J Orthop Sports Phys Ther. 2020 Mar;50(3):118-120. doi: 10.2519/jospt.2020.0603.
Clinicians who provide high-value musculoskeletal care offer evidence-based management that can improve pain, function, and quality of life. However, the current approach to improving outcomes emphasizes treatment strategies at the expense of accurate diagnosis. Guidelines rarely provide quality information on differential diagnosis and prognosis. The disconnect is worrying, because accurate diagnosis can lead to more appropriate care and improved patient outcomes. In this Viewpoint, we reflect on how the clinician can refine musculoskeletal diagnoses to provide high-value care. We (1) argue that the link between musculoskeletal diagnosis and patient outcomes must be strengthened, (2) introduce a diagnostic framework to help clinicians go beyond "special tests," and (3) present new methods for researchers to move forward from diagnostic accuracy studies. .
提供高价值肌肉骨骼护理的临床医生提供基于证据的管理,可以改善疼痛、功能和生活质量。然而,目前改善结果的方法强调治疗策略,而忽略了准确的诊断。指南很少提供有关鉴别诊断和预后的质量信息。这种脱节令人担忧,因为准确的诊断可以导致更合适的护理和改善患者的结果。在这篇观点文章中,我们反思了临床医生如何改进肌肉骨骼诊断以提供高价值的护理。我们(1)认为必须加强肌肉骨骼诊断与患者结果之间的联系,(2)引入一个诊断框架,帮助临床医生超越“特殊检查”,(3)提出新的方法,以便研究人员从诊断准确性研究中向前推进。