Treatment decisions after interdisciplinary evaluation for nonarthritic hip pain: A randomized controlled trial.
Lindsey Brown-Taylor, Marcie Harris-Hayes, Randi Foraker and 3 others
PMID 34181823WHAT IT FOUND
Interdisciplinary evaluation did not significantly increase physical therapy inclusion compared to standard care, but patients reported lower decisional conflict.
The study was underpowered, so these findings suggest potential benefits for shared decision-making rather than proving superior treatment planning.
Key findings
01The proportion of participants including physical therapy in their post-evaluation plan was higher in the interdisciplinary group (66%) than the standard group (48%), but this difference was not statistically significant.
02Participants in the interdisciplinary group reported significantly lower decisional conflict regarding their post-evaluation treatment plan compared to the standard group.
03Most participants who changed their minds after interdisciplinary evaluation were not initially interested in physical therapy but included it in their final plan, whereas most who changed minds after standard evaluation removed it.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study was underpowered because it recruited 78 participants instead of the planned 96, so it could not reliably detect differences in physical therapy inclusion. Randomization occurred before the surgeon confirmed the final eligibility diagnosis, which may have introduced bias. There was no blinding, and the content of the provider-patient discussions was not recorded, so the specific factors driving decisional conflict changes are unknown. The study only evaluated treatment plans and decisional conflict, not actual treatment delivery or long-term patient outcomes.
Declared interests
The authors declared no conflicts of interest. The study was funded by the National Institutes of Health, which played no role in the design, conduct, or reporting of the study.
The easy way to misread this
Do not conclude that interdisciplinary evaluation is proven to increase physical therapy referrals. The primary outcome was not statistically significant, and the study was underpowered. The reduction in decisional conflict was significant but is a secondary finding in a feasibility trial.