1159-1163. doi: 10.1111/jep.13473. Epub 2020 
      Sep 17.