职业健康护理或研究中使用的肌肉骨骼疾病诊断标准:基于共识和综合的病例定义的范围综述

Diagnostic criteria for musculoskeletal disorders for use in occupational healthcare or research: a scoping review of consensus- and synthesised-based case definitions.

作者信息

van der Molen Henk F, Visser Steven, Alfonso Jose Hernán, Curti Stefania, Mattioli Stefano, Rempel David, Roquelaure Yves, Kuijer P Paul F M, Tamminga Sietske J

机构信息

Department of Public and Occupational Health, Coronel Institute of Occupational Health, Netherlands Center for Occupational Diseases, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, Amsterdam, the Netherlands.

Department of Occupational Medicine and Epidemiology, National Institute of Occupational Health, Oslo, Norway.

出版信息

BMC Musculoskelet Disord. 2021 Feb 11;22(1):169. doi: 10.1186/s12891-021-04031-z.

Abstract

BACKGROUND

The aim of this study was to identify case definitions of diagnostic criteria for specific musculoskeletal disorders (MSDs) for use in occupational healthcare, surveillance or research.

METHODS

A scoping review was performed in Medline and Web of Science from 2000 to 2020 by an international team of researchers and clinicians, using the Arksey and O'Malley framework to identify case definitions based on expert consensus or a synthesis of the literature. Seven MSDs were considered: non-specific low back pain (LBP), lumbosacral radicular syndrome (LRS), subacromial pain syndrome (SAPS), carpal tunnel syndrome (CTS), lateral or medial elbow tendinopathy, and knee and hip osteoarthritis (OA). Case definitions for occupational healthcare or research were charted according to symptoms, signs and instrumental assessment of signs, and if reported, on work-related exposure criteria.

RESULTS

In total, 2404 studies were identified of which 39 were included. Fifteen studies (38%) reported on non-specific LBP, followed by knee OA (n = 8;21%) and CTS (n = 8;21%). For non-specific LBP, studies agreed in general on which symptoms (i.e., pain in lower back) and signs (i.e., absence of red flags) constituted a case definition while for the other MSDs considerable heterogeneity was found. Only two studies (5%), describing case definitions for LBP, CTS, and SAPS and lateral and medial elbow tendinopathy respectively, included work-related exposure criteria in their clinical assessment.

CONCLUSION

We found that studies on non-specific LBP agreed in general on which symptoms and signs constitute a case definition, while considerable heterogeneity was found for the other MSDs. For prevention of work-related MSDs, these MSD case definitions should preferably include work-related exposure criteria.

摘要

背景

本研究的目的是确定用于职业健康护理、监测或研究的特定肌肉骨骼疾病(MSD)诊断标准的病例定义。

方法

一个由研究人员和临床医生组成的国际团队在2000年至2020年期间对Medline和Web of Science进行了范围综述,使用阿克西和奥马利框架,根据专家共识或文献综合确定病例定义。考虑了七种肌肉骨骼疾病:非特异性腰痛(LBP)、腰骶神经根综合征(LRS)、肩峰下疼痛综合征(SAPS)、腕管综合征(CTS)、外侧或内侧肘部肌腱病,以及膝关节和髋关节骨关节炎(OA)。根据症状、体征和体征的仪器评估,以及(如报告的)与工作相关的暴露标准,绘制职业健康护理或研究的病例定义。

结果

总共识别出2404项研究,其中39项被纳入。15项研究(38%)报告了非特异性腰痛,其次是膝关节骨关节炎(n = 8;21%)和腕管综合征(n = 8;21%)。对于非特异性腰痛,研究总体上就构成病例定义的症状(即下背部疼痛)和体征(即无警示信号)达成了一致,而对于其他肌肉骨骼疾病则发现了相当大的异质性。只有两项研究(5%)分别描述了腰痛、腕管综合征、肩峰下疼痛综合征以及外侧和内侧肘部肌腱病的病例定义,在其临床评估中纳入了与工作相关的暴露标准。

结论

我们发现,关于非特异性腰痛的研究总体上就构成病例定义的症状和体征达成了一致,而其他肌肉骨骼疾病则存在相当大的异质性。为预防与工作相关的肌肉骨骼疾病,这些肌肉骨骼疾病的病例定义最好应包括与工作相关的暴露标准。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5db0/7879660/1adcf7b411d1/12891_2021_4031_Fig1_HTML.jpg

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