October 1995 AAOS Report

Algorithms pilot field test underway

The Academy's Oversight Committee on Guidelines has begun a pilot field test of its Knee Pain and Low Back Pain Phase I algorithms. The results of the pilot test will assist the committee in evaluating the Phase I algorithms' potential for improving clinical and resource outcomes. The first step in the process will be to establish if the guidelines are perceived to be appropriate and usable to first-contact physicians who would be considered the initial "customers." Once the content and feasibility for using the algorithms has been established, the Academy can then make a decision about engaging in more extensive and expensive validity and utility testing. Four focus groups are being used as the primary method for assessing the face validity of the algorithms' content. The first two focus groups are comprised of eight to 10 primary care physicians in full-time managed care practice settings or in independent or group practice where managed care comprises greater than 20 percent of patient volume. A third focus group comprised of orthopaedic surgeons also will review the algorithms. Based on the interactive discussions of the these focus groups, it is anticipated that some modifications to the algorithms will be considered. A fourth focus group of primary care physicians will review and assess the revised algorithms to determine if greater acceptance of the product has been achieved. All of the focus groups will complete a specific rating tool to assess the algorithms for various attributes prior to a group discussion. The pilot field test is expected to be completed by late November. At that time, the Oversight Committee on Guidelines will consider utilizing a limited-use test to supplement the feedback received from the focus groups. As a second step in assessing face validity, the limited-use testing only will assess whether the algorithm was perceived to be practical by the physician after briefly using it in his practice.

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