Study characteristics Table 1 Quantitative data summary Papers Country Study design ESP role/setting N = Intervention Outcome measures Key findings Aiken et al 2008 Canada Correlation Ortho TKR/THR cases 38 ESP and surgeon assessment then discussion of plan WOMAC Waiting list priority tool Patient satisfaction Kappa 67% All patients satisfied with care from both clinicians Ball et al 2007 UK Retrospective case note review ED 164 EDPP 142 ENP 127 SHO 135 M.gd 72 Cons No as notes review Chi square Fisher Freeman Halton exact P<0.05 EDPP recorded more advice and more physiotherapy referrals. SHO more medication Bath et al 2012 Canada Retrospective case note review Spinal triage patients Up to 1162 No as notes review Management recommended and if surgery or not 16.7% cases sent for surgery review with high 70% conversion rate (v normal 30%) Bath and Janzen 2012 Canada Prospective observational cohort Spinal triage 108 pts 21 referrers Evaluate satisfaction satisfaction of patients and referrers 66% patients very satisfied 90.5% referrers very satisfied Bath and Phawa 2012 Canada Prospective cohort Spinal triage 108 Triage visit and 4 week review Pain scale ODI SF36v2 Signif.icant improvement pain scale P=0.007 and physical component subscale P<0.001 of SF36v2 Desmeules et al 2013 Canada Prospective cohort Ortho hip and knee 120 Assessment ESP and surgeon. Compare decisions and satisfaction Diagnostic agreement VSQ-9 K=0.86 diagnosis K=0.77 surgery Higher satisfaction score for ESP
Griffiths et al 2013 UK Questionnaire survey Primary care ESP 99 Review surgery conversion for onward referrals Secondary care conversion rate 74% surgery conversion rate Hattam 2004 UK Cross section survey ESP ortho triage 170 Review of decision to refer to orthopaedics Surgeon agreement on referral 70.6% appropriate Heywood 2005 UK Prospective cohort Military spinal clinic 235 ESP assess/management ODI ESP managed 184 cases (78%) without further intervention Kennedy et al 2010 Canada Cross section Ortho 123 ESP review post knee/hip replacement VSQ-9 High ESP satisfaction Mackay et al 2012 Canada Prospective cohort Ortho non surgical hip and knees 87 Baseline and 6 week follow up after ESP Self efficacy Exercise behaviour All self efficacy scales improved. 83% still exercising Mackay et al 2009 Canada Cross section cohort Ortho hip and knee 62 Seen by ESP and orthopaedic surgeon. Compare decisions. Diagnostic accuracy Surgical decision 69% diagnostic agreement K=0.70 for surgery McClellan et al 2012 UK RCT ED 126 ESP 123 ENP 123 Dr ESP v Dr v ENP care of soft tissue injury DASH / LEFS / SF12v2 / SF6D ESP / ENP equivalent outcome to Dr care. McClellan et al 2006 UK Prospective cohort ED 351 ESP v Dr v ENP care Patient satisfaction SF36 VAS Higher satisfaction with ESP care. Ankle cases had very poor study FU rate Moloney 2009 Ireland Clinic evaluation Fracture clinic 60 Satisfaction ESP care satisfaction 98% very good/good Oldmeadow et al 2007 Australia Prospective observational MSK screening 52 ESP review then consultant review and comparison Diagnostic / mgt agreement Satisfaction 74% ESP surgeon agreement High ESP satisfaction from patients and medics Parfitt et al 2012 UK Retrospective review ESP primary care 130 Is surgery listing by ESP correct Surgeon review of decision 127 of 130 had surgery Razmjou et al 2013 Canada Prospective cohort ESP shoulder clinic 100 194 Diagnosis/mgt agreement VSQ-9 Diagnosis k=0.63-0.86 Surgery k=0.75