Abstract
Introduction: Early recognition and prediction of the potential risk of chronicity is essential to curtail spiraling compensable claims costs. This pilot study investigated the ability of an existing biopsychosocial Generic Screening Tool to identify and predict, in the acute-subacute phase, patient recovery time on a Global Assessment of Body and Limbs scale. Method: A new paradigm and protocol were used for prospective investigation of 61 consecutive musculo-skeleatal compensable patients, 36 male, 25 female, presenting to three physiotherapy outpatient clinics. Participants were screened at initial presentation and measured concurrently, then again, twice and fourtimes weekly till discharge or study completion at 18 months. The outcome variable was recovery to 80% of preinjury global status, calculated from three weighted key pooled indices: regional Self Report Outcome Measurement scores, work and life status data and Patient Specific Index values. Results: This pilot validation trial strongly correlated screening scores with the time required to achieve 80% of pre-injury status measured on the global scale (r = 0.835). Sub-categorisation to regions and compensable body were made favouring work-related back injury (n = 36 r = 0.862). The protocol also produced: stand-alone screening scores indicating chronicity risk; a regional outcome score providing quantitative and qualitative values and a graphical progression chart on a global scale with patient-specific clinical pathways indicating capacity, recovery time and cost. Conclusions: This study demonstrates that through pilot investigation a biopsychosocial screening questionniare can be used for early identification of compensable patients with a high risk of chronicity, claim costs and longer than expected recovery time.