A Study of Outcomes Following Collaborative Medical Doctor/Physical Therapist Primary Care Service for Musculoskeletal Problems

Background and Purpose: Collaborative medical doctor/physical therapist primary care services are not described in the literature. The 2 purposes of this observational study were to describe a collaborative medical doctor/physical therapist primary care service, and to describe simple, one question, outcomes including patient acceptable symptom state (PASS), global rating of normal function (GRNF), and success of treatment (SOT) at intake, 1 to 7 days, and 45 to 60 days follow-up. Methods: Patients were seen for 1 to 2 visits and typically received exercise, hands on treatment, ie, manual therapy, and education. Medical doctor/physical therapist collaborative encounters and provider training are described. Outcome measures were recorded at the first visit, via phone once between 1 to 7 days and once between 45 to 60 days. Descriptive data was calculated at each time point. Findings: Examples of collaborative diagnosis and treatment opportunities are tabulated. A total of 31.9% of patients were PASS Yes at intake (n=402). At 1 to 7 days (n=157; 50.3%) and 45 to 60 days (n=93; 55.9%), the proportion of PASS Yes patients were higher. There was little difference in the GRNF scale at any follow-up. At 45 to 60 days, the SOT question indicated most patients (45.7%) reported “improved” and 29.3% of patients reported as “partly cured” or “cured.” Clinical Relevance: Collaborative opportunities for diagnosis and treatment in primary care are provided. A model using the PASS, GRNF, and SOT questions for judging the urgency which a service needs modification to meet patient needs is proposed. Conclusion: A collaborative medical doctor/physical therapist model is a viable option to improve primary care services. This descriptive data suggests some level of success, however, there is little relevant data for comparison

Predicting Patients Acceptable Symptom State at Short Term Follow Up of a Collaborative Primary Care PT/MD Service

Hypothesis: Patient Reported Outcome Tools will predict a patient’s acceptable symptom state (PASS

Chromosome Xq23 is associated with lower atherogenic lipid concentrations and favorable cardiometabolic indices

Abstract Autosomal genetic analyses of blood lipids have yielded key insights for coronary heart disease (CHD). However, X chromosome genetic variation is understudied for blood lipids in large sample sizes. We now analyze genetic and blood lipid data in a high-coverage whole X chromosome sequencing study of 65,322 multi-ancestry participants and perform replication among 456,893 European participants. Common alleles on chromosome Xq23 are strongly associated with reduced total cholesterol, LDL cholesterol, and triglycerides (min P = 8.5 × 10−72), with similar effects for males and females. Chromosome Xq23 lipid-lowering alleles are associated with reduced odds for CHD among 42,545 cases and 591,247 controls (P = 1.7 × 10−4), and reduced odds for diabetes mellitus type 2 among 54,095 cases and 573,885 controls (P = 1.4 × 10−5). Although we observe an association with increased BMI, waist-to-hip ratio adjusted for BMI is reduced, bioimpedance analyses indicate increased gluteofemoral fat, and abdominal MRI analyses indicate reduced visceral adiposity. Co-localization analyses strongly correlate increased CHRDL1 gene expression, particularly in adipose tissue, with reduced concentrations of blood lipids