Inter-physician agreement on the readiness of sick-listed employees to return to work

Schreuder, Jolanda A. H.; Roelen, Corné; Boer, Marrit de; Brouwer, Sandra; Groothoff, Johan W.

doi:10.3109/09638288.2012.665125

Cited by 9 publications

(8 citation statements)

References 16 publications

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“…Our findings expand previous understanding of the relevant knowledge, skills and attitudes needed from occupational health practitioners, as well as the multi-level environmental factors that influence the application of work modifications [ 11 – 15 , 35 – 38 ]. By utilizing the TDF we were able to conduct a comprehensive theory-informed assessment of all potential factors that influence OPs’ key behaviors.…”

Section: Discussionsupporting

confidence: 79%

Application of the Theoretical Domains Framework and the Behaviour Change Wheel to Understand Physicians’ Behaviors and Behavior Change in Using Temporary Work Modifications for Return to Work: A Qualitative Study

et al. 2017

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Purpose Applying the theoretical domains framework (TDF) and the Behaviour Change Wheel (BCW) to understand physicians’ behaviors and behavior change in using temporary work modifications (TWMs) for return to work (RTW). Methods Interviews and focus group discussions were conducted with 15 occupational physicians (OPs). Responses were coded using the TDF and the BCW. Results Key behaviors related to applying TWMs were initiating the process with the employee, making recommendations to the workplace, and following up the process. OP behaviors were influenced by several factors related to personal capability and motivation, and opportunities provided by the physical and social environment. Capability comprised relevant knowledge and skills related to applying TWMs, remembering to initiate TWMS and monitor the process, and being accustomed to reflective practice. Opportunity comprised physical resources (e.g., time, predefined procedures, and availability of modified work at companies), and social pressure from stakeholders. Motivation comprised conceptions of a proper OP role, confidence to carry out TWMs, personal RTW-related goals, beliefs about the outcomes of one’s actions, feedback received from earlier cases, and feelings related to applying TWMs. OPs’ perceived means to target these identified factors were linked to the following BCW intervention functions: education, training, persuasion, environmental restructuring, and enablement. The results suggest that at least these functions should be considered when designing future interventions. Conclusions Our study illustrates how theoretical frameworks TDF and BCW can be utilized in a RTW context to understand which determinants of physicians’ behavior need to be targeted, and how, to promote desired behaviors.Electronic supplementary materialThe online version of this article (doi:10.1007/s10926-017-9706-1) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 79%

Application of the Theoretical Domains Framework and the Behaviour Change Wheel to Understand Physicians’ Behaviors and Behavior Change in Using Temporary Work Modifications for Return to Work: A Qualitative Study

et al. 2017

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“…Of 4562 potentially relevant citations identified, 101 reports proved potentially eligible after we had screened titles and abstracts. On full text screening, 23 studies, 9 11 22 23 24 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 including four non-English studies, 9 39 40 41 proved eligible for analysis (fig 1 ). All studies were published from 1992 onwards and enrolled disability claimants from 12 countries in Europe, North America, Australia, the Middle East, and northeast Asia.…”

Section: Resultsmentioning

confidence: 99%

“…In the insurance setting, 13 studies including 463 patients and 367 raters explored agreement between medical experts (two or more experts assessing the same patient) (table 1 ; appendix 4). 9 11 22 23 24 32 34 37 39 43 44 45 46 Three studies including 3729 patients (with 3562 patients from a single centre 33 ) and eight raters (information was lacking from one study 33 ) explored agreement between medical experts and claimant’s treating physicians 33 or independent rehabilitation or occupational health teams with a mandate to care. 38 42 The median number of patients per study was 13.5 (range 1-3562), and the median number of raters per study was 12 (2-103, excluding one study that did not report the number of raters 33 ).…”

Section: Resultsmentioning

confidence: 99%

Inter-rater agreement in evaluation of disability: systematic review of reproducibility studies

Barth

Boer

Busse

et al. 2017

BMJ

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Objectives To explore agreement among healthcare professionals assessing eligibility for work disability benefits.Design Systematic review and narrative synthesis of reproducibility studies.Data sources Medline, Embase, and PsycINFO searched up to 16 March 2016, without language restrictions, and review of bibliographies of included studies.Eligibility criteria Observational studies investigating reproducibility among healthcare professionals performing disability evaluations using a global rating of working capacity and reporting inter-rater reliability by a statistical measure or descriptively. Studies could be conducted in insurance settings, where decisions on ability to work include normative judgments based on legal considerations, or in research settings, where decisions on ability to work disregard normative considerations.Teams of paired reviewers identified eligible studies, appraised their methodological quality and generalisability, and abstracted results with pretested forms. As heterogeneity of research designs and findings impeded a quantitative analysis, a descriptive synthesis stratified by setting (insurance or research) was performed.Results From 4562 references, 101 full text articles were reviewed. Of these, 16 studies conducted in an insurance setting and seven in a research setting, performed in 12 countries, met the inclusion criteria. Studies in the insurance setting were conducted with medical experts assessing claimants who were actual disability claimants or played by actors, hypothetical cases, or short written scenarios. Conditions were mental (n=6, 38%), musculoskeletal (n=4, 25%), or mixed (n=6, 38%). Applicability of findings from studies conducted in an insurance setting to real life evaluations ranged from generalisable (n=7, 44%) and probably generalisable (n=3, 19%) to probably not generalisable (n=6, 37%). Median inter-rater reliability among experts was 0.45 (range intraclass correlation coefficient 0.86 to κ−0.10). Inter-rater reliability was poor in six studies (37%) and excellent in only two (13%). This contrasts with studies conducted in the research setting, where the median inter-rater reliability was 0.76 (range 0.91-0.53), and 71% (5/7) studies achieved excellent inter-rater reliability. Reliability between assessing professionals was higher when the evaluation was guided by a standardised instrument (23 studies, P=0.006). No such association was detected for subjective or chronic health conditions or the studies’ generalisability to real world evaluation of disability (P=0.46, 0.45, and 0.65, respectively).Conclusions Despite their common use and far reaching consequences for workers claiming disabling injury or illness, research on the reliability of medical evaluations of disability for work is limited and indicates high variation in judgments among assessing professionals. Standardising the evaluation process could improve reliability. Development and testing of instruments and structured approaches to improve reliability in evaluation of disability are urgently ...

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“…In a Dutch study, it was found that OPs who had training regarding existing evidence for return-to-work prognosis, and who performed scientific database searches regularly, did succeed better in advising interventions, but not in providing correct prognoses for their patients, compared with a control group [25]. An inter-individual variability has been shown to exist among OPs for decisions concerning assessment of fitness for work [26,27]. In several studies, proposals of methods for increasing quality in predicting sick leave duration among OPs are put forward [13,14].…”

Section: Discussionmentioning

confidence: 99%

Occupational health physicians have better work conditions for handling sickness certification compared with general practitioners: Results from a nationwide survey in Sweden

Ljungquist

Alexanderson

Kjeldgård

et al. 2014

Scand J Public Health

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Inter-physician agreement on the readiness of sick-listed employees to return to work

Abstract: The inter-OP agreement on intuitively rated RRTW showed a wide variability, which accentuates the need for instruments to establish an employee's RRTW and for training in giving well founded return to work recommendations.

Cited by 9 publications

References 16 publications

Application of the Theoretical Domains Framework and the Behaviour Change Wheel to Understand Physicians’ Behaviors and Behavior Change in Using Temporary Work Modifications for Return to Work: A Qualitative Study

Application of the Theoretical Domains Framework and the Behaviour Change Wheel to Understand Physicians’ Behaviors and Behavior Change in Using Temporary Work Modifications for Return to Work: A Qualitative Study

Inter-rater agreement in evaluation of disability: systematic review of reproducibility studies

Occupational health physicians have better work conditions for handling sickness certification compared with general practitioners: Results from a nationwide survey in Sweden

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