In the clinic, on the the web, and at professional meetings, I come across PT's all the time who decry Clinical Prediction Rules (CPR's) as 'cookie cutter PT'. This sentiment seems to come from a varied number of reasons. From fear of change, a feeling that their clinical practice is being dictated to them, and a lack of understanding/ignorance. So, what are clinical prediction rules?
John Childs and Josh Cleland wrote an excellent essay in the January 2006 PT Journal that inspired this blog entry. Their message is that CPR's can:
- Improve decision making in the PT practice.
- Provide PTs with diagnostic information gleaned from the H&P the can serve as an accurate predictor calling for more expansive diagnostic testing.
- Assist with subgrouping patients into more specific classifications that allow for better choices for treatment strategies.
- Assist in determining when a particular treatment may not be beneficial.
The end goal for CPRs is to help us change our behavior by using treatments and diagnostics most highly supported by the literature. Unfortunately, changing practice patterns is a difficult task for many of us due to comfort, fear of change, or no desire to improve ones practice.