of musculoskeletal disorders using these well-defined and validated measures of exposure.
2. Develop improved measures of outcomes and case definitions for use in epidemiologic and intervention studies. These should include but not be limited to:
Develop prognostic tools to identify clinical cases at increased risk for poorer outcomes and to tailor interventions to identified risk factors (e.g., ergonomic stressors, job stress).
Develop tools and measures that are capable of quantifying the extent of a musculoskeletal disorder with adequate precision so that they can be used as precise dependent measures for prospective epidemiologic studies involving the workplace.
Further develop and refine standardized survey instruments to identify symptomatic musculoskeletal outcomes with adequate sensitivity and specificity for use in epidemiologic studies in work environments.
Further develop and refine physical examination and sensory discrimination criteria to identify musculoskeletal outcomes with adequate specificity and sensitivity for use in epidemiologic studies in work environments.
Develop and refine epidemiologic case definitions of musculoskeletal disorders with adequate sensitivity and specificity for epidemiologic study in work environments. Case definitions that rely solely on self-report information are particularly useful for large survey studies. Case definitions that use both self-report and physical examination data are needed for more detailed studies.
As these criteria evolve, particular attention needs to be paid to nonspecific pain syndromes that are not congruent with established clinical syndromes. There is a need to develop an appropriate classification of subgroups of nonspecific pain syndromes in order to carry out more effective epidemiologic studies of these syndromes.
Further develop and refine physiological measures appropriate for use in epidemiologic studies that measure relevant features of the various musculoskeletal disorders, including for example, nerve conduction testing.
Develop and evaluate definitions of musculoskeletal disorders currently used in epidemiologic studies to identify the best symptom-based and physical exam-based criteria for musculoskeletal disorders that can be recommended as the standards for use in epidemiologic studies of the different syndromes in the work environment.