The studies reviewed found improvement in pain and functioning on average among patients with chronic noncancer pain who received permanent IDDS. However, their methodologic limitations preclude conclusions concerning the effectiveness of this technology long-term and as compared with other treatments. Drug side effects and hardware complications were common. Suggestions are made for methodologic improvements in future studies.

The WTR work-related indicator is highly sensitive and may identify injuries that occur in the course of exempt/excluded employment, are not reported to workers' compensation, and/or are work-related using definitions that go beyond WC coverage. Judicious use of external cause codes may identify additional work-related injuries.

This study demonstrated the importance of considering differential access to other insurance coverage and adaptation by health care settings to financial pressures when assessing trends in occupational injury incidence and reporting, especially when using WC as a proxy for work-relatedness. The addition of occupation, industry, and work status to trauma registries and hospital discharge databases would improve surveillance, research, policy and prevention efforts.

NCT0178830; Results.

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Findings suggest potentially dramatic cost shifting from WC to Medicare. This study adds to limited, but mounting evidence that, in at least some states, the burden on non-WC payers to cover health care for industrial injuries is growing, even while WC-related employer costs are decreasing-an area that warrants further research.

Capturing industry and occupation would enhance utility for occupational injury surveillance and research. Trauma registry data could contribute to prevention planning/evaluation, improve case ascertainment for severe occupational injuries, and aid identification of high-risk populations and emerging trends.