Predicting work status for patients in an occupational medicine setting who report back pain

To determine the ability of patient-reported health status information to predict physician-determined fit-for-work status for patients reporting complaints of low back pain.

Cross-sectional study using survey methods.

Occupational medicine section of a large multispecialty private clinic.

Four hundred sixty-two questionnaire packets were distributed to patients who were seen for work-related conditions or disorders over a 13-week period; 235 questionnaires were returned (51% response rate). One hundred seven responders reported low back pain and completed the Low Back Pain TyPE (Technology of Patient Experience) Tool. The mean (+/- SD) age of respondents was 39 (+/- 12) years; 67% of respondents were male, 70% were white, 87% were receiving worker's compensation, 58% were married, and 55% had a high school education or less.

Questionnaire packets for self-administration containing health/functional status questions (short form [SF]-36, COOP Charts) and the Low Back Pain TyPE Tool were distributed to the patients. Other variables were abstracted from the medical records and administrative databases.

The primary study outcome measured was fitness for work; patients were examined and categorized as fit or not fit for work by physicians who were unaware of the questionnaire results.

Logistic regression analysis consisted of variables from 107 patients who reported low back pain. The final model contained the physical functioning scale (SF-36), employment status, smoking status, and physical functioning (SF-36) by gender interaction. Seventy-seven percent of the fit-for-work cases and 90% of the not-fit-for-work cases were correctly classified.

Patient-reported physical function (as modified by gender), smoking status, and employment status predicted physician-determined work status for patients reporting low back pain in this study. Larger studies will be required to confirm this finding.