Methods in Measuring Return to Work: A Comparison of Measures of Return to Work Following Treatment of Coronary Heart Disease

Abstract

Different measures revealed some differences in proportions of RTW. However, high agreement between RTW-definitions was found. Choice of RTW-definitions should depend on study purpose; simple cross-sectional methods are sufficient in prediction of RTW and analysis of risk factors, while methods capturing relapses are recommended when sustainability, prognosis and vulnerability are in focus.

Return to Work in Out-of-Hospital Cardiac Arrest Survivors

“…This 5-week evaluation of employment status was used both at baseline and 1-year follow-up to reduce misclassification; that is, if sick leaves were <3 weeks during the 5-week span, patients were classified as working. 27 Other than evaluating employment status at baseline and 1-year follow-up, we also calculated time to return to work, counting from the day of entry (30 days/4 weeks after arrest) to the first week of employment. For patients returning to work, we further evaluated the duration of maintenance of work.…”

“…It has been shown previously that a significant proportion of patients with coronary heart disease undergoing percutaneous intervention treatment with return to work have recurrent sick leaves and, thus, return to work alone may not indicate full recovery in all cases. 27 Therefore, we further assessed definitions of maintenance of work in which we allowed for 4 to 12 weeks of work absences after return to work. Further in line with this study, we defined return to work without any sick leave relapse during the first 6 months of employment as our end point for modeling.…”

“…26,27 However, the high positive predictive value of being registered as self-supporting in the employment registry, together with the applied 5-week spans to evaluate employment status at baseline and for 1-year follow-up, the sustainable return-to-work definition for modeling, and subsequent linkages to income and industry affiliation minimized potential misclassification. Few of the studied patients who were registered as having returned to work (8.3%) did not have industry affiliation, which either indicates a missing data problem in industry affiliation codes or that these patients did not return to work but supported themselves by worker's compensation.…”

Return to work after work-related stress: a randomized controlled trial of a work-focused cognitive behavioral intervention

“…The register data was available for all participants and were not influenced by reporting bias or loss to follow-up. Lasting RTW was defined as four consecutive weeks with no transfer payment (such as health-related benefits) in DREAM, based on two prior stress management studies (22,30) and on a previous study from Biering et al (31). If one used only the first week with no transfer payment indicating sick leave, then temporary administrative breaks, such as holidays or payment changes, could easily be misinterpreted as RTW.…”

“…Studies often examine RTW without clearly specifying what is meant by the term full or lasting RTW (10,20,23). Biering et al (31) advocated the use of registers like DREAM as an opportunity to use a measure reflecting sustainable work resumption (ie, in this case four consecutive weeks of work resumption).…”