Table 2 PICOS for the study
Population | - Physiotherapists working in advanced or extended scope of practice, or in a role previously carried out by a member of the medical profession - Adults with orthopaedic/musculoskeletal disorders referred for orthopaedic consultation in all healthcare settings except emergency care |
Intervention | - Orthopaedic/musculoskeletal triage led by physiotherapists, i.e. substitution of a physician with a physiotherapist |
Comparison | - Standard care, i.e. referral by general practitioner and assessment by an orthopaedic surgeon |
Outcomes | Primary outcomes - Patient-reported outcomes, including pain, disability, health state, psychological status, and health-related quality of life - Patient-reported experiences, including patients’ views of the quality of care and satisfaction with care received - Sick-leave Secondary outcomes - Process outcomes; surgery conversion rate (rate of patients that have gone on to have surgery), agreement on treatment approach (both clinicians agreeing regarding the patients’ need for conservative or surgical treatment approach), referral for investigation (the proportion of patients referred onward for investigations), agreement on referral for investigation (both clinicians agreeing that the patient needs investigation), agreement on diagnosis (both clinicians agreeing on the patient’s diagnosis.) - Waiting times - Cost effectiveness (direct or indirect costs) |
Study design | - RCTs - Prospective decision-making agreement studies (inter-rater reliability studies) - Prospective, comparative studies (non-randomised experimental trials, controlled cohort studies, case-control studies and interrupted time series) |
Setting | All healthcare settings except emergency care/trauma or pediatrics |