Evaluation of the Contribution of Musculoskeletal Ultrasound to the General Practitioner's Overall Decision-making Strategy

Study Overview
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Brief Summary
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The hypothesis of this study is that musculoskeletal point of care ultrasonography would support the GP's decision and ultimately improve patient management. The aim of this study is to evaluate, in the context of suspected musculoskeletal abnormality, the contribution of musculoskeletal point of care ultrasonography to the general practitioner's overall decision-making strategy, defined according to the following 5 axes: diagnosis (I), therapy (II), patient orientation (III), prescription of complementary examinations (IV) and follow-up (V).

Detailed Description
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The study circuit takes place in a single visit. The investigating physician suspects a musculoskeletal anomaly following an initial clinical examination. The patient (who meets the inclusion criteria and has no non-inclusion criteria) gives consent to participate, after receiving information about the study. The investigator fills in the e-CRF (appendix III), clinical examination, medical interrogation and his or her decisions according to the 5 axes, which cannot be modified, as the structure of the e-CRF planned in advance does not allow backtracking. The investigator performs the targeted musculoskeletal ultrasound with his or her personal ultrasound machine, following his or her usual operating procedure. The investigator fills in the e-CRF with the results of the targeted ultrasound scan and indicates any modifications to the decision axes.

Official Title
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The Contribution of Targeted Musculoskeletal Ultrasound to the General Practitioner's Overall Decision-making Strategy for Patients With Suspected Musculoskeletal Pathology: a Before/After Study

Conditions
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Musculoskeletal; Anomaly

Intervention / Treatment
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* Other: musculoskeletal ultrasound


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Person who has received full information on the organization of the research and has given his/her consent Be over 18 years of age Present a symptomatology leading to suspicion of musculoskeletal pathology Be able to give consent Be affiliated to a social security scheme or benefit from such a scheme Exclusion Criteria: Chronic inflammatory rheumatism (rheumatoid arthritis, spondylitis, psoriatic arthritis, rheumatoid pseudo-polyarthritis, juvenile idiopathic arthritis, lupus, etc.). Subjects benefiting from a legal protection measure (guardianship, curatorship, safeguard of justice). Persons deprived of their liberty by judicial or administrative decision, persons under psychiatric care under articles L3212-1 and L3213-1. Pregnant women Nursing mothers
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Diagnostic
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Patients<br>Patient with musculoskeletal anomalies | Other: musculoskeletal ultrasound<br>* After clinical examination and medical interrogation, The investigating physician gives her decisions in the e-CRF according to the 5 axes: diagnosis (I), therapy (II), patient referral (III), prescription of additional tests (IV) and follow-up (V). The investigator performs the targeted musculoskeletal ultrasound with his personal ultrasound machine, following his usual operating procedure and give/keep the final diagnostic.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Percentage of patients | Percentage of patients for whom the musculoskeletal point of care ultrasonography led to a change in the GP's overall decision-making strategy (binary yes/no variable) of patients for whom led to a change in the GP's overall decision-making strategy (binary yes/no variable) | 3 years | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Frequency of the anatomical sites | Frequency of the different anatomical sites (shoulder, elbow, arm, etc.) and structures (osteoarticular pathologies, tendon and retinacular pathologies, etc.) concerned | 3 years | 
| Frequency of modifications | Frequency of different modifications for each axis and within each axis | 3 years | 
| Frequency of diagnoses of post-CTA confirmation | List and frequency of diagnoses in the case of post-CTA confirmation | 3 years | 
| Frequency of diagnoses of post-CTA modifications | List and frequency of diagnoses in the case of post-CTA modifications | 3 years | 
| Frequency of incidental diagnoses discovered at CTA | Frequency and description of incidental diagnoses discovered at CTA | 3 years | 
| Frequency of modifications per patient | Frequency of different modifications for each axis and within each axis per patient | 3 years | 
| Calculation of the cost | Calculation of the cost before and after CTA estimated a posteriori on the basis of the consultation rate | 3 years | 
| Rates for the examinations and therapies | the rates for the examinations and therapies described | 3 years | 
| Frequency with which CTA | For each doctor: the frequency with which CTA is carried out in his professional practice | 3 years | 
| Time taken to carry out the CTA | For each doctor: the time taken to carry out the CTA | 3 years | 
| Average number of ultrasound prints | For each doctor: the average number of ultrasound image prints | 3 years | 
| Time taken to produce an CTA report | For each doctor: the time taken to produce an CTA report | 3 years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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musculoskeletal anomaly, ultrasonography, general practitioners