Hegedus Eric J, Cook Chad, Lewis Jeremy, Wright Alexis, Park Jin-Young
High Point University, Department of Physical Therapy, High Point, NC 27262, USA.
Physical Therapy Program, Duke University, Durham, NC, USA.
Phys Ther Sport. 2015 May;16(2):87-92. doi: 10.1016/j.ptsp.2014.08.001. Epub 2014 Aug 10.
The use of orthopedic special tests (OSTs) to diagnose shoulder pathology via the clinical examination is standard in clinical practice. There is a great deal of research on special tests but much of the research is of a lower quality implying that the metrics from that research, sensitivity, specificity, and likelihood ratios, is likely to vary greatly in the hands of different clinicians and in varying practice environments. A way to improve the clinical diagnostic process is to cluster OSTs and to use these clusters to either rule in or out different pathologies. The aim of the article is to review the best OST clusters, examine the methodology by which they were derived, and illustrate, with a case study, the use of these OST clusters to arrive at a pathology-based diagnosis.
在临床实践中，通过临床检查使用骨科专项检查（OSTs）来诊断肩部病变是标准做法。关于专项检查有大量研究，但许多研究质量较低，这意味着该研究得出的指标，如敏感性、特异性和似然比，在不同临床医生手中以及不同的实践环境中可能会有很大差异。改进临床诊断过程的一种方法是对OSTs进行聚类，并使用这些聚类来确定或排除不同的病变。本文的目的是回顾最佳的OST聚类，研究其得出的方法，并通过一个案例研究说明如何使用这些OST聚类得出基于病变的诊断。
