Article

OBJECTIVE: To evaluate the concurrent validity of a clinical decision support
tool (Work Assessment Triage Tool (WATT)) developed to select rehabilitation
treatments for injured workers with musculoskeletal conditions. DESIGN: Methodological study with cross-sectional and prospective components. SETTING: Data were obtained from the Workers' Compensation Board of Alberta rehabilitation
facility in Edmonton, Canada. SUBJECTS: A total of 432 workers' compensation
claimants evaluated between November 2011 and June 2012. MAIN MEASURES:
Percentage agreement between the Work Assessment Triage Tool and clinician
recommendations was used to determine concurrent validity. In claimants returning
to work, frequencies of matching were calculated and compared between clinician
and Work Assessment Triage Tool recommendations and the actual programs
undertaken by claimants.
The frequency of each intervention recommended by
clinicians, Work Assessment Triage Tool, and case managers were also calculated
and compared. RESULTS: Percentage agreement between clinician and Work Assessment
Triage Tool recommendations was poor (19%) to moderate (46%) and Kappa = 0.37
(95% CI -0.02, 0.76). The Work Assessment Triage Tool did not improve upon
clinician recommendations as only 14 out of 31 claimants returning to work had
programs that contradicted clinician recommendations, but were consistent with
Work Assessment Triage Tool recommendations. Clinicians and case managers were
inclined to recommend functional restoration, physical therapy, or no
rehabilitation while the Work Assessment Triage Tool recommended additional
evidence-based interventions, such as workplace-based interventions. CONCLUSIONS:
Our findings do not provide evidence of concurrent validity for the Work Assessment Triage Tool compared with clinician recommendations. Based on these results, we cannot recommend further implementation of the Work Assessment Triage
Tool. However, the Work Assessment Triage Tool appeared more likely than
clinicians to recommend interventions supported by evidence; thus warranting
further research.
CI - (c) The Author(s) 2015.

Langue : ANGLAIS