Outcomes research: implications for occupational health

Concerns about quality, cost, and unnecessary medical care have led to substantial interest and growth in outcomes research with studies to determine the full range of effects of disease and comparative effectiveness of treatments. Investigators have developed new conceptual models of health-related quality of life and associated questionnaires, study designs that maximize use of administrative databases and the generalizability of results, and methods to control for severity and co-morbidity. As similar concerns about occupational health care have emerged, these approaches are being adapted for use in the occupational setting, and studies are beginning to address the concerns of working populations. These investigations will require development of new models of outcome, interdisciplinary research teams, adaptation of data collection methods to address the unique concerns of workers and the unique aspects of the workplace, use of new information databases, and methods of analysis. The implications of these concepts for a hypothetical study of carpal tunnel syndrome and a proposed agenda for future studies in occupational health outcomes research are presented.