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Diagnostic concordance between primary care physicians and rheumatologists in patients with work disability related to musculoskeletal disorders

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Abstract

To assess the diagnostic correlation between primary care physicians and rheumatologists in patients with temporary work disability (TWD) related to musculoskeletal diseases (MSD). All patients with TWD related to MSDs in three health districts of Madrid, Spain, were randomized into standard care by primary care physicians (PCP) or the intervention group by rheumatologists. According to the cause, every TWD episode was classified into 11 syndrome categories. To examine the concordance between the rheumatologist and the referring PCP for each diagnosis, we used Kappa statistic (k) and 95% confidence interval (CI). A total of 3,311 (62.8%) were analyzed, 49.8% women, with a mean age of 41 years ± 12 years, 93.3% were general workers. The agreement between PCP and rheumatologists in all the diagnoses was moderated (k = 0.62). The highest agreement was found in tendonitis (k = 0.81, 95% CI 0.78–0.84), and microcrystalline and undifferentiated arthritis (k = 0.72, 95% CI 0.68–0.77). Lowest agreements were found for peripheral osteoarthritis (k = 0. 48 95% CI 0.38–0.57), knee pain (k = 0.40, 95% CI 0.29–0.52), and muscular pain (k = 0.15, 95% CI 0.10–0.20) Although the global agreement on the musculoskeletal diagnosis between PCPs and rheumatologist in patients with TWD related to MSDs was reasonable, the correlation for peripheral osteoarthritis, knee pain, and muscular pain was low.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Hospital Clinico San Carlos, Madrid, Spain

    Gloria Candelas, Lydia Abasolo, Leticia Leon, Cristina Lajas, Margarita Blanco & Juan A. Jover

  2. Research Unit, Fundación Española de Reumatología, Madrid, Spain

    Estibaliz Loza

  3. Hospital Ramón y Cajal, Madrid, Spain

    Marcelino Revenga & Javier Bachiller

  4. Hospital Severo Ochoa, Madrid, Spain

    Paz Collado

  5. Hospital Infanta Sofia, Madrid, Spain

    Patricia Richi

Authors
  1. Gloria Candelas
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  2. Lydia Abasolo
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  3. Leticia Leon
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  4. Cristina Lajas
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  5. Estibaliz Loza
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  6. Marcelino Revenga
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  7. Javier Bachiller
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  8. Paz Collado
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  9. Patricia Richi
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  10. Margarita Blanco
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  11. Juan A. Jover
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Correspondence to Leticia Leon.

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Candelas, G., Abasolo, L., Leon, L. et al. Diagnostic concordance between primary care physicians and rheumatologists in patients with work disability related to musculoskeletal disorders. Rheumatol Int 31, 1549–1554 (2011). https://doi.org/10.1007/s00296-010-1522-2

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  • DOI: https://doi.org/10.1007/s00296-010-1522-2

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