ArticlePhysiotherapy Canada. Physiotherapie Canada2013
Evaluation of an advanced-practice physical therapist in a specialty shoulder clinic: diagnostic agreement and effect on wait times.
Article in Physiotherapy Canada. Physiotherapie Canada, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 3 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
33 citing papers in PubMed, 3 syntheses or guidelines pooled it, 80 citations in OpenAlex.
- Patient satisfaction with advanced practice physiotherapy internationally: A systematic mixed studies review.PloS one · 2026Pooled it
- Effects on health and process outcomes of physiotherapist-led orthopaedic triage for patients with musculoskeletal disorders: a systematic review of comparative studies.BMC musculoskeletal disorders · 2020Pooled it
- What is orthopaedic triage? A systematic review.Journal of evaluation in clinical practice · 2015Pooled it
- No major difference in perceived quality of care in patients with hip or knee osteoarthritis assessed in a physical therapy-led triage compared with standard care: a randomized controlled trial.BMC musculoskeletal disorders · 2023Trial
- Physiotherapist as primary assessor for patients with suspected knee osteoarthritis in primary care-a randomised controlled pragmatic study.BMC musculoskeletal disorders · 2019Trial
- Perceived quality of physiotherapist-led orthopaedic triage compared with standard practice in primary care: a randomised controlled trial.BMC musculoskeletal disorders · 2016Trial
- Trial
- Triage models for surgical decision-making in patients with shoulder pain: an integrative review.Pain reports · 2026Review
- A service evaluation of a newly implemented Advanced Physiotherapy Practitioner led shoulder instability service.Shoulder & elbow · 2026Article
- Joint Efforts: A Review of Large Joint and Bursa Steroid Injections and Aspirations by Primary Care Physicians.Journal of general internal medicine · 2025Review
- The Impact of a Physiotherapy-Led Virtual Clinic in a South Australian Hospital: A Quantitative and Qualitative Investigation.Healthcare (Basel, Switzerland) · 2025Article
- Using Best-Worst Scaling Survey to Investigate the Relative Importance of Attributes Associated with Public Hospital Outpatient Appointments.The patient · 2025Article
- High Patient Satisfaction with Examination by Advanced Practice Physiotherapists in an Orthopaedic Outpatient Shoulder Clinic: A Cross-Sectional Study Using Quantitative and Qualitative Methods.Physiotherapy Canada. Physiotherapie Canada · 2022Article
- Clinician's Commentary on Bødskov et al.Physiotherapy Canada. Physiotherapie Canada · 2022Article
- A physiotherapy triage service for orthopaedic upper limb service: an effective way to reduce clinic visits and identify patients for operative intervention.Irish journal of medical science · 2022Observational
- Patient gender does not influence referral to an orthopaedic surgeon by advanced practice orthopaedic providers: a prospective observational study in Canada.BMC health services research · 2021Observational
- Inter-professional agreement and collaboration between extended scope physiotherapists and orthopaedic surgeons in an orthopaedic outpatient shoulder clinic - a mixed methods study.BMC musculoskeletal disorders · 2021Article
- Telehealth and Physical Therapy Clinical Decision Making in a Patient with a Falcine Meningioma.International journal of telerehabilitation · 2020Article
- Measuring Advanced/Extended Practice Roles in Arthritis and Musculoskeletal Care in Canada.ACR open rheumatology · 2020Article
- Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeTo examine the role of an advanced-practice physiotherapist (APP) with respect to (1) agreement with an orthopaedic surgeon on diagnosis and management of patients with shoulder problems; (2) wait times; and (3) satisfaction with care.
methodsThis prospective study involved patients with shoulder complaints who were referred to a shoulder specialist in a tertiary care centre. Agreement was examined on seven major diagnostic categories, need for further examination and surgery, and type of surgical procedure. Wait times were compared between the APP- and surgeon-led clinics from referral date to date of initial consultation, date of final diagnostic test, and date of confirmed diagnosis and planned treatment. A modified and validated version of the Visit-Specific Satisfaction Instrument assessed satisfaction in seven domains. Kappa (κ) coefficients and bias- and prevalence-adjusted kappa (PABAK) values were calculated, and strength of agreement was categorized. Wait time and satisfaction data were examined using non-parametric statistics.
resultsAgreement on major diagnostic categories varied from 0.68 (good) to 0.96 (excellent). Agreement with respect to indication for surgery was κ=0.75, p<0.001; 95% CI, 0.62-0.88 (good). Wait time for APP assessment was significantly shorter than wait time for surgeon consultation at all time points (p<0.001); the surgeon's wait time was significantly reduced over 3 years. High satisfaction was reported in all components of care received from both health care providers.
conclusionsUsing experienced physiotherapists in an extended role reduces wait times without compromising patient clinical management and overall satisfaction.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.