The person-centered hypothesis framework: Advancing clinical reasoning in musculoskeletal pain management

Abstract

Introduction: The Person-Centered Hypothesis (PCH) framework is a structured clinical reasoning model designed to enhance "in action" reasoning in person-centered care (PCC). The PCH integrates elements of the biopsychosocial model, pain phenotyping, and contextual factors, addressing gaps in real-time clinical decision-making.

Purpose: To describe the proposed PCH framework that synthesizes four domains: dominant pain phenotype(s), relevant clinical patterns, regional and co-existing contributors, and psychosocial and lifestyle influencing factors. This masterclass outlines the clinical use of the PCH framework, its ability to reduce cognitive load, and its alignment with precision medicine principles.

Implications: The PCH integrates with existing care models, offering clinicians a comprehensive and adaptable framework for managing musculoskeletal pain. By emphasizing reflective practice and prioritizing person-centered domains, the PCH helps clinicians navigate the complexities of diverse patient presentations and facilitates targeted evaluation and intervention strategies. While challenges in implementation exist, the PCH has the potential to improve patient outcomes and clinician confidence. Future research and educational initiatives are recommended to refine, validate, and assess the framework's effectiveness and support its adoption in clinical practice.