Finnish Institute of Occupational Health, P.O. Box 18, FI-00032, Työterveyslaitos, Finland.
Scand J Work Environ Health. 2018 Jan 1;44(1):37-46. doi: 10.5271/sjweh.3684. Epub 2017 Oct 24.
Objective This study aimed to develop and validate a risk screening tool using a points system to assess the risk of future disability retirement due to musculoskeletal disorders (MSD). Methods The development population, the Health 2000 Survey, consisted of a nationally representative sample of Finnish employees aged 30-60 years (N=3676) and the validation population, the Helsinki Health Study, consisted of employees of the City of Helsinki aged 40-60 years (N=6391). Both surveys were linked to data on disability retirement awards due to MSD from national register for an 11-year follow-up. Results The discriminative ability of the model with seven predictors was good (Gönen and Heller's K concordance statistic=0.821). We gave points to seven predictors: sex-dependent age, level of education, pain limiting daily activities, multisite musculoskeletal pain, history of arthritis, and surgery for a spinal disorder or carpal tunnel syndrome. A score of 3 or higher out of 7 (top 30% of the index) had good sensitivity (83%) and specificity (70%). Individuals at the top 30% of the risk index were at 29 [95% confidence interval (CI) 15-55) times higher risk of disability retirement due to MSD than those at the bottom 40%. Conclusion This easy-to-use screening tool based on self-reported risk factor profiles can help identify individuals at high risk for disability retirement due to MSD.
目的 本研究旨在开发和验证一种使用积分系统评估因肌肉骨骼疾病(MSD)导致未来残疾退休风险的风险筛查工具。
方法 开发人群为健康 2000 调查,包括年龄在 30-60 岁的芬兰全国代表性员工样本(N=3676),验证人群为赫尔辛基健康研究,包括赫尔辛基市的员工(年龄在 40-60 岁)(N=6391)。这两项调查都与国家登记处因 MSD 导致残疾退休津贴的数据相联系,随访时间为 11 年。
结果 该模型具有七个预测因子的区分能力良好(Gönen 和 Heller 的 K 一致性统计量=0.821)。我们给七个预测因子打分:性别相关年龄、教育程度、疼痛限制日常活动、多部位肌肉骨骼疼痛、关节炎病史、脊柱疾病或腕管综合征手术。7 分中得 3 分或以上(指数前 30%)具有良好的敏感性(83%)和特异性(70%)。风险指数前 30%的个体因 MSD 导致残疾退休的风险是指数后 40%的个体的 29 倍(95%置信区间 [CI] 15-55)。
结论 这种基于自我报告风险因素概况的简单易用的筛查工具可以帮助识别因 MSD 导致残疾退休风险较高的个体。