Table 4:
Inappropriately used clinical practices
| Category of care | Inappropriate use (total) | Underuse | Overuse | |||||||
|---|---|---|---|---|---|---|---|---|---|---|
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| No. of total practices (no. of unique practices)* | No. of studies (no. of findings) | Median (IQR), % | No. of total practices | No. of studies (no. of findings) | Median (IQR), % | No. of total practices | No. of studies (no. of findings) | Median (IQR), % | ||
| Diagnostics | Laboratory test | 5 (5) | 9 (11) | 48.4 (26.4–73.0) | 5 | 9 (11) | 48.4 (26.4–73.0) | 0 | 0 (0) | – |
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| Referral | 10 (9) | 11 (13) | 43.0 (31.7–56.2) | 8 | 10 (11) | 45.7 (31.0–57.0) | 2 | 2 (2) | – | |
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| Assessment | 35 (34) | 32 (66) | 38.2 (24.0–63.7) | 29 | 25 (59) | 39.1 (24.3–65.8) | 6 | 6 (7) | 25.1 (3.0–42.0) | |
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| Screening | 12 (11) | 17 (21) | 29.6 (14.1–68.3) | 7 | 9 (10) | 68.3 (53.0–82.7) | 5 | 8 (11) | 14.2 (2.9–22.2) | |
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| Blood test | 25 (22) | 27 (65) | 24.7 (16.4–38.8) | 10 | 14 (42) | 27.8 (18.2–49.0) | 15 | 13 (23) | 22.4 (3.5–35.1) | |
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| Imaging | 43 (35) | 34 (77) | 13.8 (4.5–29.0) | 15 | 15 (25) | 21.3 (13.4–36.7) | 28 | 21 (52) | 9.7 (3.0–24.9) | |
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| Multiple diagnostics | 4 (4) | 4 (5) | 54.0 (28.6–75.3) | 4 | 4 (5) | 54.0 (28.6–75.3) | 0 | 0 (0) | – | |
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| Subtotal | 134 (120) | 89 (258) | 28.0 (12.7–50.4) | 78 | 52 (163) | 35.2 (21.3–61.8) | 56 | 42 (95) | 13.2 (3.3–28.1) | |
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| Therapeutics | Acute care procedure | 10 (10) | 12 (16) | 53.5 (21.8–71.4) | 6 | 6 (7) | 72.2 (51.5–97.3) | 4 | 6 (9) | 22.0 (16.3–56.3) |
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| Biophysical therapy | 29 (26) | 28 (42) | 45.8 (19.2–64.8) | 18 | 18 (28) | 57.5 (36.2–78.0) | 11 | 12 (14) | 18.4 (6.4–32.1) | |
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| Psychosocial therapy | 9 (9) | 11 (31) | 37.8 (30.5–54.2) | 9 | 11 (31) | 37.8 (30.5–54.2) | 0 | 0 (0) | – | |
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| Medications | 70 (62) | 69 (159) | 25.9 (5.8–60.2) | 32 | 34 (71) | 51.1 (24.0–71.0) | 38 | 39 (88) | 10.6 (1.7–38.5) | |
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| Multiple therapeutics | 1 (1) | 1 (1) | – | 1 | 1 (1) | – | 0 | 0 (0) | – | |
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| Subtotal | 119 (108) | 108 (249) | 34.0 (10.0–61.1) | 66 | 60 (138) | 51.1 (30.1–71.0) | 53 | 55 (111) | 13.6 (3.0–38.9) | |
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| Total | 253 (228) | 174 (507) | 30.0 (12.0–56.6) | 144 | 94 (301) | 43.9 (23.8–66.3) | 109 | 95 (206) | 13.6 (3.2–30.7) | |
Note: IQR = interquartile range.
*
Unique practices: excludes practices that are both underused and overused (n = 25).