Editor in Chief, Chad Cook, offers up an editorial on the
potential pitfalls of Clinical Prediction Rules (CPR). A CPR, for the uninitiated, is a decision making algorithm derived from a statistical analysis based on patient characteristics. For example, there are CPRs which can help decide the need for an ankle radiograph, and those which indicate the type of treatment indicated for someone with low back pain.
The CPR has become popular in rehabilitation research recently, with CPRs being developed to help prescribe treatment for a variety of conditions. As with any research, a critical analysis is important to determine how the findings impact your practice:
there is little debate that carefully constructed CPRs can improve
clinical practice, to my knowledge, there are no guidelines that
specify methodological requirements for CPRs for infusion into all
clinical practice environments. Guidelines are created to improve the
rigor of study design and reporting. The following editorial outlines
potential methodological pitfalls in CPRs that may significantly weaken
the transferability of the algorithm. Within the field of
rehabilitation, most CPRs have been prescriptive; thus, my comments
here are reflective of prescriptive CPRs."