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Article ; Online: Inter-rater agreement of the Pain and Disability Drivers Management rating scale.

Naye, Florian / Décary, Simon / Tousignant-Laflamme, Yannick

Journal of back and musculoskeletal rehabilitation

2022 Volume 35, Issue 4, Page(s) 893–900

Abstract: Background: A framework to establish the biopsychosocial patient profile for persons with low back pain has been recently proposed and validated: The Pain and Disability Drivers Management model (PDDM). In order to facilitate its clinical integration, ... ...

Abstract	Background: A framework to establish the biopsychosocial patient profile for persons with low back pain has been recently proposed and validated: The Pain and Disability Drivers Management model (PDDM). In order to facilitate its clinical integration, we developed the PDDM rating scale. Objectives: To determine the inter-rater agreement of the PDDM rating scale. A second objective was to determine if this inter-rater agreement varies according to the complexity of patients' clinical presentation. Methods: We recruited physiotherapists during one-day workshops on the PDDM. We asked each participant to assess two clinical vignettes using the rating scale. One vignette presented a typical clinical presentation (moderate level of difficulty) and one presented an atypical presentation (complex level of difficulty). We determined inter-rater agreement with the proportion of participants who gave the same answer for each PDDM domain. Results: For the typical vignette, the inter-rater agreement per domain was moderate to good (between 0.54 and 0.97). For the complex vignette, the inter-rater agreement per domain was poor to good (between 0.49 and 0.81). The comparison between the two vignettes showed a significant difference (p< 0.01) for nociceptive and cognitive-emotional domains. Conclusion: Overall performance indicates that the rating scale present adequate agreement for clinical use, but specific domains require further development.
MeSH term(s)	Humans ; Low Back Pain/diagnosis ; Low Back Pain/therapy ; Observer Variation ; Physical Therapists ; Reproducibility of Results
Language	English
Publishing date	2022-01-17
Publishing country	Netherlands
Document type	Case Reports ; Journal Article
ZDB-ID	1184721-9
ISSN	1878-6324 ; 1053-8127
ISSN (online)	1878-6324
ISSN	1053-8127
DOI	10.3233/BMR-210125
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Article ; Online: Development and content validity of a rating scale for the pain and disability drivers management model.

Naye, Florian / Décary, Simon / Tousignant-Laflamme, Yannick

Archives of physiotherapy

2022 Volume 12, Issue 1, Page(s) 14

Abstract: Background: Establishing the biopsychosocial profile of patients with low back pain (LBP) is essential to personalized care. The Pain and Disability Drivers Management model (PDDM) has been suggested as a useful framework to help clinicians establish ... ...

Abstract	Background: Establishing the biopsychosocial profile of patients with low back pain (LBP) is essential to personalized care. The Pain and Disability Drivers Management model (PDDM) has been suggested as a useful framework to help clinicians establish this biopsychosocial profile. Yet, there is no tool to facilitate its integration into clinical practice. Thus, the aim of this study is to develop a rating scale and validate its content, to rapidly establish the patient's biopsychosocial profile, based on the five domains of the PDDM. Methods: The tool was developed in accordance with the principles of the COSMIN methodology. We conducted three steps: 1) item generation from a comprehensive review, 2) refinement of the scale with clinicians' feedback, and 3) statistical analyses to assess content validity. To validate the item assessing with Likert scales, we performed Item level-Content Validity Index (I-CVI) analyses on three criteria (clarity, presentation and clinical applicability) with an a priori threshold of > 0.78. We conducted Average-Content Validity Index (Ave-CVI) analyses to validate the overall scale with a threshold of > 0.9. Results: In accordance with the PDDM, we developed a 5-item rating scale (1 per domain) with 4 score options. We selected clinical instruments to screen for the presence or absence of problematic issues within each category of the 5 domains. Forty-two participants provided feedback to refine the scale's clarity, presentation, and clinical applicability. The statistical analysis of the latest version presented I-CVI above the threshold for each item (I-CVI ranged between 0.94 and 1). Analysis of the overall scale supported its validation (Ave-CVI = 0.96 [0.93;0.98]). Conclusion: From the 51 biopsychosocial elements contained within the 5 domains of the PDDM, we developed a rating scale that allows to rapidly screen for problematic issues within each category of the PDDM's 5 domains. Involving clinicians in the process allowed us to validate the content of the first scale to establish the patient's biopsychosocial profile for people with low back pain. Future steps will be necessary to continue the psychometric properties analysis of this rating scale.
Language	English
Publishing date	2022-05-16
Publishing country	England
Document type	Journal Article
ISSN	2057-0082
ISSN (online)	2057-0082
DOI	10.1186/s40945-022-00137-2
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Article ; Online: New galaxies in the universe of shared decision-making and rheumatoid arthritis.

Barton, Jennifer L / Décary, Simon

Current opinion in rheumatology

2020 Volume 32, Issue 3, Page(s) 273–278

Abstract: Purpose of review: Implementing shared decision-making (SDM) is a top international priority to improve care for persons living with rheumatoid arthritis. Using SDM tools, such as decision aids improve patients' knowledge and support communication with ... ...

Abstract	Purpose of review: Implementing shared decision-making (SDM) is a top international priority to improve care for persons living with rheumatoid arthritis. Using SDM tools, such as decision aids improve patients' knowledge and support communication with their clinicians on treatment benefits and risks. Despite calls for SDM in treat-to-target, studies demonstrating effective SDM strategies in rheumatology clinical practice are scarce. Our objective was to identify recent and relevant literature on SDM in rheumatoid arthritis. Recent findings: We found a burgeoning literature on SDM in rheumatoid arthritis that tackles issues of implementation. Studies have evaluated the SDM process within clinical consultations and found that uptake is suboptimal. Trials of newly developed patient decision aids follow high methodological standards, but large-scale implementation is lacking. Innovative SDM strategies, such as shared goals and preference phenotypes may improve implementation of treat-to-target approach. Research and patient engagement are standardizing measures of SDM for clinical uses. Summary: Uptake of SDM in rheumatoid arthritis holds promise in wider clinicians' and patients' awareness, availability of decision aids, and broader treat-to-target implementation strategies, such as the learning collaborative. Focused attention is needed on facilitating SDM among diverse populations and those at risk of poorer outcomes and barriers to communication.
MeSH term(s)	Arthritis, Rheumatoid/therapy ; Communication ; Decision Making, Shared ; Humans ; Patient Participation ; Physician-Patient Relations
Language	English
Publishing date	2020-03-28
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Review
ZDB-ID	1045317-9
ISSN	1531-6963 ; 1040-8711
ISSN (online)	1531-6963
ISSN	1040-8711
DOI	10.1097/BOR.0000000000000699
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Article ; Online: Optimising management of low back pain through the pain and disability drivers management model: Findings from a pilot cluster nonrandomised controlled trial.

Longtin, Christian / Décary, Simon / Cook, Chad E / Tousignant, Michel / Lacasse, Anaïs / Tousignant-Laflamme, Yannick

Musculoskeletal care

2023 Volume 21, Issue 3, Page(s) 667–682

Abstract: Introduction: Low back pain (LBP) remains the leading cause of disability. The Low Back Pain and Disability Drivers Management (PDDM) model aims to identify the domains driving pain and disability to guide clinical decisions. The objectives of this ... ...

Abstract	Introduction: Low back pain (LBP) remains the leading cause of disability. The Low Back Pain and Disability Drivers Management (PDDM) model aims to identify the domains driving pain and disability to guide clinical decisions. The objectives of this study were to determine the feasibility of conducting a pragmatic controlled trial of the PDDM model and to explore its effectiveness compared to clinical practice guidelines' recommendations for LBP management. Methods: A pilot cluster nonrandomised controlled trial. Participants included physiotherapists and their patients aged 18 years or older presenting with a primary complaint of LBP. Primary outcomes were the feasibility of the trial design. Secondary exploratory analyses were conducted on LBP-related outcomes such as pain severity and interference at 12-week follow-up. Results: Feasibility of study procedures were confirmed, recruitment exceeded our target number of participants, and the eligibility criteria were deemed suitable. Lost to follow-up at 12 weeks was higher than expected (43.0%) and physiotherapists' compliance rates to the study protocol was lower than our predefined threshold (75.0% vs. 57.5%). A total of 44 physiotherapists and 91 patients were recruited. Recommendations for a larger scale trial were formulated. The PDDM model group demonstrated slightly better improvements in all clinical outcome measures compared to the control group at 12 weeks. Conclusion: The findings support the feasibility of conducting such trial contingent upon a few recommendations to foster proper future planning to determine the effectiveness of the PDDM model. Our results provide preliminary evidence of the PDDM model effectiveness to optimise LBP management. Clinical trial registration: Clinicaltrial.gov, NCT04893369.
MeSH term(s)	Humans ; Low Back Pain/therapy ; Outcome Assessment, Health Care ; Pain Management ; Patient Compliance ; Research Design
Language	English
Publishing date	2023-02-07
Publishing country	England
Document type	Clinical Trial ; Controlled Clinical Trial ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2171452-6
ISSN	1557-0681 ; 1478-2189
ISSN (online)	1557-0681
ISSN	1478-2189
DOI	10.1002/msc.1738
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Article ; Online: Higher order thinking about differential diagnosis.

Cook, Chad E / Décary, Simon

Brazilian journal of physical therapy

2019 Volume 24, Issue 1, Page(s) 1–7

Abstract: Background: Differential diagnosis is a systematic process used to identify the proper diagnosis from a set of possible competing diagnoses.: Methods: The goal of this masterclass is to discuss the higher order thinking components of differential ... ...

Abstract	Background: Differential diagnosis is a systematic process used to identify the proper diagnosis from a set of possible competing diagnoses. Methods: The goal of this masterclass is to discuss the higher order thinking components of differential diagnosis. Conclusions: For healthcare providers, diagnosis is one of many necessary components during the clinical decision making process and it is hallmarked by differentiation of competing structures for a definitive understanding of the underlying condition. The diagnostic process involves identifying or determining the etiology of a disease or condition through evaluation of patient history, physical examination, and review of laboratory data or diagnostic imaging; and the subsequent descriptive title of that finding. Whereas differential diagnosis is a varied skill set among all healthcare providers, the concept of a diagnosis is equally germane, regardless of one's background. In theory, a diagnosis improves the use of classification tools, improves clarity and communication, provides a trajectory of treatment, improves understanding of a person's prognosis, and in some cases, may be useful for preventative treatments. To achieve these improvements, one must have an understanding of relation of the clinical utility of tests and measures with diagnosis, and how to best implement these findings in clinical practice. This requires a deeper understanding (higher order thinking) of the role of diagnosis in the management of patients.
MeSH term(s)	Diagnosis, Differential ; Humans ; Physical Examination/methods ; Prognosis
Language	English
Publishing date	2019-01-30
Publishing country	Brazil
Document type	Journal Article ; Review
ZDB-ID	2252917-2
ISSN	1809-9246 ; 1809-9246
ISSN (online)	1809-9246
ISSN	1809-9246
DOI	10.1016/j.bjpt.2019.01.010
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Article ; Online: Letters to the editor: "Treatment based classification systems for patients with non-specific neck pain. A systematic review".

Gerard, Thomas / Naye, Florian / Decary, Simon / Tousignant-Laflamme, Yannick

Musculoskeletal science & practice

2023 , Page(s) 102751

Language	English
Publishing date	2023-04-04
Publishing country	Netherlands
Document type	Letter
ZDB-ID	2888772-4
ISSN	2468-7812
ISSN (online)	2468-7812
DOI	10.1016/j.msksp.2023.102751
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Article ; Online: Response to Letter to the Editor regarding "Concerns for Potential Risk of Bias in Diagnostic Validity Study of Patellofemoral Pain".

Décary, Simon / Desmeules, François

Archives of physical medicine and rehabilitation

2018 Volume 99, Issue 9, Page(s) 1932–1933

MeSH term(s)	Humans ; Pain ; Patellofemoral Pain Syndrome ; Physical Examination
Language	English
Publishing date	2018-06-18
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	80057-0
ISSN	1532-821X ; 0003-9993
ISSN (online)	1532-821X
ISSN	0003-9993
DOI	10.1016/j.apmr.2018.05.018
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Article ; Online: Does the Collaborative Consensus Guidance Statement put the exercise "cart" before the pacing and pharmacological "horses" in long COVID/PASC?

Décary, Simon / Brown, Darren / Davenport, Todd E / Ngeh, Etienne

PM & R : the journal of injury, function, and rehabilitation

2021 Volume 13, Issue 12, Page(s) 1437–1438

MeSH term(s)	Animals ; COVID-19/complications ; Consensus ; Horses ; Humans ; SARS-CoV-2 ; Post-Acute COVID-19 Syndrome
Language	English
Publishing date	2021-11-02
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	2608988-9
ISSN	1934-1563 ; 1934-1482
ISSN (online)	1934-1563
ISSN	1934-1482
DOI	10.1002/pmrj.12718
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Article ; Online: What does it take to facilitate the integration of clinical practice guidelines for the management of low back pain into practice? Part 1: A synthesis of recommendation.

Longtin, Christian / Décary, Simon / Cook, Chad E / Tousignant-Laflamme, Yannick

Pain practice : the official journal of World Institute of Pain

2021 Volume 21, Issue 8, Page(s) 943–954

Abstract: Background: Despite the emergence of multiple clinical practice guidelines (CPGs) for the rehabilitation of low back pain (LBP) over the last decade, self-reported levels of disability in this population have not improved. This may be explained by the ... ...

Abstract	Background: Despite the emergence of multiple clinical practice guidelines (CPGs) for the rehabilitation of low back pain (LBP) over the last decade, self-reported levels of disability in this population have not improved. This may be explained by the numerous implementation barriers, such as the complexity of information and sheer volumes of CPGs. Objectives: The purpose of this study was to summarize the evidence and recommendations from the most recent and high-quality CPGs on the rehabilitation management of LBP by developing an infographic summarizing the recommendations to facilitate dissemination into clinical practice. Methods: We performed a systematic review of high-quality CPGs with an emphasis on rehabilitation approaches. We searched major health-related research databases (e.g., PubMed, CINAHL, and PEDro). We performed quality assessment via the AGREE-II instrument. Contents of the CPGs were synthesized by extracting recommendations, which were then compared to one another to identify consistencies based on an iterative evaluation process. Results: We identified and assessed 5 recent high-quality CPGs. We synthesized 13 recommendations on the rehabilitation management of LBP (2 for screening procedures, 3 for assessment procedures, and 8 involving treatment approaches) and 2 underlying principles were highlighted. These results were then synthetized and illustrated in a concise infographic that serves as a conceptual roadmap that identifies the specific behavior changes (i.e., adoption of CPGs' recommendations) rehabilitation professionals should adopt in order to integrate an evidenced-based approach for the management of LBP. Conclusions: We systematically reviewed the literature for CPGs' recommendations for the physical rehabilitation management of LBP and synthesized the information through an infographic.
MeSH term(s)	Databases, Factual ; Humans ; Low Back Pain/diagnosis ; Low Back Pain/therapy
Language	English
Publishing date	2021-06-08
Publishing country	United States
Document type	Journal Article ; Review ; Systematic Review
ZDB-ID	2151272-3
ISSN	1533-2500 ; 1530-7085
ISSN (online)	1533-2500
ISSN	1530-7085
DOI	10.1111/papr.13033
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Article ; Online: What does it take to facilitate the integration of clinical practice guidelines for the management of low back pain into practice? Part 2: A strategic plan to activate dissemination.

Longtin, Christian / Décary, Simon / Cook, Chad E / Tousignant-Laflamme, Yannick

Pain practice : the official journal of World Institute of Pain

2021 Volume 22, Issue 1, Page(s) 107–112

Abstract: Low back pain (LBP) is the leading cause of disability worldwide among all musculoskeletal disorders despite an intense focus in research efforts. Researchers and decision makers have produced multiple clinical practice guidelines for the rehabilitation ... ...

Abstract	Low back pain (LBP) is the leading cause of disability worldwide among all musculoskeletal disorders despite an intense focus in research efforts. Researchers and decision makers have produced multiple clinical practice guidelines for the rehabilitation of LBP, which contain specific recommendations for clinicians. Adherence to these recommendations may have several benefits, such as improving the quality of care for patients living with LBP, by ensuring that the best evidence-based care is being delivered. However, clinicians' adherence to recommendations from these guidelines is low and numerous implementation barriers and challenges, such as complexity of information and sheer volume of guidelines have been documented. In a previous paper, we performed a systematic review of the literature to identify high-quality clinical practice guidelines on the management of LBP, and developed a concise yet comprehensive infographic that summarizes the recommendations from these guidelines. Considering the wealth of scientific evidence, passive dissemination alone of this research knowledge is likely to have limitations to help clinicians implement these recommendations into routine practice. Thus, an active and engaging dissemination strategy, aimed at improving the implementation and integration of specific recommendations into practice is warranted. In this paper, we argue that a conceptual framework, such as the theoretical domains framework, could facilitate the implementation of these recommendations into clinical practice. Specifically, we present a systematic approach that could serve to guide the development of a theory-informed knowledge translation intervention as a means to overcome implementation challenges in rehabilitation of LBP.
MeSH term(s)	Guideline Adherence ; Humans ; Low Back Pain/diagnosis ; Low Back Pain/therapy ; Musculoskeletal Diseases ; Translational Science, Biomedical
Language	English
Publishing date	2021-06-08
Publishing country	United States
Document type	Journal Article ; Review ; Systematic Review
ZDB-ID	2151272-3
ISSN	1533-2500 ; 1530-7085
ISSN (online)	1533-2500
ISSN	1530-7085
DOI	10.1111/papr.13032
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