Association Between Compensation Status and Outcome After Surgery

Harris, Ian; Mulford, Jonathan; Solomon, Michael J.; Gelder, James M. van; Young, Jane

doi:10.1001/jama.293.13.1644

Cited by 329 publications

(224 citation statements)

References 83 publications

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“…The findings are consistent with previous meta-analytic studies on the effect of compensation status on the outcome after surgery in general [15].…”

Section: Discussionsupporting

confidence: 92%

“…The selective reporting of this type of study has been previously commented upon by Harris et al in their 2005 meta-analysis of all surgical interventions [15]. Their results suggested that bias could be present as a result of selective publication of studies showing an association or the selective reporting of an association only when it exists.…”

Section: Discussionmentioning

confidence: 80%

“…Amongst the articles in which workers' compensation status was recorded, the three most common anatomical sites involved were the lumbar spine, shoulder, and carpel tunnel [15].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Difference in outcome of shoulder surgery between workers’ compensation and nonworkers’ compensation populations

Koljonen¹,

Chong²,

Yip³

2007

International Orthopaedics (SICOT)

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The purpose of this study was to review the association between compensation status and surgical outcome especially of the shoulder. Given the high prevalence of shoulder injuries in the workplace and the large proportion of workers compensation (WC) claims involving such injuries, it is worth examining the correlation between WC status and surgical outcome of the shoulder. All studies published in journals (MEDLINE and PubMed) from 1980 through 2007 on surgical interventions performed on the shoulder in which workers compensation status was documented and the postoperative functional outcome was compared according to that status were pooled for meta-analysis. This systematic review shows that compensation status of an individual receiving shoulder surgery is a consistent positive predictor of poor functional outcome. The majority of questions posed in the most commonly adopted shoulder-specific functional outcome measurement tools were subjective in nature and may account for part of the phenomenon.

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“…The findings are consistent with previous meta-analytic studies on the effect of compensation status on the outcome after surgery in general [15].…”

Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 80%

See 1 more Smart Citation

Difference in outcome of shoulder surgery between workers’ compensation and nonworkers’ compensation populations

Koljonen¹,

Chong²,

Yip³

2007

International Orthopaedics (SICOT)

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“…For the workers compensation analysis, the authors reported that this difference came from worsening patient-reported outcomes in the surgically treated workers compensation group over time [1]. Previous studies have also demonstrated an association between workers compensation status and patient-reported outcomes after surgery [7]. Most of the ODI changes for surgery were associated with anatomic characteristics of the disc herniation (ie, posterolateral, sequestered herniation) or direct effects of the disc herniation (predominantly leg pain, intact sensation).…”

Section: Discussionmentioning

confidence: 99%

Which Variables Are Associated With Patient-reported Outcomes After Discectomy? Review of SPORT Disc Herniation Studies

Koerner

Glaser

Radcliff

2015

Clinical Orthopaedics &Amp; Related Research

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Background The Spine Patient Outcomes Research Trial (SPORT) evaluated the effects of surgery versus nonoperative treatment for lumbar intervertebral disc herniation (IDH), among other pathologies. Multiple subgroup analyses have been completed since the initial publications, which have further defined which patient factors lead to better or worse patient-reported outcomes; however, the degree to which these factors influence patient-reported outcomes has not been explored. Questions/purposes We reviewed the subgroup analyses of the SPORT IDH studies to answer the following questions: (1) What factors predicted improvement in patientreported outcomes after operative or nonoperative treatment of lumbar IDH? (2) What factors predicted worse patient-reported outcomes compared to baseline after operative or nonoperative treatment of lumbar IDH? And (3) what factors influenced patient-reported outcomes of surgery in patients with lumbar IDH? Methods We conducted a MEDLINE 1 search to identify the subgroup analyses of the SPORT IDH data that were responsive to our study questions. Eleven articles were identified that met our search criteria. Results The patient factors associated with larger improvements in Oswestry Disability Index at 4 years with either surgical or nonoperative treatment included a higher baseline Oswestry Disability Index, BMI of less than 30, not being depressed, being insured, having no litigation pending, not having workers compensation, and having symptoms for less than 6 weeks, though there were others. Factors leading to improvement with surgical treatment were mostly related to anatomic characteristics of the disc herniation such as posterolateral and sequestered herniations. There were no patient or clinical factors identified that were associated with worse patient-reported outcomes compared to baseline after either operative or nonoperative treatment. At 2-year followup, the treatment effects were greater for those patients with upper-level herniations, patients not receiving workers compensation, and nondiabetic patients. In a 4-year multivariate analysis, being married, without joint problems, and having worse symptoms at baseline resulted in greater treatment effect with surgery. Conclusions While most patients with IDH will likely see improvement with either surgical or nonoperative treatment, there are patient-related factors that can help predict which subgroups will demonstrate a greater improvement with surgery, such as not having joint problems, being married, having worsening symptoms at baseline, and not having diabetes. These results can help providers and patients when discussing treatment options.

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“…Measurement science has extended such work to facilitate the interpretation of changes in outcomes in terms of their clinical significance [1][2][3], and has paved the way for evidence-based clinical treatment guidelines [4][5][6]. As part of this evolution, studies in spine research have documented a wide range of factors that influence treatment outcome, including medical factors (e.g., co-morbidities [7]), sociodemographic factors [8] (e.g., gender, age), and behavioral factors [8,9] (workers' compensation status [10,11]). …”

Section: Background Contextmentioning

confidence: 99%

Relevance of Lifestyle and Attitudinal Factors to Spine Surgery Outcomes: Empirical Results on a Heterogeneous Sample

Schwartz¹,

Quaranto²,

Samaha³

et al. 2011

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Background Context: Patient demographic and medical indicators influence the well-being of spine surgery patients. It may, however, be worthwhile to evaluate other lifestyle and attitudinal factors. We hypothesized that such factors would explain at least as much variance in outcome as more commonly considered covariates. Purpose: To compare explained variance in outcome of lifestyle and attitudinal factors as compared to standard demographic and medical covariates. Study Design/Setting: Cross-sectional observational study of patients drawn from an active clinic and internet-based support group. Patient Sample: A heterogeneous sample of 376 patients was recruited, comprised of people with diagnoses of cervical (n = 80), lumbar (n = 228), and scoliosis (n = 68) spine disorders. Outcome Measures: Quality of Life (QOL) outcomes were measured using the Oswestry Disability Index, Neck Disability Index, Rand-36, PROMIS Pain Impact, NRS Back and Leg Pain, Scoliosis Research Society-22r, and Global Health. Methods: This study compared explained variance in QOL outcomes of demographic and medical versus lifestyle and attitudinal factors. Demographic and medical factors included age, gender, body mass index, and co-morbidities. Lifestyle factors included exercise and commuting practice. Attitudinal factors related to social connectedness: giving and receiving emotional support, feeling overwhelmed by others' needs, helping orientation, and general helping behaviors. Regression analyses estimated explained variance. Patient groups differed in most factors evaluated, so the regression analyses were computed separately by group. R2 statistics were characterized as null, small (0.02), medium (0.15), and large (0.35) effect sizes (ES), and proportions were compared for the medical/demographic versus lifestyle/attitudinal factors by group. Results: Similar proportions of variance were explained by demographic/medical and lifestyle/attitudinal covariates across groups, with half of effect sizes being small in magnitude and 6% being medium. Lumbar patients tended to have more small effect sizes among lifestyle and attitudinal covariates than among medical/demographic covariates (z = -1.29, p < 0.10). Similar patterns were found for both generic and disease-specific outcomes. Conclusions: Spine surgery outcome research should investigate lifestyle and attitudinal factors to enhance the personal and salutogenic relevance of the research. Time spent commuting, exercise practice, and social connectedness appear to be relevant factors. A pre-operative evaluation of overweight and smoking status, limited social connectedness, and long daily commutes could alert the surgeon to delay or avoid performing procedures on these patients to avoid poor outcomes.

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Association Between Compensation Status and Outcome After Surgery

Cited by 329 publications

References 83 publications

Difference in outcome of shoulder surgery between workers’ compensation and nonworkers’ compensation populations

Difference in outcome of shoulder surgery between workers’ compensation and nonworkers’ compensation populations

Which Variables Are Associated With Patient-reported Outcomes After Discectomy? Review of SPORT Disc Herniation Studies

Relevance of Lifestyle and Attitudinal Factors to Spine Surgery Outcomes: Empirical Results on a Heterogeneous Sample

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