Development of a clinical decision-support tool for Management of Adolescent knee Pain (The MAP-Knee Tool)

Abstract

Objective This study aimed to develop a clinical decision-support tool (The MAP-Knee Tool) to improve the management of adolescents with non-traumatic knee pain. Methods This multi-step study consisted of five steps ((1-4) initial development and (5) end-user testing with adolescents with or without non-traumatic knee pain and medical doctors). It ended with the first version of the MAP-Knee Tool for the six most common non-traumatic knee pain conditions. The tool includes four components: 1) tool for diagnosing, 2) credible explanations of the diagnoses based on two systematic literature searches and an Argumentative Delphi process with international experts, 3) prognostic factors based on an individual participant data meta-analysis, and 4) option grid including an unbiased presentation of management options based on the available evidence. Results We included seven children/adolescents (8-15 years old) and seven medical doctors for the end-user testing. All four components were revised accordingly, and the text was condensed as the initial draft was too comprehensive. Conclusion We developed a clinical decision-support tool for clinicians and adolescents with non-traumatic knee pain to support the consultation in clinical practice. Practice Implications The tool targets clinicians and adolescents with four components that may decrease diagnostic uncertainty and increase shared decision-making.

The Effectiveness of Using a Clinical Support Tool in Managing Adolescents with Non-Traumatic Knee Pain (MAP-Knee): protocol for a cluster-randomised superiority trial with delayed intervention and embedded realist evaluation

“…After the initial prototype of the tool, including all four components, had been made, we performed end-user testing using think-aloud sessions with adolescents suffering from non-traumatic knee pain, adolescents with no history of knee pain, and medical doctors. (22)…”

“…After the initial prototype of the tool, including all four components, had been made, we performed end-user testing using think-aloud sessions with adolescents suffering from non-traumatic knee pain, adolescents with no history of knee pain, and medical doctors. (22) Before the start of crossover, there will be a 2-week transition period for training the clinicians in using the support tool in their clinical practice. The clinicians will participate in a 1-hour training session with the project manager, where they will be educated on using the MAP-Knee Tool.…”

“…(18)(19)(20) We recently developed a clinical decision-support tool intending to support shared decision-making between adolescents, medical doctors, and parents. The development included systematic literature searches, an Argumentative Delphi process, and end-user involvement (21), ultimately leading to the MAP-Knee Tool (22), which clinicians may use during consultation with adolescents with nontraumatic knee pain. The tool is intended to support the entire consultation, from diagnosing the condition and explaining the condition to providing information regarding possible management options.…”