Interrelationships among workload, illness severity, and function on return to work following acute respiratory distress syndrome.

This was an observational study, so it cannot show that function, illness severity, or early work caused later employment. Follow-up stopped at 12 months, so it does not show whether these links hold later. Each function domain was modelled separately, so the study cannot determine the relative importance of combined cognitive, psychological, interpersonal, and physical disability. Cognitive function was measured only with the MMSE, which had small variability and fair to moderate agreement with comprehensive testing, and it did not show a direct link to work. Physical and psychological function were measured by self-report SF-36 subscales rather than performance tests. Participants who retired during follow-up were excluded, and the reason for retirement was unknown. The job workload measure was based on a US occupational database and may not apply in other countries. The results text reports 52% and 55% working at 6 and 12 months, while Table 1 reports 52% and 56%.

The authors declared no conflicts. The analysis used data from the National Institutes of Health-funded ARDS Network Long-Term Outcomes Study, supported by NHLBI contracts and grants, and one author received a University of Washington dissertation award.

Do not read work at 6 months as proof that early return to work causes employment at 12 months. This was an observational study, and it showed associations, not tested effects.