Hypermetabolism has no association with clinical data and thus is an extrahepatic manifestation of liver disease. Increased beta-adrenergic activity may explain approximately 25% of hypermetabolism.

The German heiQ™ is comprehensible for German-speaking patients suffering from different types of chronic conditions; it assesses relevant outcomes of self-management programs in a reliable and valid manner. Further studies involving its practical application are warranted.

Use of the JR-DL for the improvement of communication and exchange of relevant information is feasible and supportive for both rehabilitation and occupational physicians. Its positive impact on reintegration and return to work was apparent. Delays in receipt of the JR-DL should be eliminated by appropriate quality assurance measures.