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Biomedical subjects

A L Colledge

Publications and source records attributed to A L Colledge.

6 recordsLinked to original sources
PubMed2001

Outcomes of posterolateral lumbar fusion in Utah patients receiving workers' compensation: a retrospective cohort study.

STUDY DESIGN: A retrospective cohort study consisting of a medical record review and a follow-up telephone survey of patients with lumbar fusion, at least 2 years after their surgery, was performed. OBJECTIVE: To identify presurgical correlates and long-term outcomes from posterolateral lumbar fusion in Utah patients receiving workers' compensation. SUMMARY OF BACKGROUND DATA: Lumbar fusion has been criticized for its highly variable outcomes, and compensated workers are at particular risk for poor outcomes. Evidence suggests that presurgical psychosocial factors may be important modifiers of back pain reporting and back surgery outcomes. METHODS: The patients in this study were 185 compensated workers in Utah who underwent posterolateral lumbar fusion. Patient medical records were independently reviewed, and medical and sociodemographic variables were coded. A telephone outcome survey was completed with 130 patients (70%) an average of 4.6 years after their surgery. RESULTS: Reported solid fusion, reoperation, and disability rates for the follow-up sample were 74%, 24%, and 25%, respectively. As reported by the patients, 41% experienced no change or a worsened quality of life. Mean scores from the Roland and Morris Back Pain Disability Questionnaire, the Stauffer-Coventry-Index, and the Short-Form 20 Multidimensional Health Survey indicate that many patients experienced postsurgical dysfunction. Presurgical predictors of outcomes were number of prior low back operations, income at time of injury, age, litigation, and depression. CONCLUSIONS: Outcomes of posterolateral lumbar fusion among compensated workers in Utah are inconsistent. Outcomes can be predicted by presurgical sociodemographic variables. Screening for such presurgical risk factors may be important for prudent surgical decisions and rehabilitation planning.

Adult↗
PubMed1999

Functional ability assessment: guidelines for the workplace.

Short- and long-term disability certification is required in all Western countries for extended time away from work. The Americans With Disabilities Act mandates that medical providers use rational thought and justifiable criteria when evaluating an employee's "fitness for duty". In order to facilitate employment/disability decisions, physicians must now serve as an advisor to the employer. Both the employer and the physician are legally obligated to carefully justify any recommendations for placement or exclusion from the workplace. We propose a uniform methodology that both physicians and employers could use together to determine the performance capability of an individual with a temporary or permanent impairment or disability in terms of essential job functions as defined under the Americans With Disabilities Act.

Disability Evaluation↗
PubMed1994

Chronic, recurrent low back pain. A methodology for analyzing fitness for duty and managing risk under the Americans with Disabilities Act.

Chronic, recurrent low back pain, although one of the most commonly encountered medical conditions in the workplace, is one of the most difficult to manage. With the passage of the Americans with Disabilities Act, the proper management of the worker with recurrent low back pain poses an even greater challenge. We propose an interdisciplinary methodology to evaluate the worker at high medical risk of recurrent low back pain and determine the potential ergonomic risks of essential function tasks in material-handling work. The proposal considers the ethical and legal liabilities of risk assessment and fitness for duty evaluation that physicians, ergonomists, attorneys, and ultimately business managers and supervisors experience in balancing the societal interests represented by the Americans with Disabilities Act.

Biomechanical Phenomena↗
PubMedDate not supplied

S.P.I.C.E.--a model for reducing the incidence and costs of occupationally entitled claims.

A review of national statistics and recent studies strongly suggests that current administrative and medical systems, when applied to managing workers' compensation claims and other disability-related benefit programs, are often ineffective and costly, and can even promote disability. With numerous medical and occupational health articles published daily, it is difficult to develop practical strategies for daily management of disability claims that make use of current information. It is the authors' view that a comprehensive, dynamic model for management exists within the military's "Forward Treatment" methodology. This model, originally published in The Journal of Occupational Rehabilitation, has been expanded to include those methods demonstrated in literature to both reduce claims and deal with them in an efficient, fair, and timely manner. Because military personnel and employed individuals are similarly entitled, the military's proven model can be effective in reducing claim rates and costs associated with workers' compensation as well as short- and long-term disability programs. The model, given the acronym S.P. I.C.E., includes five components: Simplicity, Proximity, Immediacy, Centrality, and Expectancy.

Disability Evaluation↗
PubMedDate not supplied

Unified fitness report for the workplace.

Fitness statements often are required of physicians by patients, employers, governmental agencies, and insurance providers to determine if the patient is fit for duty. Physicians making these ability statements are legally obligated to carefully justify them when placing or excluding individuals from the workplace. The Americans with Disabilities Act (ADA) mandates that medical providers use justifiable criteria and rational thought when determining the capability and risk of an individual. This chapter reviews the legal requirements of the ADA for employers and physicians and presents a uniform methodology that both can use to determine the performance capability of an individual with a temporary or permanent impairment or disability.

Evaluation Studies as Topic↗