Optimizing management of musculoskeletal pain disorders in primary care (SUPPORTPRIM)

Optimizing management of musculoskeletal pain disorders in primary care (SUPPORTPRIM) Musculoskeletal disorders are the number one cause of years lived with disability worldwide. In Norway, every fourth patient in primary care suffers from musculoskeletal disorders. The benefits from treatment are modest however, and knowledge of best practice is limited. The SUPPORTPRIM project will address these challenges in two main steps: 1) To optimise person-centered care, we will employ innovative methods from artificial intelligence using an approach called Case-Based Reasoning to build a clinical decision support system that uses patient data already collected from patients who have received primary care physiotherapy. Case-Based Reasoning aims to guide new treatment decision-making based on the outcomes in similar patients who received the treatment in the past. Previous cases with musculoskeletal disorders will be used to help similar cases in the future, just as humans learn from their own experience. The study team will then assess the efficacy of the clinical decision support system in physiotherapy practice in a randomised controlled trial in Norway. 2) This effort will be expanded to general practice in Norway by implementing a stratified care approach, involving the matching of patients with musculoskeletal disorders to specific treatments, using the Keele STarT MSK Tool. The efficacy of the stratified care approach will be assessed in a randomized controlled trial in general practice. Finally, the clinical decision support system from physiotherapy practice will be extended and adapted to fit general practice. State-of-the-art personalized treatment plans are envisioned to benefit a much larger proportion of patients with musculoskeletal disorders than a "one-size-fits-all" approach. SupportPRIM facilitates and emphasizes the co-decision process between the patient and physiotherapist.

Musculoskeletal disorders (MSDs) is the number one cause of years lived with disability andreduced health worldwide. In Norway, every fourth patient in primary care suffers from MSDs. Treatment effects are however modest and knowledge of best practice limited. The SUPPORTPRIM project will address these challenges in two main steps:1) To optimize person-centered care, we will employ innovative methods from artificial intelligence in terms of Case-Based Reasoning to build a clinical decision support system (cDSS ) based on patient data already collected in primary care physiotherapy. Case-Based Reasoning aims to solve new problems based on the solutions to similar problems in the past. In other words, previous MSD cases will be used to help similar cases in the future, just as humans learn from their own experience. We will then assess the efficacy of the cDSS in physiotherapy practice in a randomised controlled trial.2) This effort will be expanded to general practice by implementing The STarT MSK screening Tool as basis for stratified care for MSD patients. The efficacy of the stratified care will be assessed in a randomized controlled trial in general practice. Finally, the cDSS from physiotherapy practice will be extended and adapted to fit general practice. State-of-the-art personalized treatment plans are envisioned to benefit a much larger proportion of MSD patients than a "one-size-fits-all" approach. In addition, SupportPRIM facilitates and emphasizes the co-decision process between the patient and physiotherapist. The innovative approach using artificial intelligence to develop personalised decision support systems are far beyond current state of art, is highly relevant for other patient groups in health care, and can be integrated in future medical record systems.