title: The Added Value of Collecting Information on Pain Experience When Predicting Time on Benefits for Injured Workers with Back Pain.
abstract: Objectives Some injured workers with work-related, compensated back pain experience a troubling course in return to work. A prediction tool was developed in an earlier study, using administrative data only. This study explored the added value of worker reported data in identifying those workers with back pain at higher risk of being on benefits for a longer period of time. Methods This was a cohort study of workers with compensated back pain in 2005 in Ontario. Workplace Safety and Insurance Board (WSIB) data was used. As well, we examined the added value of patient-reported prognostic factors obtained from a prospective cohort study. Improvement of model fit was determined by comparing area under the curve (AUC) statistics. The outcome measure was time on benefits during a first workers' compensation claim for back pain. Follow-up was 2 years. Results Among 1442 workers with WSIB data still on full benefits at 4 weeks, 113 were also part of the prospective cohort study. Model fit of an established rule in the smaller dataset of 113 workers was comparable to the fit previously established in the larger dataset. Adding worker rating of pain at baseline improved the rule substantially (AUC = 0.80, 95 % CI 0.68, 0.91 compared to benefit status at 180 days, AUC = 0.88, 95 % CI 0.74, 1.00 compared to benefits status at 360 days). Conclusion Although data routinely collected by workers' compensation boards show some ability to predict prolonged time on benefits, adding information on experienced pain reported by the worker improves the predictive ability of the model from 'fairly good' to 'good'. In this study, a combination of prognostic factors, reported by multiple stakeholders, including the worker, could identify those at high risk of extended duration on disability benefits and in potentially in need of additional support at the individual level.
authors.affiliation: Institute for Work & Health, 481 University Ave., Suite 800, Toronto, ON, M5G 2E9, Canada. isteenstra@iwh.on.ca.|Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada. isteenstra@iwh.on.ca.
authors.forename: Ivan A
authors.initials: IA
authors.lastname: Steenstra
authors.affiliation: Institute for Work & Health, 481 University Ave., Suite 800, Toronto, ON, M5G 2E9, Canada.|WorkSafe BC, Vancouver, BC, Canada.|Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada.|School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada.
authors.forename: Renée-Louise
authors.initials: RL
authors.lastname: Franche
authors.affiliation: Institute for Work & Health, 481 University Ave., Suite 800, Toronto, ON, M5G 2E9, Canada.|Department of Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.|Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada.
authors.forename: Andrea D
authors.initials: AD
authors.lastname: Furlan
authors.affiliation: Institute for Work & Health, 481 University Ave., Suite 800, Toronto, ON, M5G 2E9, Canada.|Department of Health Policy and Management, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA.
authors.forename: Ben
authors.initials: B
authors.lastname: Amick
authors.affiliation: Institute for Work & Health, 481 University Ave., Suite 800, Toronto, ON, M5G 2E9, Canada.|Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
authors.forename: Sheilah
authors.initials: S
authors.lastname: Hogg-Johnson
mesh_terms: D000328:Adult; D001416:Back Pain / Q000191:economics* / Q000534:rehabilitation; D015331:Cohort Studies; D016208:Databases, Factual; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D060051:Occupational Injuries / Q000150:complications*; D009864:Ontario; D017063:Outcome Assessment, Health Care; D011237:Predictive Value of Tests; D011446:Prospective Studies; D062707:Return to Work / Q000191:economics / Q000706:statistics & numerical data*; D013997:Time Factors; D014942:Workers' Compensation / Q000191:economics / Q000706:statistics & numerical data*
keywords: Cohort; Depression; Functional status; Job satisfaction; Low back pain; Pain; Prediction; Prognosis; Return to work; Workers compensation