A Diagnostic Assistant Tool for Work-Related Low Back Pain in Hospital Workers

Abstract

Aims: The study objective was to develop a clinical risk score to assist occupational medicine physicians in diagnosing hospital workers’ occupational lower back pain (LBP). Settings and Design: A cross-sectional data collection design was conducted at Saraburi Hospital, Thailand. Methods and Materials: The sample consisted of 220 hospital workers who cared for patients and had LBP. They were assessed for the frequency of targeted activities (CPR, lifting, transferring patients) and other activities from work as well as ergonomic assessments, and diagnosed with LBP by three occupational medicine physicians. Statistical Analysis Used: Predicted factors of multivariable logistic regression were analysed to find clinical risk scores to help the diagnosis. Results: The physicians agreed on the diagnosis, based on ergonomic risk factors and their experiences that 86 persons have occupational LBP. A diagnostic assistant tool consists of six predictors: the duration of LBP, having LBP within the last 7 days, bending, twisting, lateral bending, and reaching. The scores predicted occupational LBP correctly with an AuROC of 90.0% (95% CI; 84.8–93.5%). The positive likelihood ratio for occupational LBP was 0 in the low risk category (<6 points) and 16.8 (95% CI; 8.0–35.6) in the high risk (>8 points). Conclusions: A diagnostic assistant tool is used to assist occupational medicine physicians in diagnosing hospital workers' occupational LBP.

Diagnostic clinical prediction rules for categorising low back pain: A systematic review

“…(2019) and Saengdao et al. (2021). The StEP tool (Scholz et al., 2009) demonstrated the best discrimination (AUC = 0.98, p < 0.001; sensitivity = 92.0%, specificity = 97.0%) for detecting a diagnosis between radicular and axial LBP.…”

“…(2018), Saengdao et al. (2021), and Ye et al. (2022) have all shown strong positive evidence and low risk of bias during the early stages of development.…”

“…The RoB regarding the ‘index test’ domain was frequently unclear ( n = 7) but was considered high in two cases (Scholz et al., 2009; Stynes et al., 2018). The RoB concerning the ‘reference standard’ domain was deemed high in five studies (Braun et al., 2011; Kato et al., 2009; Konno, Hayashino, et al., 2007; Saengdao et al., 2021; Tominaga et al., 2022), and unclear in three studies (Aghaei et al., 2015; Konno, Hayashino, et al., 2007; Scholz et al., 2009). The RoB concerning the ‘flow and timings’ domain was generally low ( n = 14), but high in two studies (Kato et al., 2009; Konno, Hayashino, et al., 2007).…”

“…RoB concerning the 'patient selection' domain was generally low (n = 12) but considered high in four studies (Chatprem et al, 2021;Roman et al, 2010;Saengdao et al, 2021;Stynes et al, 2018). The RoB regarding the 'index test' domain was frequently unclear (n = 7) but was considered high in two cases (Scholz et al, 2009;Stynes et al, 2018).…”