Accuracy of the Orebro Musculoskeletal Pain Questionnaire and Work Assessment Triage Tool for selecting interventions in workers with spinal conditions

BACKGROUND: Accurate clinical decision support tools may help clinicians select appropriate interventions for patients with spinal conditions. The Orebro Musculoskeletal Pain Questionnaire (OMPQ) is a screening questionnaire extensively studied as a predictive tool. The Work Assessment Triage Tool (WATT) is a clinical decision support tool developed to help select interventions for injured workers. OBJECTIVE: To compare the classification accuracy of the OMPQ and WATT to clinician recommendations for selecting interventions leading to a successful return to work in patients with spinal conditions. METHODS: A secondary analysis was undertaken of data from injured workers with spinal conditions assessed between 2013 and 2016. We considered it a success if the workers did not receive wage replacement benefits 30 days after assessment. Analysis included positive likelihood ratio (LR+) as an indicator of predictive accuracy. RESULTS: Within the database, 2,872 patients had complete data on the OMPQ, WATT, and clinician recommendations. At 30 days, the OMPQ was most accurate for identifying treatments that lead to successful outcomes with a LR+= 1.51 (95% Confidence Interval 1.26–1.82) compared to 1.05 (95% Confidence Interval 1.02–1.09) for clinicians, and 0.85 (95% Confidence Interval 0.79–0.91) for the WATT. CONCLUSIONS: All tool recommendations had poor accuracy, however the OMPQ demonstrated significantly better results.