Abstract
BACKGROUND AND OBJECTIVES: Prognostic tools are widely used to guide early management of musculoskeletal (MSK) injuries. However, social identity factors such as age, gender, race, and socioeconomic status may influence symptom experience and reporting, potentially affecting the accuracy of risk classification. The purpose of this study is to identify those social identity variables associated with scores on common prognostic tools or their prognostic accuracy. METHODS: We analyzed data from a cohort of workers (n = 203) with acute musculoskeletal injuries. Participants completed the Numeric Pain Rating Scale (NPRS), Traumatic Injuries Distress Scale (TIDS), EuroQoL (EQ5D-5L), and a demographic survey including age, sex, race, income, education, and perceived discrimination. Differences in baseline scores were assessed between identity groups. Recovery was dichotomized (fully recovered/not fully recovered) using 3 different recovery indicators. Predictive accuracy for recovery was evaluated using area under the receiver operating characteristic curve, sample-wide and when stratified by social identity variables. RESULTS: Older participants reported significantly higher pain (5.5 vs. 4.3/10, p < 0.01) and those indicating more experiences of discrimination rated higher post-trauma distress (11.1 vs. 9.2/24, p < 0.05). 8-week recovery rates were 21.7% to 54.7%. Lower education predicted