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Orthopaedic Proceedings
Vol. 101-B, Issue SUPP_9 | Pages 14 - 14
1 Sep 2019
Steenstra I McIntosh G Chen C D'Elia T Amick B Hogg-Johnson S
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Purposes and Background

Musculoskeletal disorders are leading causes of work disability. Our purpose was to develop a predictive model in a cohort from 2012 and validate the model in 2016 data.

Methods and Results

Prospectively collected data was used to identify inception cohorts in 2012 (n=1652) and 2016 (n=199). Data from back pain claimants receiving treatment in physiotherapy clinics and the Ontario workers' compensation database were linked. Patients were followed for 1 year.

Variables from a back pain questionnaire and clinical, demographic and administrative factors were assessed for predictive value. The outcome was cumulative number of calendar days receiving wage-replacement benefits.

Cox regression revealed 8 significant predictors of shorter time on benefits in the 2012 cohort: early intervention (HR=1.51), symptom duration < 31 days (HR=0.88), not in construction industry (HR=1.89), high Low Back Outcome Score (HR=1.03), younger age (HR=0.99), higher benefit rate (HR=1.00), intermittent pain (HR=1.15), no sleep disturbance (HR=1.15). The 2012 model c-statistic was 0.73 with a calibration slope of 0.90 (SE=0.19, p=0.61) in the 2016 data, meaning not significantly different. The c-statistic in the 2016 data was 0.69. Median duration on benefits of those with a high risk score was 129 days in 2012 and 45 days in 2016.