The Why, Where, and How Clinical Reasoning Model for the Evaluation and Treatment of Patients with Low Back Pain
The objective of this theoretical clinical reasoning model is to provide a framework to help clinicians integrate linear and non-linear clinical reasoning approaches to minimize clinical reasoning errors related to logically fallacious thinking and cognitive biases.
This masterclass proposes a hypothesis-driven and probabilistic approach that uses clinical reasoning for managing LBP that seeks to eliminate the challenges related to using any single diagnostic paradigm.
This model integrates the why (mechanism of primary symptoms), where (location of the primary driver of symptoms), and how (impact of mechanical input and how it may or may not modulate the patient's primary complaint). The integration of these components individually, in serial, or simultaneously may help to develop clinical reasoning through reflection on and in action. A better understanding of what these concepts are and how they are related through the proposed model may help to improve the clinical conversation, academic application of clinical reasoning, and clinical outcomes.
Riley, S. P., Swanson, B. T., & Cleland, J. A. (2020). The why, where, and how clinical reasoning model for the evaluation and treatment of patients with low back pain. Brazilian Journal of Physical Therapy. Doi: 10.1016/j.bjpt.2020.12.001
Brazilian Journal of Physical Therapy