SynthesisBMC musculoskeletal disorders2020
Effects on health and process outcomes of physiotherapist-led orthopaedic triage for patients with musculoskeletal disorders: a systematic review of comparative studies.
Synthesis in BMC musculoskeletal disorders, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 1 of them a synthesis that pooled it.
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
26 citing papers in PubMed, 1 synthesis or guideline pooled it, 49 citations in OpenAlex.
- The educational pathway to Advanced Practice for the physiotherapist: A systematic mixed studies review.PloS one · 2025Pooled 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 or physician as primary assessor for patients with suspected knee osteoarthritis in primary care - a cost-effectiveness analysis of a pragmatic trial.BMC musculoskeletal disorders · 2022Trial
- In safe hands - patients with knee and hip osteoarthritis expectations and experience of physical therapist-led triage in a secondary care setting.BMC musculoskeletal disorders · 2026Article
- Practice Areas, Skills, and Core Competencies of Advanced Practice Physiotherapists Working in Tertiary Care in Germany: Protocol for a 3-Round Delphi Study to Establish Expert Consensus.JMIR research protocols · 2026Article
- "A very good program … but I still have the knee problem": A qualitative study exploring patient acceptability of physiotherapy-led osteoarthritis services.Osteoarthritis and cartilage open · 2026Article
- Integrating Physical Therapy into Primary Care to Enhance Veteran Access to Healthcare: Findings from the Veterans Health Administration's PACT-PT Program.Journal of general internal medicine · 2026Article
- Factors influencing referrals amongst allied health and medical practitioners managing people with musculoskeletal conditions in Australian primary care.BMC health services research · 2026Article
- Economic evaluation of advanced practice physiotherapy models of care for upper extremity musculoskeletal disorders In Denmark: a registry-based cohort study.The European journal of health economics : HEPAC : health economics in prevention and care · 2026Article
- Patients and Advanced Practice Physiotherapists' Experiences and Perceptions in a Specialized Spine Model of Care: A Qualitative Study.Physiotherapy Canada. Physiotherapie Canada · 2026Article
- Redefining Urogynaecology Services: The Impact of Nurse-Physiotherapist Triage Clinics on Reducing Delays and Improving Patient Care.International urogynecology journal · 2026Article
- Implementation of Direct Access Physiotherapy Policy in Saudi Arabia: Insights from Practicing Physiotherapists: A Cross-Sectional Study.Risk management and healthcare policy · 2026Article
- Using Best-Worst Scaling Survey to Investigate the Relative Importance of Attributes Associated with Public Hospital Outpatient Appointments.The patient · 2025Article
- Patient and clinician perceptions of telehealth in musculoskeletal physiotherapy services - A systematic review of the evidence-base.PLOS digital health · 2025Article
- What is the global perspective on advanced practice physiotherapy: A qualitative study across five countries.PloS one · 2025Article
- General practitioners experience multi-level barriers to implementing recommended care for hip and knee osteoarthritis: a qualitative study.BMC primary care · 2024Article
- Addressing Health Care Access Disparities Through a Public Health Approach to Physical Therapist Practice.Physical therapy · 2024Article
- The Musculoskeletal 30-question multiple choice questionnaire (MSK-30): a new assessing tool of musculoskeletal competence in a sample of Italian physiotherapists.BMC musculoskeletal disorders · 2024Article
- The Referrer Matters. Musculoskeletal Surgical Conversion Rates: A Systematic Review With Meta-Analysis.Health services insights · 2024Article
- The educational pathway to Advanced Practice for the physiotherapist: Protocol for a systematic mixed studies review.PloS one · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPhysiotherapist-led (PT-led) orthopaedic triage is an evolving model of care for patients with musculoskeletal disorders. Objectives for this study were to establish the current evidence body on the impact of PT-led orthopaedic triage on health, quality, and service outcomes for patients referred for orthopaedic consultation, compared with standard (orthopaedic surgeon) care.
methodsMedline, EMBASE, Scopus and CINAHL were searched from inception until 7 May 2018; search updated 24 April 2020. Search terms (including derivatives) included physiotherapy, advanced/extended scope, musculoskeletal/orthopaedic, triage. The search was framed as Population = patients referred for orthopaedic consultation; Intervention = PT-led orthopaedic triage; Comparison = standard care; Outcomes = health, quality and process outcomes. Only randomised controlled trials (RCTs) and prospective comparative cohort studies were eligible for inclusion. Screening, study selection, data extraction, and assessment of methodological quality were performed independently by reviewer pairs. Quality was scored with the Downs and Black checklist. Certainty of evidence was determined using GRADE. PROSPERO registration number CRD42017070950.
resultsWe included two RCTs and eleven cohort studies (n = 1357 participants) of variable methodological quality (range 14-23 of possible 28). Certainty of evidence was low to moderate. There was no difference between PT-led orthopaedic triage and standard care for patient-reported outcomes (two RCTs). Perceived quality of care with PT-led orthopaedic triage was higher (two RCTs, four cohort studies) or equal (one cohort study) compared with standard care. PT-led orthopaedic triage had higher surgery conversion rates (one RCT, three cohort studies) (55-91% vs 22-38%), lower (two RCTs) or equal rate (two cohort studies) of referral for investigations, shorter waiting times (one RCT, one cohort study), and lower costs (one RCT). Furthermore, there was high agreement between physiotherapists' and orthopaedic surgeons' treatment approach (eight cohort studies), referral for investigation (five cohort studies), and diagnosis (nine cohort studies). Study limitations were the low number of RCTs, and variable methodological quality.
conclusionsEvidence of low to moderate certainty suggests that PT-led orthopaedic triage leads to similar diagnostic decisions as standard care, has a higher conversion-to-surgery rate, reduces waiting times, is cost effective and valued by patients, and that health outcomes are equivalent.
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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.