Abstract
The study aim was development and validation of a psychosocial Generic Screening Tool (GST) for evaluation of the risk of chronicity in musculoskeletal compensable patients and determination of effectiveness in identifying poor prognosis. Development utilised the Guyatt three-stage process with item generation and reduction enabling face, content, and construct validity producing a final tool that was effectively a modified Orebro Musculoskeletal Pain Questionnaire (OMPQ) with critical differences in five areas. Subsequent validation was performed with a prospective trial using a physiotherapy population sample of convenience from 10 Australian physiotherapy clinics (n = 153) that employed four subgroups for the determination of tool characteristics and psychometric properties. The GST and OMPQ demonstrated test-retest reliability (n = 12) with respectively r = 0.945 and 0.965 (p < 0.001) and criterion validity (n = 50) r = 0.992, p < 0.001. Predictive capacity (n = 103) was determined by the time required to achieve 80% pre-injury Global status with a logarhythmic correlation at p < 0.001 for all analysis with the total data pool r = 0.85 and sub-categorisation favouring lumbothoracic (r = 0.89), cervical (r = 0.84), upper limb (r = 0.79), and lower limb (0. 69). A subgroup (n = 61) demonstrated specificity and sensitivity for absenteeism (91% and 87%), total cost (93% and 94%) and days to closure (78% and 75%) at GST 110-points cutoff. The GST is clinically reliable and valid for predicting poor prognosis in musculoskeletal compensable patients.