{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,17]],"date-time":"2026-05-17T23:35:31Z","timestamp":1779060931449,"version":"3.51.4"},"reference-count":40,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,2,27]],"date-time":"2021-02-27T00:00:00Z","timestamp":1614384000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2021,2,27]],"date-time":"2021-02-27T00:00:00Z","timestamp":1614384000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Med Inform Decis Mak"],"published-print":{"date-parts":[[2021,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Currently the diagnosis of shoulder instability, particularly in children, is difficult and can take time. These diagnostic delays can lead to poorer outcome and long-term complications. A Diagnostic Decision Support System (DDSS) has the potential to reduce time to diagnosis and\u00a0improve outcomes for patients. The aim of this study was to develop a concept map for a future DDSS in shoulder instability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A modified nominal focus group technique, involving three clinical vignettes, was used to elicit physiotherapists decision-making processes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Twenty-five physiotherapists, (18F:7\u00a0M) from four separate clinical sites participated. The themes identified related to \u2018Variability in diagnostic processes and lack of standardised practice\u2019 and \u2018Knowledge and attitudes towards novel technologies for facilitating assessment and clinical decision making\u2019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>No common structured approach towards assessment and diagnosis was identified. Lack of knowledge, perceived usefulness, access and cost were identified as barriers to adoption of new technology. Based on the information elicited a conceptual design of a future DDSS has been proposed. Work to develop a systematic approach to assessment, classification and diagnosis is now proposed.<\/jats:p>\n                    <jats:p>\n                      <jats:italic>Trial Registraty<\/jats:italic>\n                      This was not a clinical trial and so no clinical trial registry is needed.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12911-021-01446-5","type":"journal-article","created":{"date-parts":[[2021,2,27]],"date-time":"2021-02-27T07:02:56Z","timestamp":1614409376000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Implications for the design of a Diagnostic Decision Support System (DDSS) to reduce time and cost to diagnosis in paediatric shoulder instability"],"prefix":"10.1186","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8552-7869","authenticated-orcid":false,"given":"Fraser","family":"Philp","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4865-181X","authenticated-orcid":false,"given":"Alice","family":"Faux-Nightingale","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7623-2866","authenticated-orcid":false,"given":"Sandra","family":"Woolley","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3824-4444","authenticated-orcid":false,"given":"Ed","family":"de Quincey","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2180-197X","authenticated-orcid":false,"given":"Anand","family":"Pandyan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,2,27]]},"reference":[{"issue":"5","key":"1446_CR1","doi-asserted-by":"publisher","first-page":"758","DOI":"10.1177\/03635465030310052001","volume":"31","author":"J Deitch","year":"2003","unstructured":"Deitch J, Mehlman CT, Foad SL, Obbehat A, Mallory M. 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All methods were carried out in accordance with relevant guidelines and regulations. All participants have given their informed consent for participation.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"All participants have given their informed consent for publication.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"In accordance with Springer Nature policy and my ethical obligation as a researcher, I am reporting that Professor Anand Pandyan has received unrestricted educational support from Allergan and Biometrics Ltd., and Honorarium payments from Allergan, Biometrics Ltd, Ipsen, and Merz. These companies are unlikely to be affected by the research reported in the enclosed paper. I have disclosed those interests fully to Springer Nature, and I have in place an approved plan for managing any potential conflicts arising from that involvement. All other authors have no conflict of interest.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"78"}}