Associations of Steroid Injection, Referral to Physiotherapist, and Medical Specialist: Results of Multivariate Logistic Regression Analyses (Multilevel)
| Variables | Steroid Injection OR (95% CI) | Physical Therapist OR (95% CI) | Medical Specialist OR (95% CI) |
|---|---|---|---|
| All variables in the final model have a multivariate association with a P <.05. | |||
| DASH = Disability of Arm Shoulder and Hand questionnaire; 4DSQ = Four-Dimensional Symptom Questionnaire; OR = odds ratio; n = number of patients; ref = reference group. | |||
| aScored on a range from 1 to 10 with 10 being the most severe, and 6 is the median. | |||
| bEach item scored on a 5-point Likert scale and summed and transferred to a score ranging from 0 (no disability) to 100 (completely disabled).15 | |||
| cScored on a range from 0 to 32; a higher score indicates more somatization or distress.19 | |||
| dUrbanization rate: rural = addresses ≥ 1,000/km2, urban=addresses >1,000/km2.20 | |||
| Diagnosis | |||
| Epicondylitis | 2.0 (0.8–5.2) | 0.9 (0.4–2.2) | 1.6 (0.5–4.7) |
| Impingement, biceps tendonitis, frozen shoulder | 9.6 (4.9–18.7) | 0.5 (0.3–0.8) | 2.0 (0.9–4.6) |
| Other specific diagnosis | 3.7 (1.4–9.7) | 0.3 (0.2–0.5) | 5.0 (2.2–11.3) |
| Nonspecific diagnosis, ref | 1.0 | 1.0 | 1 |
| Patient and complaint characteristics | |||
| Younger age (18–45 y) vs older (46–64 y) | 0.6 (0.4–0.9) | – | – |
| Duration of the complaint at consultation: | |||
| 0–6 wk (ref) | 1.0 | 1.0 | 1 |
| 6 wk – 6 mo | 1.3 (0.8–2.1) | 1.7 (0.9–3.1) | 4.9 (1.2–20.4) |
| >6 mo | 1.7 (1.0–2.8) | 2.4 (1.4–4.3) | 16.4 (4.9–54.8) |
| High complaint severity in the last week (score >6) vs lowa | 1.8 (1.1–2.9) | – | – |
| Many functional limitations (DASH score >35.34) vs littleb | 1.6 (1.1–2.4) | – | 2.1 (1.1–4.1) |
| Recurrent complaint vs incident complaint | – | 1.6 (1.2–2.1) | – |
| Distress, 4DSQc | – | – | |
| Low (score 0–10) | – | 1.0 | – |
| Medium (score 11–20) | – | 1.4 (1.0–2.0) | – |
| High (score 21–32) | – | 1.9 (1.3–2.8) | – |
| GP characteristics | |||
| Few years of practice (<13 years) vs many | – | – | 2.3 (1.2–4.6) |
| Special interest in musculoskeletal complaints vs no | 4.4 (1.7–11.4) | – | – |
| Rural vs urband | – | 1.9 (1.2–3.1) | – |