A challenge to improve the Quality of Care.Rehabilitation outcome measures in the Emergency Department: a scoping review.
Bibliographic record
Abstract
BACKGROUND: The integration of physiotherapists within Emergency Departments (EDs) is increasing internationally; however, the outcome measures employed in this setting remain heterogeneous and largely non-standardized. OBJECTIVE: To map and describe clinical, functional, psychological, prognostic, and patient experience outcome measures currently used by physiotherapists working in EDs. METHODS: A scoping review was conducted following PRISMA-ScR guidelines. PubMed and Google Scholar were searched from their inception to November 2025. Studies were included if they involved patients of any age presenting to the ED with musculoskeletal, traumatic, vestibular conditions or concussion, where physiotherapists applied or reported at least one standardized outcome measure. Two reviewers independently screened titles, abstracts, and full texts. RESULTS: Of 9,790 records identified, 27 met eligibility criteria. Most research originated from Australia, Canada, the United Kingdom, Ireland, and the United States, primarily involving low-complexity musculoskeletal conditions, vestibular disorders, and concussion, including pediatric pathways. Pain intensity scales (NPRS, VAS) and pain interference (BPI-PI) were the most commonly used measures. Functional and disability outcomes (NDI, ODI/mODI, LEFS, QuickDASH, PROMIS Physical Function, PSFS) were predominantly applied during post-ED follow-up. Psychological and prognostic instruments (PCS, STarT Back, 5P Rule) supported risk stratification, while PREMs such as PedsQL Healthcare Satisfaction, SAPS, and VSQ-9 assessed patient experience. Considerable heterogeneity in outcome measurement remains, with few randomized trials, limited long-term follow-up, and scarce economic evaluations. No studies were identified from Italy or Southern Europe. CONCLUSIONS: The use of validated outcome measures by physiotherapists in EDs is feasible and clinically valuable; however, a lack of standardization and limited high-quality evidence particularly within the Italian healthcare context highlight the need for further research to establish shared outcome sets and transferable models of care.
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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 | 0.133 | 0.348 |
| Meta-epidemiology (narrow) | 0.002 | 0.002 |
| Meta-epidemiology (broad) | 0.010 | 0.007 |
| Bibliometrics | 0.021 | 0.025 |
| Science and technology studies | 0.002 | 0.003 |
| Scholarly communication | 0.012 | 0.015 |
| Open science | 0.006 | 0.005 |
| Research integrity | 0.007 | 0.006 |
| Insufficient payload (model declined to judge) | 0.007 | 0.002 |
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".