Stover Bert, Silverstein Barbara, Wickizer Thomas, Martin Diane P, Kaufman Joel
Health Services Department, School of Public Health and Community Medicine, University of Washington, Seattle, WA, USA.
J Occup Rehabil. 2007 Jun;17(2):227-45. doi: 10.1007/s10926-007-9083-2. Epub 2007 May 9.
Work related upper extremity musculoskeletal disorders (MSD) result in substantial disability, and expense. Identifying workers or jobs with high risk can trigger intervention before workers are injured or the condition worsens.
We investigated a disability instrument, the QuickDASH, as a workplace screening tool to identify workers at high risk of developing upper extremity MSDs. Subjects included workers reporting recurring upper extremity MSD symptoms in the past 7 days (n = 559).
The QuickDASH was reasonably accurate at baseline with sensitivity of 73% for MSD diagnosis, and 96% for symptom severity. Specificity was 56% for diagnosis, and 53% for symptom severity. At 1-year follow-up sensitivity and specificity for MSD diagnosis was 72% and 54%, respectively, as predicted by the baseline QuickDASH score. For symptom severity, sensitivity and specificity were 86% and 52%. An a priori target sensitivity of 70% and specificity of 50% was met by symptom severity, work pace and quality, and MSD diagnosis.
The QuickDASH may be useful for identifying jobs or workers with increased risk for upper extremity MSDs. It may provide an efficient health surveillance screening tool useful for targeting early workplace intervention for prevention of upper extremity MSD problems.
与工作相关的上肢肌肉骨骼疾病（MSD）会导致严重的残疾和费用支出。识别高风险的工人或工作岗位可以在工人受伤或病情恶化之前触发干预措施。
我们研究了一种残疾评估工具QuickDASH，将其作为一种工作场所筛查工具，以识别有发展为上肢MSD高风险的工人。研究对象包括在过去7天内报告有复发性上肢MSD症状的工人（n = 559）。
QuickDASH在基线时具有合理的准确性，MSD诊断的敏感性为73%，症状严重程度的敏感性为96%。诊断的特异性为56%，症状严重程度的特异性为53%。在1年的随访中，根据基线QuickDASH评分预测，MSD诊断的敏感性和特异性分别为72%和54%。对于症状严重程度，敏感性和特异性分别为86%和52%。症状严重程度、工作节奏和质量以及MSD诊断达到了70%的先验目标敏感性和50%的特异性。
QuickDASH可能有助于识别上肢MSD风险增加的工作岗位或工人。它可能提供一种有效的健康监测筛查工具，有助于针对早期工作场所干预措施以预防上肢MSD问题。
