Predicting return to work after low back injury using the Psychosocial Risk for Occupational Disability Instrument: a validation study

J Occup Rehabil. 2005 Sep;15(3):365-76. doi: 10.1007/s10926-005-5943-9.


Introduction: This paper reports on the predictive validity of a Psychosocial Risk for Occupational Disability Scale in the workers' compensation environment using a paper and pencil version of a previously validated multimethod instrument on a new, subacute sample of workers with low back pain.

Methods: A cohort longitudinal study design with a randomly selected cohort off work for 4-6 weeks was applied. The questionnaire was completed by 111 eligible workers at 4-6 weeks following injury. Return to work status data at three months was obtained from 100 workers. Sixty-four workers had returned to work (RTW) and 36 had not (NRTW).

Results: Stepwise backward elimination resulted in a model with these predictors: Expectations of Recovery, SF-36 Vitality, SF-36 Mental Health, and Waddell Symptoms. The correct classification of RTW/NRTW was 79%, with sensitivity (NRTW) of 61% and specificity (RTW) of 89%. The area under the ROC curve was 84%.

Conclusions: New evidence for predictive validity for the Psychosocial Risk-for-Disability Instrument was provided.

Implications: The instrument can be useful and practical for prediction of return to work outcomes in the subacute stage after low back injury in the workers' compensation context.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Accidents, Occupational / psychology*
  • Adult
  • Back Injuries / physiopathology
  • Back Injuries / psychology*
  • British Columbia
  • Disability Evaluation*
  • Female
  • Humans
  • Injury Severity Score*
  • Logistic Models
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Prognosis
  • Psychometrics / instrumentation*
  • ROC Curve
  • Registries
  • Workers' Compensation