Phone: 866-782-6258

The Future of Clinical Prediction Rules

Stephen C. Allison, PT, PhD

October 17, 2012



Where do you see CPRs headed in the future of Physical Therapy?


I see us coming to some convergence on some of the controversies that surrounds CPRs.  First of all, on what to call them. Do we keep calling them CPRs which sounds like, "Annie, Annie, are you OK?" Do we call them Clinical Decision Rules which the Brits like to call them? Do we call them Clinical Prediction Guides - CPGs?  That is problematic because it sounds like a Clinical Practice Guideline which also uses the abbreviation CPGs. Nobody even knows what abbreviation to use consistently.

I think that once people get out there and start publishing books-  This book [Glynn PE, Weisbach PC. Clinical Prediction Rules: A Physical Therapy Reference Manual. Boston: Jones &Bartlett; 2011.] published last year by Glynn and Weisbach is going to have an influence.  You will start seeing those books show up in PT schools and people will learn the nomenclature. Glynn and Weisbach call them Clinical Prediction Rules. So, I think there will be a convergence in the nomenclature.  

And I think there will also be some resolution in some of the other controversies which are pretty interesting.  They are fairly polarized. I myself submitted a letter to the editor when the Australian group of authors lead by Hancock, Herbert and Maher [Physical Therapy 2009 89:1009-110;doi:10.2522/ptj.2009.89.10.100] submitted a very strong criticism of all existing interventional CPRs in Physical Therapy.  They basically called them all junk. (I may be being too harsh there.)  But that was the bottom line saying that they were all derived from single-arm trials, and you can't trust any of them. They are no good.  I submitted a response - a letter to the editor - and they replied back. It is interesting that there are differing perceptions and differing opinions among experts about the direction that we are headed with this. But I think the debate is healthy, and that we will see a resolution of this debate over time.  It is an evolution, so a 10 year timeframe is interesting.  10 years ago, we had zero.  No one had even thought about using this approach or developing these tools for Physical Therapists to use to make clinical decisions. The next 10 years should probably see even more change and perhaps even more clarity about accepted standards for this stuff. 

stephen c allison

Stephen C. Allison, PT, PhD

Stephen C. Allison is a physical therapist engaged in teaching, research, and consultation. He holds degrees from Brigham Young University (BS), Baylor University (MPT), the U.S. Army War College (MSS), and The University of Texas at Austin (PhD). He was a faculty member and Director of the U.S. Army-Baylor University Graduate Program in Physical Therapy at Fort Sam Houston, Texas from 1994 - 2001. He has numerous publications in peer-reviewed journals and serves as an Associate Editor for the Journal of Orthopaedic and Sports Physical Therapy. Dr. Allison currently holds faculty appointments at Baylor University and Rocky Mountain University of Health Professions, where he holds the Evidence in Motion Chair in Evidence-Based Practice. Dr. Allison is also working for the US Army Research Institute for Environmental Medicine to develop computational and statistical models to predict injury and physical performance deficits in military training. He is a nationally known speaker and an expert on the integration of research evidence in clinical practice.

Related Courses

Breaking Down Research for the Physical Therapist Assistant
Presented by Kevin Cezat, PT, DPT, GCS
Recorded Webinar


Kevin Cezat, PT, DPT, GCS
Course: #4665Level: Introductory2 Hours
  'Very interesting and knowledgeable'   Read Reviews
This course will review the common terminology and definitions used within research and the role of research literature within physical therapy practice. We will review example techniques for breaking down the quality of research and ways to implement research within therapy practice.

Understanding Data and Statistics for the Physical Therapist
Presented by Kevin Cezat, PT, DPT, GCS
Recorded Webinar


Kevin Cezat, PT, DPT, GCS
Course: #4708Level: Intermediate2 Hours
  'It made me pause and really think'   Read Reviews
This course will review definitions and guidelines on data and statistical tools commonly used within research and their application to physical therapy programming. We will review example research article breakdowns and the knowledge translation process to identify how to accurately manipulate, interpret, and implement data and statistics into your physical therapy practice.

Improving Your Professional Writing: Tips to Assignment and Publishing Success
Presented by Teresa Fair-Field, OTD, OTR/L
Recorded Webinar


Teresa Fair-Field, OTD, OTR/L
Course: #3988Level: Intermediate1 Hour
  'The breakdown of the presentation components was extremely helpful '   Read Reviews
This course aims to elevate your writing skills and improve the ability to communicate in academic, professional and research environments. Learners will examine tricky writing conventions, citations, writing organization, and professional voice, along with the chart writing habits we need to un-learn to communicate outside of our profession! This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.

Supporting the LGBTQ Senior in Healthcare
Presented by Kathleen D. Weissberg, OTD, OTR/L, CMDCP, CDP, CFPS
Recorded Webinar


Kathleen D. Weissberg, OTD, OTR/L, CMDCP, CDP, CFPS
Course: #4096Level: Intermediate2 Hours
  'Excellent research backed information'   Read Reviews
This training describes the required elements for responding to the emerging needs of long term care communities to provide sensitive and respectful services to LGBT elders. The training reviews definitions related to sexual orientation and gender identity challenges experienced by LGBT older adults, and strategies for communication and policies that honor residents' rights. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT and PTA.

Alzheimer's and Other Dementias: Overview for Healthcare Professionals
Presented by Megan L. Malone, MA, CCC-SLP
Recorded Webinar


Megan L. Malone, MA, CCC-SLP
Course: #4864Level: Introductory1 Hour
  'The course is concise and very helpful to patient care'   Read Reviews
An overview for healthcare professionals about Alzheimer’s disease and related disorders is provided in this course. Characteristics of the dementias, such as symptoms, progression, and how they are diagnosed, are described. Care planning strategies for improving communication with patients and families, understanding and managing behavioral challenges, and promoting independence are also discussed.

Our site uses cookies to improve your experience. By using our site, you agree to our Privacy Policy.