Abstract
The early identification of high risk, long term musculoskeletal patients is now a reality. However, new generation research is gaining the capacity to produce the accurate prediction of an individual patient's actual future recovery rate, total recovery time and total costs. This is achieved through melding mobile interactive technology, integrated Patient-Reported Outcome (PRO) measures and screening within the bio-psycho-social (BPS) health model. Existing screening methods use either or both physical and BPS tools to provide data and evidence that dichotomises patients into risk categories. These categories are functional impairment levels on specific PROs at defined periods-such as 6 months post-injury; and directly measurable variables-such as total paid days off or total cost. Future methodologies integrate current research oncepts, including decision support software programsand Computer Adaptive Technology (CAT) using Item Response Theory (IRT) to consider both compensable and general population groups. They reflect on statistically analysed test-case data through correlation coefficients, regression analysis, and mathematical modelling. These analytical methods, along with injury specifics, forecast changes in a patient's overall status and the rate at which it does and will occur. This creates a common language and visual history, both retrospective and predictive, that is immediate, easy to use and can be communicated instantly between all stake holders-patient, GP, therapist, specialist and payer. This presentation details these practices and highlights the direction of future methods using real case examples, summarised data as clinical pathway indicators and what it means to the physiotherapy profession. The importance of this work: technology is rapidly altering the way in which patient status is measured and predicted. There is an agenda to move toward decision support software to determine current and future patient outcome status. This philosophy is driven by the international community and is funded by corporate, association and government sectors. Common examples for Australian physiotherapists are the US-FDA PROMIS project, registration of PRO Tools through the PROQOLID-MAPI French database, and the push towards CAT technology using Item Response Theory (IRT). Physiotherapists must choose to embrace and utilise these imminent changes, becoming directive and involved within the process. Alternatively, the risk is having decision methodology and treatment justification dictated by government and corporate policies that relinquish any control and may not reflect patient and therapist interests.