SynthesisBMJ open2019
Musculoskeletal care pathways for adults with hip and knee pain referred for specialist opinion: a systematic review.
Synthesis in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
6 citing papers in PubMed, 7 citations in OpenAlex.
- Use of primary care physiotherapy and its associations with clinical and socioeconomic outcomes in musculoskeletal disorders: a cohort study.Scandinavian journal of primary health care · 2026Article
- Improving Identification and Management of Modifiable Risk Factors in Hip and Knee Osteoarthritis: A Quality Improvement Project in an NHS Orthopaedic Interface Service.Musculoskeletal care · 2026Article
- National and Subnational Models of Care That Support Primary Health Care: A Mixed-Methods Study.The International journal of health planning and management · 2026Article
- Optimizing people's movement across the health system: a scoping review of referral systems within a primary health care approach.Primary health care research & development · 2025Article
- Integrated care policy recommendations for complex multisystem long term conditions and long COVID.Scientific reports · 2024Article
- Using routine referral data for patients with knee and hip pain to improve access to specialist care.BMC musculoskeletal disorders · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveMusculoskeletal care pathways are variable and inconsistent. The aim of this systematic review was to evaluate the evidence for the clinical and/or cost effectiveness of current care pathways for adults with hip and/or knee pain referred for specialist opinion.
designSystematic review. DATA SOURCES: Electronic database searches were carried out in MEDLINE, MEDLINE In-Process, Cumulative Index of Nursing and Allied Health Literature, Embase, PEDro, PubMed, Web of Science, Cochrane Central and Health Management Information Consortium without language restriction from 1990 onwards. Websites were reviewed for grey literature. ELIGIBILITY CRITERIA: All study designs and documents that considered care pathways for adults with musculoskeletal hip and/or knee pain referred for specialist opinion were screened by two reviewers. Risk of bias was assessed using The Critical Appraisal Skills Programme checklist for randomised controlled trials and the Joanna Briggs Institute checklists. DATA EXTRACTION AND SYNTHESIS: Data extraction and quality assessment were performed by one reviewer and checked by a second. Findings are reported narratively.
resultsThe titles and abstracts of 1248 articles were screened and 140 full-text articles retrieved. 19 papers reporting 17 studies met the study inclusion criteria. Quality was low due to study design and methodological flaws. Most of the outcomes relate to organisational process at the 'meso' level of a whole systems approach.
conclusionIt can be concluded that the pathway is not linear, containing variations and activity loops. The available evidence suggests that, from the point of referral for specialist opinion, a model is required that integrates the skills of all the different healthcare professionals and streamlining is required to ensure that individuals are seen by the healthcare professional that best meets their needs. There is very limited evidence of patient experience informing knee and hip care pathways. PROSPERO REGISTRATION NUMBER: CRD42016035510.
Indexed as
Identifiers
What OpenQuestion holds
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.