{"doi":"10.1093/ptj/pzaf093","title":"Development and Validation of PT-PENCIL: The Physical Therapy Frequency Clinical Decision Support Tool to Increase Hospital Discharge to Home","abstract":"IMPORTANCE: Identifying patients most likely to benefit from physical therapy in the hospital could aid physical therapists in optimizing treatment allocation for the purpose of increasing discharge to home. OBJECTIVE: The aims of this study were to develop and externally validate a predictive model for discharge to home on the basis of physical therapy frequency for patients who were hospitalized. DESIGN: A predictive model was developed using retrospective cohort data collected between April 2017 and August 2022, with external validation conducted in a separate sample. SETTING: The setting was a large health system. PARTICIPANTS: Participants were adult patients who were hospitalized and received physical therapy. MAIN OUTCOME AND MEASURES: Predictors were extracted from the electronic health record and included demographics, clinical characteristics, and therapist-entered variables such as home set-up and prehospital level of function. Physical therapy frequency was quantified as once daily, defined as ≥5 times per week. The outcome was discharge to home. Variables were included in the final multivariable logistic regression model on the basis of associations with physical therapy frequency and/or outcome and clinical relevance. Calibration and discrimination of the models were assessed. RESULTS: The development sample included 205,659 adult patient (average age = 72.2 [SD = 14.3] years; 55.3% female) hospitalizations, with 52.5% of patients receiving physical therapy daily and an overall proportion of 67.1% being discharged to home. The final multivariable model included 8 variables, with good calibration and discrimination. Internal validity was established with an optimism-corrected concordance statistic of 0.874 (95% CI = 0.872-0.875). The external sample included 102,311 patient (average age = 67.7 [SD = 16.5] years; 50.9% female) admissions, with 64.5% of patients receiving physical therapy daily and 77.8% being discharged to home. Predictive performance was high (calibration slope = 0.908), and discrimination was good (concordance statistic = 0.851). CONCLUSIONS AND RELEVANCE: This study developed and externally validated the underlying prediction model for a clinical decision support tool, termed Physical Therapy Frequency Clinical Decision Support Tool (PT-PENCIL), to identify patients most likely to benefit from daily physical therapy to discharge to home. Future work will evaluate the implementation of PT-PENCIL to determine its effect on patient-centered outcomes.","journal":"Physical Therapy","year":2025,"id":553492,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":1,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9556,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1450487,"name":"Sandra Passek","orcid":null,"position":1,"is_corresponding":false},{"id":1450101,"name":"Andrew Schuster","orcid":"0000-0002-0907-3199","position":2,"is_corresponding":false},{"id":762743,"name":"Mary Stilphen","orcid":null,"position":3,"is_corresponding":false},{"id":708963,"name":"Kate I. Minick","orcid":"0000-0003-4683-1937","position":4,"is_corresponding":false},{"id":462847,"name":"Dave S. Collingridge","orcid":"0000-0002-5796-1166","position":5,"is_corresponding":false},{"id":1450488,"name":"Beth Hunt","orcid":null,"position":6,"is_corresponding":false},{"id":946709,"name":"Devyn Woodfield","orcid":null,"position":7,"is_corresponding":false},{"id":717965,"name":"Michael B. Rothberg","orcid":"0000-0002-2063-1876","position":8,"is_corresponding":false},{"id":762164,"name":"Joshua K. Johnson","orcid":"0000-0001-7077-232X","position":9,"is_corresponding":false},{"id":816298,"name":"Brittany Lapin","orcid":"0000-0002-4314-2282","position":0,"is_corresponding":true}],"reference_count":40,"raw_metadata":null,"created_at":"2026-07-19T02:54:41.819682Z","pmid":"40652311","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}