Correspondence in Stakeholder Assessment of Health, Work Capacity and Sick Leave in Workers with Comorbid Subjective Health Complaints? A Video Vignette Study.
Silje Maeland, Liv Heide Magnussen, Hege R Eriksen and 3 others
PMID 26615412WHAT IT FOUND
Stakeholders watching videos of workers with subjective, multiple complaints disagreed about health, work capacity and sick leave.
GPs were more likely than supervisors or the public to support full sick leave for one worker, and less likely for another.
Key findings
01The stakeholder groups differed in the labels they used for the workers' health problems in all four video cases.
02For the worker with general, musculoskeletal and psychological complaints, GPs were more likely than other stakeholders to assess poor health and reduced work capacity and to suggest full sick leave; the public was 6 and 12 times more likely than GPs to suggest partial sick leave and full time work.
03For the worker with neurological complaints, the public and supervisors were more likely than GPs to assess poor health, comorbidity or reduced work capacity, and all other stakeholders were less likely than GPs to suggest full time work.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The participants were recruited by convenience and self-selection, so they may have been more interested in sickness absence than typical stakeholders. The insurer group had only 28 participants, which weakens confidence in findings for insurance representatives. Some confidence intervals were wide, so those estimates had low statistical power. The study used only four video cases, so it cannot show how stakeholders would assess all workers with subjective health complaints. Participants could not ask follow-up questions to the workers, which may have limited their understanding and decisions. The methods and results report 514 participants, while the tables label the sample as 529; this inconsistency should be noted. The public group watched different numbers of vignettes, so the number analysing each worker varied. The study measured assessments of video cases, not patient outcomes or the effect of any treatment.
Declared interests
The funding section names Norges Forskningsråd (NO). The supplied text does not report author conflicts of interest.
The easy way to misread this
Do not read these results as proof that any stakeholder assessment is correct or that disagreement causes harm. The study asked people to judge four video cases, not real patients, and it did not test a return-to-work intervention or measure patient recovery.