FROM:   
J Occup Environ Med. 2018 (Jul); 60 (7): 617–621 ~ FULL TEXT
 
Cristina Demian; Bruce Barron; Anthony Almudevar
   
Department of Environmental Medicine, 
University of Rochester Medical Center
  OBJECTIVE:      Examine the association between New York State Workers' Compensation Medical Treatment Guidelines (Guidelines) adherence and return-to-work after occupational low back injuries. Assess adherence to Guidelines by examining diagnostic and treatment utilization.  
  METHOD:      Retrospective chart review of cases. Outcomes of interest were lost time duration and diagnostic/treatment utilization rates. Time to event analyses performed using Kaplan Meier plots and Cox proportional hazard model.  
  RESULTS:      Care received after implementation of Guidelines resulted in decreased lost time. Treatment rates were consistent, while diagnostic imaging use was inconsistent with Guidelines recommendations.  
  CONCLUSIONS:      Guidelines use positively influenced return-to-work after acute occupational low back injuries. Inconsistencies in following Guidelines were observed for diagnostic tests, having a potential paradoxical effect on lost time. Further studies are necessary to test for additional hypotheses.