Do you personally have a Diagnostic Accuracy cutoff in terms of diagnostic factors to determine if you would use the test?
No, but if there are multiple tests available I look at the most accurate ones. I do not really like it when clinicians do every test available just because.
Are we image happy?
X-ray, MRI, Ultrasound – it is visual, so it gives us something to see
But blood tests do not really give us that. It has to be done against controls.
Having every injury get an MRI would be great, but it is cost-prohibitive for a lot of people
“If we are sending every patient to get an ultrasound image, then why are we there?”
Talk about treating the patient vs treating the image or diagnostic test.
- In Athletics, the nice thing is most injuries are life-threatening.
- But for internal injuries MRIs are lifesavers.
It is hard to argue with an x-ray showing a fracture
What is the conversation you would have with parents before the season begins about your confidence in your evaluations and role at the school?
If I think we can treat them here we will if I think they need imaging I will refer them to our team doctor and he can order the images.
Mention this though: “a non-sports medicine doctor will likely default to out two weeks” once they do that we are obligated to follow that before beginning rehab and return to play work.
Is there any uncertainty in using diagnostic accuracy values in Athletic Training?
YES! There is untold value – the new ATs have learned this but it is a new development in AT education.
How do we make Diagnostic Accuracy Language more universal?
It is growing as we have more and more ATs learning about it as part of their education.
More talks at conventions with catchy names
When would you not focus on diagnostic accuracy measures?
In short, yes you can go with your gut and try a few other tests when things seem off.
How do you get students to buy-in?
This is how you win arguments.
If someone questions you and your evaluation you Have numbers and research to back it up…this usually will end the argument.
Make them understand it is not just statistics.
Some orthopedic tests have minimum research or no reported value, where does proof of the value come in?
Yes, you can still do the test if there is a value that is not reported.
Usually, this requires MRI proof.
Some conditions do not have a good test
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Dr. Mark Knoblauch – maknobla@Central.UH.EDU
Dr. Layci Harrison – lharris5@Central.UH.EDU
Bob Marley – Bob.Marley@uth.tmc.edu
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