Predicting work status for patients in an occupational medicine setting who report back pain
M. A. Krousel-Wood, T. W. McCune, A. Abdoh and R. N. Re
Research Division, Alton Ochsner Medical Foundation, New Orleans, La.
OBJECTIVE: To determine the ability of patient-reported health status
information to predict physician-determined fit-for-work status for
patients reporting complaints of low back pain. DESIGN: Cross-sectional
study using survey methods. SETTING: Occupational medicine section of a
large multispecialty private clinic. PATIENTS: Four hundred sixty-two
questionnaire packets were distributed to patients who were seen for
work-related conditions or disorders over a 13-week period; 235
questionnaires were returned (51% response rate). One hundred seven
responders reported low back pain and completed the Low Back Pain TyPE
(Technology of Patient Experience) Tool. The mean (+/- SD) age of
respondents was 39 (+/- 12) years; 67% of respondents were male, 70% were
white, 87% were receiving worker's compensation, 58% were married, and 55%
had a high school education or less. INTERVENTIONS: Questionnaire packets
for self-administration containing health/functional status questions
(short form [SF]-36, COOP Charts) and the Low Back Pain TyPE Tool were
distributed to the patients. Other variables were abstracted from the
medical records and administrative databases. MAIN OUTCOME MEASURES: The
primary study outcome measured was fitness for work; patients were examined
and categorized as fit or not fit for work by physicians who were unaware
of the questionnaire results. RESULTS: Logistic regression analysis
consisted of variables from 107 patients who reported low back pain. The
final model contained the physical functioning scale (SF-36), employment
status, smoking status, and physical functioning (SF-36) by gender
interaction. Seventy-seven percent of the fit-for-work cases and 90% of the
not-fit-for-work cases were correctly classified. CONCLUSION:
Patient-reported physical function (as modified by gender), smoking status,
and employment status predicted physician-determined work status for
patients reporting low back pain in this study. Larger studies will be
required to confirm this finding.
