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Journal of Occupational Rehabilitation

Published in:

01-09-2007

Exploring the Contribution of Patient-Reported and Clinician Based Variables for the Prediction of Low Back Work Status

Authors: Martijn W. Heymans, Jon J. Ford, Joan M. McMeeken, Alexander Chan, Henrica C. W. de Vet, Willem van Mechelen

Published in: Journal of Occupational Rehabilitation | Issue 3/2007

Abstract

Background

Successful management of workers on sick leave due to low back pain by the general physician and physiotherapist depends on reliable prognostic information on the course of low back pain and work resumption.

Methods

Retrospective cohort study in 194 patients who were compensated because of chronic low back pain and who were treated by a physiotherapy functional restoration program. Patient-reported and clinician based prognostic indicators were assessed at baseline before patients entered the functional restoration program. We investigated the predictive value of these indicators on work status at 6 months. Relationships were studied using logistic regression analysis in a 2-step bootstrap modelling approach and a nomogram was developed. Discrimination and calibration of the nomogram was evaluated internally and the explained variation of the nomogram calculated.

Results

Seventy percent of workers were back to work at 6 months. We found that including duration of complaints, functional disability, disc herniation and fear avoidance beliefs resulted in the “best” prognostic model. All these factors delayed work resumption. This model was used to construct a nomogram. The explained variation of the nomogram was 23.7%. Discrimination was estimated by the area under the receiver operating characteristic curve and was 0.76 and for calibration we used the slope estimate that was 0.91. The positive predictive values of the nomogram at different cut-off levels of predicted probability were good.

Conclusions

Knowledge of the predictive value of these indicators by physicians and physiotherapists will help to identify subgroups of patients and will thus enhance clinical decision-making.

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Title: Exploring the Contribution of Patient-Reported and Clinician Based Variables for the Prediction of Low Back Work Status
Authors: Martijn W. Heymans
Jon J. Ford
Joan M. McMeeken
Alexander Chan
Henrica C. W. de Vet
Willem van Mechelen
Publication date: 01-09-2007
Publisher: Springer US
Published in: Journal of Occupational Rehabilitation / Issue 3/2007
Print ISSN: 1053-0487
Electronic ISSN: 1573-3688
DOI: https://doi.org/10.1007/s10926-007-9084-1

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Springer Medicine

Exploring the Contribution of Patient-Reported and Clinician Based Variables for the Prediction of Low Back Work Status

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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