| Are components of a comprehensive medical assessment predictive of work disability after an episode of occupational low back trouble? | |
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MedLine Citation:
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PMID: 12461398 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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STUDY DESIGN: One hundred fifty-nine subacute low back work-injured patients completed a full medical assessment at baseline. A full repeat examination was performed 3 months later, when return-to-work status was determined. OBJECTIVE: To determine the prognostic value of a comprehensive medical assessment for the prediction of return-to-work status. SUMMARY OF BACKGROUND DATA: A systematic review of the work disability prediction literature of low back trouble prognosis revealed that no high-quality studies included a full medical history and physical examination in the design. The results of studies included in the systematic review were equivocal with respect to predictive usefulness of medical variables. METHODS: Participants completed medical history questionnaires and then were clinically examined by one of six experienced examiners (three physicians and three physiotherapists). Return-to-work status was measured 3 months later, and predictive validity was evaluated using logistic regression modeling. RESULTS: Medical variables (, medical history subscales, physical examination subscales, and lumbar range-of-motion tests) showed modest correct classification rates varying between 61.6% and 69.1% for participants. CONCLUSIONS: Comprehensive medical assessments play a crucial role in the early identification of serious pathology after low back trouble. We were unable to identify, however, any medical evaluation variables that would account for significant proportions of variance in return to work. The weight of evidence obtained in this study suggests that injured workers' subjective interpretations and appraisals may be more powerful predictors of the course of postinjury recovery than exclusively medical assessments. |
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Authors:
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David G Hunt; Oonagh A Zuberbier; Allan J Kozlowski; Jonathan Berkowitz; Izabela Z Schultz; Ruth A Milner; Joan M Crook; Dennis C Turk |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Spine Volume: 27 ISSN: 1528-1159 ISO Abbreviation: Spine Publication Date: 2002 Dec |
Date Detail:
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Created Date: 2002-12-03 Completed Date: 2003-01-15 Revised Date: 2009-07-09 |
Medline Journal Info:
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Nlm Unique ID: 7610646 Medline TA: Spine (Phila Pa 1976) Country: United States |
Other Details:
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Languages: eng Pagination: 2715-9 Citation Subset: IM |
Affiliation:
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Workers Compensation Board of British Columbia, Vancouver, British Columbia, Canada. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Back Injuries
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complications,
diagnosis*,
rehabilitation British Columbia Disability Evaluation* Disabled Persons / classification Humans Logistic Models Low Back Pain / diagnosis*, etiology, rehabilitation Lumbosacral Region Medical History Taking* Occupational Diseases / complications, diagnosis*, rehabilitation Outcome Assessment (Health Care)* Physical Examination* Predictive Value of Tests Prognosis Range of Motion, Articular Rehabilitation, Vocational Reproducibility of Results Risk Factors Work Capacity Evaluation |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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