Evidence map›Paper›PMID 36106901›Full record

Observational studyMuscle & nerve2023

The quality of occupational healthcare for carpal tunnel syndrome, healthcare expenditures, and disability outcomes: A prospective observational study.

Teryl K Nuckols, Michael Dworsky, Craig Conlon, Michael Robbins, Douglas Benner, Seth Seabury, Steven M Asch

Abstract readObservational Study
In one paragraph

Observational study in Muscle & nerve, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Teryl K NuckolsRAND Health Care, RAND Corporation, Santa Monica, California, USA.ORCID 0000-0002-0416-1595
Michael DworskyRAND Health Care, RAND Corporation, Santa Monica, California, USA.
Craig ConlonEmployee Health, The Permanente Medical Group, Oakland, California, USA.
Michael RobbinsRAND Health Care, RAND Corporation, Santa Monica, California, USA.
Douglas BennerEK Health Inc., San Jose, California, USA.
Seth SeaburyDepartment of Pharmaceutical and Health Economics, USC School of Pharmacy, University of Southern California, Los Angeles, California, USA.
Steven M AschRAND Health Care, RAND Corporation, Santa Monica, California, USA.

Funding

The Value of High Quality Medical Care for Work-Associated Carpal Tunnel SyndromeR01HS018982 · AHRQ · RAND CORPORATION · PI NUCKOLS, TERYL · 2010 to 2014
$2.5M
AHRQ HHS R01 HS018982
6 · The paper itself

Abstract

INTRODUCTION/

aimsIn prior work, higher quality care for work-associated carpal tunnel syndrome (CTS) was associated with improved symptoms, functional status, and overall health. We sought to examine whether quality of care is associated with healthcare expenditures or disability.

methodsAmong 343 adults with workers' compensation claims for CTS, we created patient-level aggregate quality scores for underuse (not receiving highly beneficial care) and overuse (receiving care for which risks exceed benefits). We assessed whether each aggregate quality score (0%-100%, 100% = better care) was associated with healthcare expenditures (18-mo expenditures, any anticipated need for future expenditures) or disability (days on temporary disability, permanent impairment rating at 18 mo).

resultsMean aggregate quality scores were 77.8% (standard deviation [SD] 16.5%) for underuse and 89.2% (SD 11.0%) for overuse. An underuse score of 100% was associated with higher risk-adjusted 18-mo expenditures ($3672; 95% confidence interval [CI] $324 to $7021) but not with future expenditures (-0.07 percentage points; 95% CI -0.48 to 0.34), relative to a score of 0%. An overuse score of 100% was associated with lower 18-mo expenditures (-$4549, 95% CI -$8792 to -$306) and a modestly lower likelihood of future expenditures (-0.62 percentage points, 95% CI -1.23 to -0.02). Quality of care was not associated with disability. DISCUSSION: Improving quality of care could increase or lower short-term healthcare expenditures, depending on how often care is currently underused or overused. Future research is needed on quality of care in varied workers' compensation contexts, as well as effective and economical strategies for improving quality.

Indexed as

Carpal Tunnel SyndromeOccupational DiseasesAdultDelivery of Health CareHealth ExpendituresHumansProspective StudiesWorkers' Compensationcarpal tunnel syndromedisabilityhealthcare expendituresquality of careworkers' compensation

Identifiers

PMID36106901
PMCPMC9780165

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.