Digital Assessment Routing Tool (DART): Pilot Study
Validation and Implementation of a Digital Assessment Routing Tool (DART) as an Alternative to Physiotherapy-led Remote Triage for Musculoskeletal Disorders: Protocol for a Pilot Randomised Crossover Non-inferiority Trial
1 other identifier
interventional
78
1 country
1
Brief Summary
In the pilot study, we aim to explore trial design, assess procedures, and collect exploratory data to inform the design of a future Randomised Controlled Trial. The intervention involves a Digital Assessment Routing Tool (DART) that provides triage outcomes with recommended management pathways for participants with musculoskeletal problems. Participants complete DART either before or after their consultation with usual care clinicians (Physiotherapy-led remote triage). The triage outcome dispositions between DART and usual care clinicians will be compared. A panel will be formed to provide consensus on disagreements that may result in adverse triage outcomes, as well as on a sample of agreements between DART and usual care clinicians.
Trial Health
Trial Health Score
Automated assessment based on enrollment pace, timeline, and geographic reach
participants targeted
Target at P50-P75 for not_applicable
Started May 2022
Shorter than P25 for not_applicable
1 active site
Health score is calculated from publicly available data and should be used for screening purposes only.
Trial Relationships
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Study Timeline
Key milestones and dates
First Submitted
Initial submission to the registry
March 19, 2021
CompletedFirst Posted
Study publicly available on registry
May 27, 2021
CompletedStudy Start
First participant enrolled
May 30, 2022
CompletedPrimary Completion
Last participant's last visit for primary outcome
July 25, 2022
CompletedStudy Completion
Last participant's last visit for all outcomes
July 25, 2022
CompletedJanuary 23, 2023
May 1, 2021
2 months
March 19, 2021
January 18, 2023
Conditions
Keywords
Outcome Measures
Primary Outcomes (1)
The agreement rate between triage outcomes with management pathways from physiotherapy-led and DART triage assessments.
The primary outcome measure will be the agreement rate of triage decisions made by both the clinician and the Digital Assessment Routing Tool (DART). The possible triage outcomes with management pathways are classified in three categories, namely 1) Medical care, 2) Physiotherapy care, and 3) Self-management. 1. Medical care * A\&E referral * Urgent GP * Routine GP * Consultant review * Physiotherapy care 2. Post-fracture or surgery physiotherapy * Physiotherapy referral * Physiotherapy referral plus psychosocial support * Self-management 3. Self-management * Self-management with SOS * Continue self-management advice
Immediately after the intervention.
Other Outcomes (3)
Proportion of participants identified, shown interest to participate, and recruited to the study.
Through study completion, an average of 3 months.
The number of errors reported in randomisation, allocation concealment, blinding or data collection.
Immediately after the intervention.
Time burden (in minutes) of interventions.
Immediately after the intervention.
Study Arms (2)
1. Digital Assessment Routing Tool (DART) 2. Physiotherapy-led remote triage
EXPERIMENTALParticipants complete the Digital Assessment Routing Tool (DART), which is followed by physiotherapy-led remote triage with the usual care clinician.
1. Physiotherapy-led remote triage 2. Digital Assessment Routing Tool (DART)
EXPERIMENTALParticipants complete their physiotherapy-led remote triage with the usual care clinician, which is followed by the Digital Assessment Routing Tool.
Interventions
DART is a first contact web-based and mobile health system that uses clinical algorithms to triage patients and recommend management pathways. Participants complete an online web-based questionnaire that follows a clinical reasoning process commonly observed in face-to-face physiotherapy consultations. Based on the participant's answers, the clinical algorithm generates sets of questions, leading up to a triage disposition with recommended management pathway. The triage outcomes with management pathways are classified; 1. Medical care * A\&E referral * Urgent GP * Routine GP * Consultant review 2. Physiotherapy care * Post-fracture or surgery physiotherapy * Physiotherapy referral * Physiotherapy referral plus psychosocial support 3. Self-management * Self-management with SOS * Continue self-management advice
Participants will receive usual physiotherapy-led remote triage services by a registered health care professional. This service is either a telephone or video consult and includes any diagnostic procedure (e.g. patient history, remote assessments) and treatment, such as management advise or home-based exercise therapy. Participants may seek help elsewhere or opt-out the study at any point, which will not affect their usual physiotherapy-led remote care
Eligibility Criteria
You may qualify if:
- A current musculoskeletal injury for which they are seeking treatment
- Over 18 years old
- Able to read and speak English
- Live in the UK
- Able to access the internet
You may not qualify if:
- Cognitive impairments or learning disabilities that limits the participants to follow study- related procedures
- Unwillingness or inability to follow protocol-related procedures
- Optima Health employees
- Has an assessment from a health care professional for the same condition within the last 7 days
Contact the study team to confirm eligibility.
Sponsors & Collaborators
- Queen Mary University of Londonlead
- Optima Healthcollaborator
Study Sites (1)
Haydock Medical Centre
St Helens, Herts, WA11 0NA, United Kingdom
Related Publications (2)
Lowe C, Sephton R, Marsh W, Morrissey D. Evaluation of a Musculoskeletal Digital Assessment Routing Tool (DART): Crossover Noninferiority Randomized Pilot Trial. JMIR Form Res. 2024 Jul 30;8:e56715. doi: 10.2196/56715.
PMID: 39078682DERIVEDLowe C, Hanuman Sing H, Marsh W, Morrissey D. Validation of a Musculoskeletal Digital Assessment Routing Tool: Protocol for a Pilot Randomized Crossover Noninferiority Trial. JMIR Res Protoc. 2021 Dec 13;10(12):e31541. doi: 10.2196/31541.
PMID: 34898461DERIVED
MeSH Terms
Conditions
Study Officials
- PRINCIPAL INVESTIGATOR
Dylan Morissey, PhD
Queen Mary University of London
Study Design
- Study Type
- interventional
- Phase
- not applicable
- Allocation
- RANDOMIZED
- Masking
- TRIPLE
- Who Masked
- CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
- Masking Details
- The investigator will be blinded for group intervention and outcomes data-analysis.
- Purpose
- OTHER
- Intervention Model
- CROSSOVER
- Sponsor Type
- OTHER
- Responsible Party
- SPONSOR
Study Record Dates
First Submitted
March 19, 2021
First Posted
May 27, 2021
Study Start
May 30, 2022
Primary Completion
July 25, 2022
Study Completion
July 25, 2022
Last Updated
January 23, 2023
Record last verified: 2021-05
Data Sharing
- IPD Sharing
- Will not share