A scoping review protocol: Investigating the extent and legal process of cauda equina syndrome claims for UK physiotherapists.

INTRODUCTION: Cauda equina syndrome (CES) is a condition where early identification and treatment is crucial to avoid potentially devastating effects. There is a high number of litigation cases linked with CES given it is a relatively rare condition. This scoping review protocol proposes to explore the extent and process of CES litigation in UK healthcare context cases amongst UK physiotherapists. METHODS AND ANALYSIS: The methodological framework recommended by Arksey and O'Malley, Levac et al. and the Joanna Briggs Institute will be used throughout this review to aid reporting and transparency. A patient and public involvement (PPI) group meeting was convened at the beginning of the review process in order to provide knowledge exchange to inform the search strategy and propose resources to be used during the scoping review. Two reviewers will independently review the literature in order to apply the inclusion and exclusion criteria. Once the studies to be included have been identified, the data from these studies will be extracted and charted. Results will show quantitative data of the studies included in the review and a narrative synthesis of the literature. DISSEMINATION: This scoping review will evaluate the existing knowledge relating to CES and litigation and will map the key concepts around this topic. Results will be disseminated to practitioners and policy-makers through peer-reviewed publications, conferences, reports and social media. This method may prove helpful to others who are investigating extent and processes relating to medicolegal cases involving healthcare practitioners. REGISTRATION: The current paper is registered with OSF registries (DOI 10.17605/OSF.IO/MP6Y3).

A scoping review: Investigating the extent and legal process of cauda equina syndrome claims for UK physiotherapists.

INTRODUCTION: Cauda Equina Syndrome (CES) is a condition where early identification and treatment is crucial to avoid potentially life changing devastating effects. This paper reviews the extent and process of CES litigation amongst UK physiotherapists. METHODS: A well-established framework by Arksey and O'Malley was followed when completing the current scoping review. Records were identified via a comprehensive search of three databases as well as website and grey literature searching. Data was extracted and a descriptive analysis and thematic summary were formed. RESULTS AND DISCUSSION: A total of N = 1639 records were identified, following removal of duplicates and screening of titles and abstracts N = 211 full text records were screened and N = 39 were included for full analysis. CONCLUSIONS: This study is the first to investigate the extent and process of CES litigation for physiotherapists in the UK. Our data suggest that between 2009 and 2021 there were 15 CES claims recorded against physiotherapists which is 0.7% of all CES claims recorded in the UK. In terms of the legal process for CES claims, there is currently limited information for physiotherapists and what steps they would need to take once they receive notification they are being sued. REGISTRATION: The current paper is registered with OSF registries (DOI 10.17605/OSF.IO/6FCXN).

International Framework for Red Flags for Potential Serious Spinal Pathologies.

SYNOPSIS: The International Federation of Orthopaedic Manipulative Physical Therapists (IFOMPT) led the development of a framework to help clinicians assess and manage people who may have serious spinal pathology. While rare, serious spinal pathology can have devastating and life-changing or life-limiting consequences, and must be identified early and managed appropriately. Red flags (signs and symptoms that might raise suspicion of serious spinal pathology) have historically been used by clinicians to identify serious spinal pathology. Currently, there is an absence of high-quality evidence for the diagnostic accuracy of most red flags. This framework is intended to provide a clinical-reasoning pathway to clarify the role of red flags. J Orthop Sports Phys Ther 2020;50(7):350-372. Epub 21 May 2020. doi:10.2519/jospt.2020.9971.