Workers’ compensation board claims and emergency department diagnostic management of non-specific low back pain
Bibliographic record
Abstract
Background: Low back pain is a leading cause of disability worldwide and results in enormous healthcare and lost productivity costs. Guidelines exist to guide the management of low back pain, but guideline adherence varies.Objective: This study assessed whether initial presentation to the emergency department for non-specific low back pain with a Workers’ Compensation Board of Nova Scotia claim was associated with different diagnostic management from non-claimants.Methods: In this retrospective cohort study, we analyzed administrative data from four emergency departments in Nova Scotia on 18,337 adult patients who presented for non-specific low back pain between July 15, 2009 and May 1, 2019. All data were retrieved from the Nova Scotia Health Authority Emergency Department Information System.Results: Patients had a mean age of 43 years and 51.3% were female. Most patients were assigned a Canadian Triage Acuity Scale score of 3 (51.9%) and reported moderate (51.2%) to severe pain (41.5%). Occupational injuries consisted of 11.6% of visits. More than 37% of patients received one or more diagnostic test. Patients with occupational injuries were less likely to receive diagnostic tests (odds ratio [OR] = 0.52, 95% CI 0.47 to 0.58), imaging (OR = 0.60, 95% CI 0.54 to 0.67), and laboratory tests (OR = 0.35, 95% CI 0.29 to 0.43). These results remained consistent when controlling for covariates.Conclusion: Patients who presented to the emergency department for occupational non-specific low back pain were less likely to receive diagnostic tests compared to non-occupational non-specific low back pain patients.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.006 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".