What clinicians say they advise for low back pain is not what they actually do in clinical practice

In this study actors were trained to simulate patients with non-specific low back pain. The participating physiotherapists were initially asked what they would do for sample clinical vignettes. They were then told they would have an actor visit them for an appointment at an unknown time in the future. The simulated patients consulted physiotherapists in clinical practice to capture the advice given by physiotherapists on how to cope with their disabling pain. The advice given to the actors differed from what physiotherapists initially said they would do based on the clinical vignettes. The poor agreement between what physiotherapists said they would do for the vignettes, and what they actually did with the actors illustrates the potentially insufficient validity of vignettes as measures of clinical behaviour.

In conclusion, this study showed that healthcare professionals (physiotherapists) do not make the decisions they say they would make for people with low back pain.

Emanuel Brunner is a PhD student at the University of Leuven, in Belgium, under the supervision of Professor Michel Probst and Professor Wim Dankaerts. The PhD project is conducted at Zurich University of Applied Sciences, Switzerland. In addition to his research, Emanuel works in clinical practice with patients suffering from complex chronic pain disorders at Kantonsspital Winterthur, Switzerland.

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