{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T10:10:54Z","timestamp":1780654254867,"version":"3.54.1"},"reference-count":30,"publisher":"Cambridge University Press (CUP)","issue":"6","license":[{"start":{"date-parts":[[2016,4,21]],"date-time":"2016-04-21T00:00:00Z","timestamp":1461196800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["journals.cambridge.org"],"crossmark-restriction":true},"short-container-title":["Prim Health Care Res Dev"],"published-print":{"date-parts":[[2016,11]]},"abstract":"\n Aim<\/jats:title>\n To develop a simple cauda equina syndrome (CES) toolkit to facilitate the\n subjective examination of low back pain patients potentially at risk of CES. To\n undertake preliminary validation of the content of the toolkit.<\/jats:p>\n <\/jats:sec>\n \n Background<\/jats:title>\n CES is a rare condition which can be very challenging to identify in a\n generalist medical setting.<\/jats:p>\n <\/jats:sec>\n \n Method<\/jats:title>\n A three phase iterative design with two stake holder groups; extended\n scope practitioners experienced in managing CES patients and CES\n sufferers.<\/jats:p>\n <\/jats:sec>\n \n Toolkit development<\/jats:title>\n Synthesis of existing CES literature with CES patient data generated from\n in depth interviews.<\/jats:p>\n <\/jats:sec>\n \n Toolkit validation<\/jats:title>\n Content validation of the draft toolkit with CES patients.<\/jats:p>\n <\/jats:sec>\n \n Toolkit validation<\/jats:title>\n Content validation of the draft toolkit with extended scope\n physiotherapists.<\/jats:p>\n <\/jats:sec>\n \n Findings<\/jats:title>\n A three arm toolkit has been developed for use with patients considered by\n the clinician as at risk of developing CES (eg, worsening low back pain with\n symptoms\/signs of progressive sensory-motor deficit in the lower limbs);\n patient expertise, clinical expertise, research and pathways. Uniquely, the\n toolkit drew upon the lived experiences of patients suffering from CES to\n inform the content.<\/jats:p>\n <\/jats:sec>","DOI":"10.1017\/s1463423616000062","type":"journal-article","created":{"date-parts":[[2016,4,21]],"date-time":"2016-04-21T02:54:11Z","timestamp":1461207251000},"page":"559-567","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":14,"title":["Development of a toolkit for early identification of cauda equina\n syndrome"],"prefix":"10.1017","volume":"17","author":[{"given":"Sue","family":"Greenhalgh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carole","family":"Truman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerie","family":"Webster","sequence":"additional","affiliation":[{"name":"Glasgow Caledonian University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Selfe","sequence":"additional","affiliation":[{"name":"Manchester Metropolitan University Brooks"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2016,4,21]]},"reference":[{"key":"S1463423616000062_manual_ref-6","unstructured":"Cauda Equina Charity UK. 2014: (official website).\n Retrieved 3 February 2014 from http:\/\/www.\n 432caudaequinauk.com\/welcome.php"},{"key":"S1463423616000062_manual_ref-2","first-page":"9","article-title":"Cauda equina syndrome","volume":"20","author":"Anthony","year":"2003","journal-title":"UK Casebook"},{"key":"S1463423616000062_manual_ref-24","first-page":"643","article-title":"Urinary retention in adults: diagnosis and management","volume":"77","author":"Selius","year":"2008","journal-title":"American Family Physician"},{"key":"S1463423616000062_manual_ref-27","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1017\/S1463423613000376","article-title":"Developing an early alert system for metastatic spinal cord compression","volume":"16","author":"Turnpenney","year":"2013","journal-title":"Primary Health Care Research and Development"},{"key":"S1463423616000062_manual_ref-20","unstructured":"Mitchell, E. , Rubin, G. and Macleod, U. 2012: Improving\n diagnosis of cancer: a toolkit for general practice. Retrieved 16 January 2015\n from\n www.rcgp.org.uk\/...\/Cancer\/Improving%20Cancer%20Diagnosis%20-%20A%20Toolkit%20for%20General%20Practice%20(2).ashx"},{"key":"S1463423616000062_manual_ref-25","first-page":"1745","article-title":"Evaluation of a toolkit to improve cardiovascular disease screening and treatment for people with type 2 diabetes:protocol for a cluster-randomized pragmatic trial","volume":"11","author":"Shah","year":"2010","journal-title":"Trials [Electronic Resource]"},{"key":"S1463423616000062_manual_ref-21","unstructured":"Monroe, M. 2000: The value of a toolkit. Retrieved 9\n February 2015 from\n http:\/\/www.joe.org\/joe\/2000december\/tt5.php"},{"key":"S1463423616000062_manual_ref-28","doi-asserted-by":"crossref","first-page":"2855","DOI":"10.1002\/art.24858","article-title":"Diagnosing acute nonspecific low back pain: time to lower the red flags?","volume":"60","author":"Underwood","year":"2009","journal-title":"Arthritis and Rheumatology"},{"key":"S1463423616000062_manual_ref-12","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1080\/0268869021000032887","article-title":"Cauda equina syndrome: what is the relationship between timing of surgery and outcome?","volume":"16","author":"Gleave","year":"2002","journal-title":"British Journal of Neurosurgery"},{"key":"S1463423616000062_manual_ref-16","doi-asserted-by":"crossref","first-page":"1019","DOI":"10.1007\/s00586-012-2601-8","article-title":"Complaints of micturition, defecation and sexual function in cauda equina syndrome due to lumbar disk herniation: a systematic review","volume":"22","author":"Korse","year":"2013","journal-title":"European Spine Journal"},{"key":"S1463423616000062_manual_ref-9","first-page":"49","volume-title":"Journal of Trauma and Orthopaedics","author":"Fairbank","year":"2014"},{"key":"S1463423616000062_manual_ref-29","doi-asserted-by":"crossref","first-page":"259","DOI":"10.5014\/ajot.64.2.259","article-title":"Supporting safe driving with arthritis: developing a driving toolkit for clinical practice and consumer use","volume":"64","author":"Vrkljan","year":"2010","journal-title":"American Journal of Occupational Therapy"},{"key":"S1463423616000062_manual_ref-7","doi-asserted-by":"crossref","first-page":"581","DOI":"10.12968\/ijpn.2012.18.12.581","article-title":"Improving pain assessment for patients with cognitive impairment: development of a pain assessment toolkit","volume":"18\/12","author":"Chatterjee","year":"2012","journal-title":"International Journal of Palliative Nursing"},{"key":"S1463423616000062_manual_ref-13","doi-asserted-by":"crossref","unstructured":"Greenhalgh, S. , Truman, C. , Webster, V. and Selfe, J.\n 2014: An investigation into the patient experience of cauda equina syndrome.\n Poster presentation, CSP Congress, Liverpool.","DOI":"10.3233\/PPR-140047"},{"key":"S1463423616000062_manual_ref-19","doi-asserted-by":"crossref","first-page":"S138","DOI":"10.1016\/S1090-3801(09)60467-5","article-title":"Cauda equina syndrome secondary to lumbar disc herniation: pitfalls in clinical pain management","volume":"13","author":"Mestrum","year":"2009","journal-title":"European Journal of Pain"},{"key":"S1463423616000062_manual_ref-14","doi-asserted-by":"crossref","first-page":"23","DOI":"10.3233\/PPR-140047","article-title":"An investigation into the patient experience of cauda equina syndrome (CES)","volume":"36","author":"Greenhalgh","year":"2015","journal-title":"Physiotherapy Practice and Research"},{"key":"S1463423616000062_manual_ref-26","doi-asserted-by":"crossref","first-page":"596","DOI":"10.1097\/BRS.0000000000000079","article-title":"Assessment of cauda equina syndrome progression pattern to improve diagnosis","volume":"39","author":"Sun","year":"2014","journal-title":"Spine"},{"key":"S1463423616000062_manual_ref-3","first-page":"1214","article-title":"Cauda equina syndrome: a review of clinical progress","volume":"122","author":"Bin","year":"2009","journal-title":"Chinese Medical Journal"},{"key":"S1463423616000062_manual_ref-1","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1186\/1471-2296-13-38","article-title":"GPs\u2019 decision-making \u2013 perceiving the patient as a person or a disease","volume":"13","author":"Andr\u00e9","year":"2012","journal-title":"BMC Family Practice"},{"key":"S1463423616000062_manual_ref-8","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1348\/000709900158001","article-title":"Non-formal learning and tacit knowledge in professional work","volume":"70","author":"Eraut","year":"2000","journal-title":"British Journal of Educational Psychology"},{"key":"S1463423616000062_manual_ref-5","doi-asserted-by":"crossref","first-page":"640","DOI":"10.1016\/j.wneu.2013.11.007","article-title":"Timing of surgical intervention in cauda equina syndrome: a systematic review","volume":"81","author":"Chau","year":"2014","journal-title":"World Neurosurge"},{"key":"S1463423616000062_manual_ref-4","unstructured":"Buchanan, E. 2013: How commonly do patients self-report\n subjective symptoms of cauda equina syndrome when asked on a screening form in\n a musculoskeletal triage service. 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