Boocock Mark G, Collier Jill M K, McNair Peter J, Simmonds Marian, Larmer Peter J, Armstrong Bridget
Health and Rehabilitation Research Centre, Auckland University of Technology, Auckland, New Zealand.
Semin Arthritis Rheum. 2009 Feb;38(4):296-311. doi: 10.1016/j.semarthrit.2007.10.006. Epub 2008 Feb 20.
A frequently cited problem in epidemiological research is the inadequate operational definition of umbrella terms such as Musculoskeletal Disorders (MSD). Specific conditions attached to these labels and their corresponding signs and symptoms are also poorly defined. The purpose of this study was to identify internationally applied terminology and definitions appropriate to work-related upper extremity (UE) conditions.
An extensive literature search of 15 electronic databases supplemented by personal communications with representatives from national and international health and safety organizations was undertaken to identify recognized terminology and definitions appropriate to work-related UE conditions.
Information specific to the umbrella terms and their corresponding conditions was obtained from 15 countries. The findings revealed a lack of international consensus over appropriate terminology to encapsulate the wide range of conditions falling within the umbrella terms used by these countries. UE conditions could be classified into 3 broad categories: (1) 14 "specific conditions" with evidence-based diagnostic criteria; (2) 34 "other specific conditions" with no clearly defined diagnosis; and (3) "nonspecific conditions" requiring a clear pattern of signs and symptoms to be present for a diagnosis to be made. A dynamic model for classifying work-related UE conditions is proposed which places greater emphasis on specific diagnosis.
A systematic approach to the classification and diagnosis of work-related UE conditions is attractive, as it is likely to lead to more precise estimates of the prevalence and cost of UE conditions, as well as improved quality of information on the efficacy of medical and workplace interventions.
流行病学研究中一个经常被提及的问题是诸如肌肉骨骼疾病（MSD）等笼统术语的操作定义不充分。附着于这些标签的具体病症及其相应的体征和症状也定义不清。本研究的目的是确定适用于与工作相关的上肢（UE）疾病的国际通用术语和定义。
对15个电子数据库进行了广泛的文献检索，并辅以与国家和国际健康与安全组织代表的个人交流，以确定适用于与工作相关的UE疾病的公认术语和定义。
从15个国家获得了与笼统术语及其相应病症相关的信息。研究结果显示，对于涵盖这些国家所使用的笼统术语范围内的广泛病症的适当术语，缺乏国际共识。UE疾病可分为三大类：（1）14种有循证诊断标准的“特定病症”；（2）34种无明确诊断的“其他特定病症”；（3）需要有明确的体征和症状模式才能做出诊断的“非特定病症”。提出了一种用于对与工作相关的UE疾病进行分类的动态模型，该模型更加强调特定诊断。
对与工作相关的UE疾病进行分类和诊断的系统方法很有吸引力，因为它可能会更精确地估计UE疾病的患病率和成本，以及提高有关医疗和工作场所干预效果的信息质量。
