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Table 3.

The usefulness of each patient characteristic in predicting whether a clinical scenario containing that characteristic was rated inappropriate or appropriate for each therapy (i.e., the percent of scenarios each characteristic helps classify)

Patient characteristics*Predicting a rating of
inappropriate**
Predicting a rating of
appropriate**
MobilizationManipulationMobilizationManipulation
Presence of red flags100.0%100.0% 65.3%35.0%

Prior unfavorable experience with spinal manual therapy86.3%86.3% 51.6% 61.0%

Major neurologic findings18.7%86.3%41.5%27.1%

Previous non-manual conservative care failed13.0%24.5%------

Additional (e.g., advanced imaging) testing show cervical disc herniation, stenosis, or foraminal osteophytosis6.5%2.9%***100.0% 100.0%

Clinically substantial traumatic etiology---21.9%30.7%23.5%

No signs of painful/limited active range of motion---4.7%------

Radiographs showing advanced spinal degeneration------26.0%65.3%

No cervical nerve root radiculopathy------7.6%---

Joint dysfunction in upper cervical spine---------14.8%

No local pathology---------11.9%

Continued psychosocial stress------------

*The patient characteristics are all fully defined in the Appendix.

**Predictions of a rating of inappropriate were versus ratings of equivocal or appropriate. Predictions of appropriate were versus ratings of equivocal or inappropriate.

***Tests negative for serious pathology included here with other test results.

= This patient characteristic predicts this rating.

= This patient characteristic predicts against this rating.