Documents Hudak, Pamela L. 2 results

The evidence concerning prognosis among workers with nonspecific work related musculoskeletal disorders (WMD) was reviewed and discussed. Data were taken from 13 published studies identified through a keyword search. Two of the studies were based on workplace surveillance; five clinical studies gathered their study groups from workplace screening. Seven studies provided an operational definition of cases and criteria for exclusion. One study used an inception cohort of employees without known previous similar disorders. Three studies reported blinded assessment of outcomes appropriate to the disorder and replicable. Nine studies measured and reported various potential prognostic factors along with the treatment provided. Most of the papers only offered crude proportions of response, recovery or recurrence. In contrast to the duration of weeks expected by many clinicians when first seeing the patients studied, the workers with nonspecific or multiple WMD had durations of their symptoms of months if not years. The authors state that the quality of the work reported here was hindered through deficiencies in patient selection, measurement of outcomes, and analysis for prognostic factors. The authors urge the adoption of clear operational definitions of cases. The authors recommend that the duration of symptoms and severity and other potential factors be measured. Follow up assessments at multiple time points should be included for as long as possible. Clinical, disability scales, psychological tests, work performance measures, and work status should all be measured and included in any analysis. Analysis by both stratified and multivariate methods incorporating time varying covariates should be employed.