Identifying cumulative trauma disorders of the upper extremity in workers' compensation databases.
BACKGROUND
Impeding the use of workers' compensation databases for surveillance of cumulative trauma disorder of the upper extremity (CTDUE) is the lack of valid and reliable extraction strategies.


METHODS
Using the Z795-96 Coding of Work Injury or Disease Information standard, an algorithm was developed to classify claims as definite, possible, or non-CTDUE. Reliability was assessed with standardized claim reviews.


RESULTS
Moderate to substantial agreement (Kappa = 0.48, 95% CI 0.42-0.54, n = 328; weighted Kappa = 0.75, 95% CI 0.70-0.80, n = 328) was demonstrated. The algorithm produced relatively homogeneous groups of definite and non-CTDUE claims but 29.1% of the possible CTDUE claims were categorized as definite CTDUE by claim review. Part of body agreement was almost perfect (Kappa = 0.81-1.00) when determining whether the upper extremity or specific parts of the upper extremity were involved.


CONCLUSIONS
The algorithm can be used to estimate the number of CTDUE and extract homogeneous groups of definite and non-CTDUE claims. Furthermore, certain upper extremity part of body codes can be used to target anatomically defined claims.
Zakaria
Dianne
D
Department of Epidemiology and Biostatistics, University of Western Ontario, London, Ontatio, Canada. diannez@biostats.uwo.ca
Mustard
Cam
C
Robertson
James
J
MacDermid
Joy C
JC
Hartford
Kathleen
K
Clarke
Judy
J
Koval
John
J
D000465:Algorithms; D012090:Cumulative Trauma Disorders / Q000453:epidemiology*; D019992:Databases as Topic / Q000706:statistics & numerical data; D005568:Forms and Records Control; D006801:Humans; D007345:Insurance Claim Review / Q000706:statistics & numerical data; D034941:Upper Extremity; D014942:Workers' Compensation / Q000706:statistics & numerical data*