Code of Colorado Regulations
1100 - Department of Labor and Employment
1101 - Division of Workers' Compensation
7 CCR 1101-3 R17 Ex 08 - Rule 17, Exhibit 8 - CERVICAL SPINE INJURY MEDICAL TREATMENT GUIDELINES
Appendix 7 CCR 1101-3-17-08
Functional Outcome Measures
|
Name of Test |
Body Part |
Description |
|
36-Item Short Form Survey (SF-36) and 12-Item Short Form Survey (SF-12) |
Physical Health |
Assesses activities of daily living (ADLs) |
|
Brief Pain Inventory |
General |
Sleep, walking, ADLs |
|
Focus on Therapeutic Outcomes (FOTO) |
Various Body Parts |
Functional ADLs specific to body part |
|
Oxford Shoulder Instability Score |
Shoulder |
Functional ADLs |
|
Quick DASH (Disabilities of the Arm, Shoulder and Hand) |
Upper Extremity |
Shoulder, elbow and hand assessment |
|
Simple Shoulder Test |
Shoulder |
Shoulder function only |
|
Upper Extremity Functional Scale |
Upper Extremity |
Functional ADLs related to Upper Extremity |
Psychological Screens
|
Name of Test |
Description |
|
Brief Battery for Health Improvement, 2nd Edition (BBHI 2) |
Measures pain, functioning, somatization, depression, anxiety, and defensiveness; brief measure of risk factors for delayed recovery |
|
Distress and Risk Assessment Method (DRAM) |
Measures depression and somatic symptoms of anxiety, risk factors commonly associated with chronic pain |
|
Center for Epidemiological Studies Depression Scale (CES-D) |
Measures depression, 20 items |
|
Beck Depression Inventory-II (BDI-II) |
Measures depression, 21 items |
|
Primary Care Evaluation for Mental Disorders (PRIME-MD) Must be filled out by a provider |
2 components: paper and pencil screen for patient and follow-up interview by physician. Assesses mood, anxiety, somatoform tendencies, and alcohol and eating disorders |
|
Zung Depression Inventory |
Measures depression, brief measure |
|
Patient Health Questionnaire (PHQ) and PHQ-9 |
Self-administered version of the PRIME-MD. Assesses mood, anxiety, somatoform tendencies, and alcohol and eating disorders |
|
Generalized Anxiety Disorder Scale (GAD-7) |
Assesses generalized anxiety, 7 questions |
|
Behavioral Health Index-Multimedia Version (BHI-MV) |
Screens for addiction |
