Presentation M P8

M P8 (Poster Presentation):
Concurrent Validity of A Clinical Decision Support Tool For Selecting Optimal Rehabilitation Interventions For Musculoskeletal Conditions In Injured Workers

Presented by: Douglas Paul Gross

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Authors

Qin ZL1, Gross DP1, Armijo-Olivo S1

  1. Department of Physical Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, Alberta, Canada

Abstract

Background

A triage algorithm and computer-based decision support tool named Work Assessment Triage Tool (WATT) has been developed to assist with identifying the most appropriate rehabilitation interventions for workers' compensation claimants off work due to a variety of musculoskeletal disorders. However, WATT has not been validated in a clinical trial or using data from a rehabilitation setting. Prior to implementation into clinical practice, validity testing is a necessary and important procedure. This study was designed to evaluate the concurrent validity of the WATT against clinician recommendations (i.e. gold standard) to select appropriate rehabilitation interventions for claimants who were not part of the original development database for WATT (i.e. external validation).

Methods

This is a secondary data analysis. Data were collected from a clinical trial conducted previously at the Workers’ Compensation Board of Alberta rehabilitation facility.The database contained information on 434 claimants undergoing return-to-work assessment between November 2011 and June 2012.A variety of statistical methods were used to compare recommendations for rehabilitation strategies determined using the WATT, clinician recommendations, actual programs claimants undertook and return-to-work outcomes. Percent of agreement between the WATT and recommendations by clinicians was used to determine concurrent validity.

Results

Percent agreement between clinician and WATT recommendations was low (19%) to moderate (46%).The WATT did not appear to improve upon clinician recommendations as rehabilitation interventions undertaken by claimants with successful return-to-work outcomes corresponded more with clinician recommendations than WATT recommendations.

Conclusions

Findings do not provide evidence of concurrent validity of the WATT against the current gold standard, clinician recommendations. Based on these results, we cannot recommend further implementation of the WATT. However, the WATT appeared more likely than the clinicians to recommend interventions supported by evidence, and further research is needed.

Schedule Details

Monday September 29
12:45 - 13:45 Poster Viewing
Session: RTW interventions