![]() ![]() Somatization and medicalization in the era of managed care. A simple patient classification to identify distress and evaluate the risk of poor outcome. Main CJ, Wood PLR, Hollis S, Spanswick CC, Waddel G. Failed lumbar disc surgery and repeat surgery following industrial injuries. Waddell G, Kummel EG, Lotto WN, Graham JD, Hall H, McClulloch JA. Effects of active and completed litigation on treatment results: Workers' compensation patients compared with other litigation patients. Litigation and employment status: Effects on patients with chronic pain. Analysis of 2932 workers' compensation back injury cases. Expenditure for non-specific back injuries in the work place. Sanders SH: Cross-validation of the Back Pain Classification Scale with chronic, intractable pain patients. McNeill TW, Sinkora G, Leavitt F: Psychologic classification of low-back pain patients: A prognostic tool. Use of verbal pain measurement in the detection of hidden psychological morbidity among low back pain patients with objective organic findings. The detection of psychological disturbance in patients with low back pain. Detecting psychological disturbance using verbal pain measurement. Back injuries in industry: A retrospective study II. New York: Simon & Schuster, 1981.īigos SJ, Spengler DM, Martin NA, Zeh J, Fisher L, Nachemson A, Wang MH. The adult spine: Principles and practice. Synopsis: Workshop on idiopathic low-back pain. The usefulness of this information was explored from an actuarial and medical perspective. Motor strength and radiographs taken together accounted for 8.4% of the variance. Litigation was present in 72% of the cases and accounted for 9.1% of the cost variance. Psychological disturbance was detected in 27% of the sample and accounted for 10.5% of the cost variance. Surgery accounted for 19.9% of the variance and contained the most expensive cases ($68,310 vs. These five variables accounted for 48% of the cost variance. More expensive cases were associated with a surgical intervention, psychological disturbance, litigation, motor weakness, and positive radiographs. Data on treatment, final resolution, and cost were obtained from computerized files of the insurance company. Since it relies exclusively on pain language for diagnosis, it does not identify the specific nature of the psychological conflict. The instrument uses pain language as a clinical marker of psychological disturbance linked to a range of conflictual issues such as suppressed anger, burdensome feeling of inferiority, damaged self- esteem, role confusion, abnormal mentation, fear of responsibility or intimacy, gender issues, sexual concerns, disturbing arousal, and the like. A standard measure of psychological status (Low Back Pain Symptom Check List) was filled out. Data on demographic variables, litigation, work, injury history, physical examination, and imaging studies were recorded. The independent medical examination (IME) included a history, physical examination, and review of imaging and other studies. Cost factors were examined in 157 patients with work- related spine injuries who were referred to a second opinion program between 19. ![]()
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