title: Does the Upper-Limb Work Instability Scale Predict Transitions Out of Work Among Injured Workers?
abstract: OBJECTIVE
  To investigate the predictive ability of the Upper-Limb Work Instability Scale (UL-WIS) for transitioning out of work among injured workers with chronic, work-related upper extremity disorders (WRUEDs).
  
  
  METHODS
  Secondary analysis of a 12-month cohort study with data collection at baseline and 3-, 6-, and 12-month follow-up. Survey questionnaires were used to collect data on an array of sociodemographic, health-related, and work-related variables.
  
  
  METHODS
  Upper extremity specialty clinics.
  
  
  METHODS
  Injured workers (N=356) with WRUEDs who were working at the time of initial clinic attendance.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Transitioning out of work.
  
  
  RESULTS
  Multivariable logistic regression that considered 9 potential confounders revealed baseline UL-WIS (range, 0-17) to be a statistically significant predictor of a subsequent transition out of work (adjusted odds ratio, 1.18; 95% confidence interval [CI], 1.07-1.31; P=.001). An assessment of predictive values across the UL-WIS score range identified cut-scores of <6 (negative predictive value, .81; 95% CI, .62-.94) and >15 (positive predictive value, .80; 95% CI, .52-.96), differentiating the scale into 3 bands representing low, moderate, and high risk of exiting work.
  
  
  CONCLUSIONS
  The UL-WIS was shown to be an independent predictor of poor work sustainability among injured workers with chronic WRUEDs; however, when applied as a standalone tool in clinical settings, some limits to its predictive accuracy should also be recognized.
authors.affiliation: Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario, Canada; Institute for Work & Health, Toronto, Ontario, Canada; School of Rehabilitation Science, Faculty of Health Sciences, McMaster University, Hamilton, Ontario, Canada. Electronic address: ktang@mcmaster.ca.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Tang
authors.affiliation: Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Musculoskeletal Health and Outcomes Research, Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario, Canada; Institute for Work & Health, Toronto, Ontario, Canada.
authors.forename: Dorcas E
authors.initials: DE
authors.lastname: Beaton
authors.affiliation: Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; Institute for Work & Health, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Sheilah
authors.initials: S
authors.lastname: Hogg-Johnson
authors.affiliation: Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Faculty of Health Sciences and University of Ontario Institute of Technology - Canadian Memorial Chiropractic College Center for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology, Oshawa, Ontario, Canada.
authors.forename: Pierre
authors.initials: P
authors.lastname: Côté
authors.affiliation: Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Patrick
authors.initials: P
authors.lastname: Loisel
authors.affiliation: Institute for Work & Health, Toronto, Ontario, Canada; Department of Health Policy and Management, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL.
authors.forename: Benjamin C
authors.initials: BC
authors.lastname: Amick
mesh_terms: D000328:Adult; D000368:Aged; D002908:Chronic Disease; D015331:Cohort Studies; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000534:rehabilitation*; D009784:Occupational Diseases / Q000534:rehabilitation*; D034941:Upper Extremity; D014938:Work Capacity Evaluation; D055815:Young Adult
keywords: Occupational injuries; Predictive value of tests; Rehabilitation; Upper extremity; Work; Workers’ compensation