Improving the referral process for orthopedic services: Results of the rehabilitation medicine access program (orthopedics)
Bibliographic record
Abstract
LAY SUMMARY Many non-acute muscle and skeletal injuries can be rehabilitated with conservative management, such as physiotherapy or physiatry, rather than orthopedic surgery. In the primary care centre, the authors noted that almost half of patients with non-acute muscle and skeletal injuries referred to orthopedic surgery did not need orthopedic intervention. Referrals to orthopedic surgery, for which conservative management is more appropriate, contribute to wait times and delay the recovery process. To improve access to conservative management and reduce the demand for orthopedic services, this study looked at the benefits of using physiotherapists to screen electronic medical records (EMRs) to determine if patients needed orthopedic intervention or conservative management. The results show physiotherapy screening increased the percentage of patients referred to orthopedic surgery that truly required orthopedic intervention from 47.9% to 63.7%. This emerging practice may lead to shorter wait times for patients to see an orthopedic surgeon, fewer in-person assessments, and improved access to conservative treatment.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.011 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.006 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".