Problem-knowledge coupling: a tool for physical therapy clinical practice

The purposes of this article are 1) to summarize the development, function, and philosophy of the Problem-Knowledge Coupler (PKC), a computerized tool that is designed to aid the clinical decision-making process in medical practice, and 2) to speculate on the value this system has in meeting clinical practice, needs and addressing professional practice issues in physical therapy. The evolution of the PKC system from its origins in the problem-oriented system of medical care is described, and the philosophy of problem-knowledge coupling is contrasted to the basic philosophy of traditional clinical medical practice and never computerized expert decision-support systems. We suggest that problem-knowledge coupling could be a useful tool in physical therapy because it improves the collection and synthesis of patient information and uses the unique nature of individual patient problems coupled with the clinical literature as the bases for clinical practice decisions.