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What makes a CPR a good CPR?

Posted Sep 14 2008 1:31pm

Clelandcpr A new issue of the Journal of Manual and Manipulative Therapy (JMMT) has been posted online. As always, this journal offers a large portion of its content free to you!

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:

"Although 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."

Here is the link to the current issue, where you can download this and other articles, including a look at the criterion validity of special tests for hip labral tears.

Enjoy.
ERIC

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