Document Detail


Are components of a comprehensive medical assessment predictive of work disability after an episode of occupational low back trouble?
MedLine Citation:
PMID:  12461398     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Spine     Volume:  27     ISSN:  1528-1159     ISO Abbreviation:  Spine     Publication Date:  2002 Dec 
Date Detail:
Created Date:  2002-12-03     Completed Date:  2003-01-15     Revised Date:  2009-07-09    
Medline Journal Info:
Nlm Unique ID:  7610646     Medline TA:  Spine (Phila Pa 1976)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2715-9     Citation Subset:  IM    
Affiliation:
Workers Compensation Board of British Columbia, Vancouver, British Columbia, Canada.
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MeSH Terms
Descriptor/Qualifier:
Back Injuries / 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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