Practical use of a framework (the HOAC II) for clinical reasoning with complex pain patients

What is it about?

This case problem describes the diagnostic process and subsequent interventions for an elite athlete with subacute low back pain. The patient, a long-distance speed skater, complained of pain localized in the left lumbopelvic region, radiating in the left gluteal region and posterior aspect of the left thigh. The diagnostic process as described in this case report is based on the Hypothesis-Oriented Algorithm for Clinicians II (HOAC II). The HOAC II describes a method for monitoring a plan of care and altering care when needed. The focus of the HOAC algorithm on patient-centered outcomes was an innovation which laid a foundation for the implementation of the algorithm in clinical decision making.

Featured Image

Photo by A. Zuhri on Unsplash

Photo by A. Zuhri on Unsplash

Why is it important?

Structured clinical reasoning processes lead to more complete diagnostic process and hypothesis building, taking into account the multi-factorial underlying mechanisms, much like the ICF does with the RPS-form (Stucki , Steiner)