Evidence needs, training demands, and opportunities for knowledge translation in social security and insurance medicine: A European survey.
Regina Kunz, Adrian Verbel, Rebecca Weida-Cuignet and 12 others
PMID 33778897WHAT IT FOUND
Insurance physicians across Europe consistently report needing more evidence on mental and musculoskeletal disorders, work capacity, and prognosis.
Most find systematic reviews and guidelines trustworthy, but half lack confidence in interpreting studies or applying evidence to cases.
Key findings
01Mental disorders, musculoskeletal disorders, and work-related health complaints were the top priorities for more evidence syntheses, cited by 79%, 67%, and 65% of respondents respectively.
02While 95% of respondents considered evidence-based medicine a method to enhance decision-making, only 44% felt comfortable interpreting studies and 48% applying evidence to cases, with roughly half welcoming training in these skills.
03Respondents preferred guidelines and systematic reviews as sources of evidence, but only 25% of those who recently searched the Cochrane Library found the information they sought.
STILL TO COME
How it was doneWhat they found
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What it does not show
The overall response rate was 30%, with significant variation between countries (from 5% to 47%), raising the possibility of participation bias where those already comfortable with evidence-based medicine were more likely to respond. The study relied on self-reported perceptions of skills and needs, which may not align with actual competency or objective evidence gaps. The survey did not enforce answers, so the number of respondents varied by question, and the sampling method prevented analysis of non-responders' characteristics. Findings are specific to insurance medicine and social security physicians, a distinct professional group from clinical treating therapists.
Declared interests
The study was funded in-house. The authors declared no conflicts of interest, except for R. Kunz, who was employed part-time by the Swiss National Accident Insurance Funds.
The easy way to misread this
Do not interpret the high endorsement of evidence-based medicine as evidence that insurance physicians consistently apply it in practice. The study found that while 95% supported the method, only 48% felt comfortable applying evidence to cases, and many lacked access to or familiarity with key resources like Cochrane reviews.