A qualitative study: Clinical decision making in low back pain

Abstract

Classification systems are available to subgroup patients with acute/nonspecific low back pain (LBP) to determine interventions. The use of classification systems by physical therapists (PT) has little published evidence. The aims of this study were to understand the process PTs use when assessing and determining interventions for patients with acute/nonspecific LBP in outpatient settings and what classification systems, if any, are used in clinical practice. Qualitative methods were used to investigate the decision-making process PTs use when managing patients with LBP. Semi-structured interviews focused on the decision-making process of examination and intervention selection for patients with LBP. Findings were verified through member checking, triangulation, and audit trail. Thirteen PTs were included in the study. Four decision-making preferences emerged from the data: 1) identifying the root cause, 2) eclectic approach, 3) experience-based management, and 4) evidence-based management. Experience, education, and other aspects of the PTs' backgrounds influenced their preferred decision-making style, and use of resources, such as classification systems, varied broadly.