Predicting Long-Term Sickness Absence and Identifying Subgroups Among Individuals Without an Employment Contract.
Ilse Louwerse, H Jolanda van Rijssen, Maaike A Huysmans and 2 others
PMID 32030546WHAT IT FOUND
Three questions predict who stays sick-listed for a year: education level, expected absence duration, and help-seeking ability.
Workers expecting absence over three months or lacking help-seeking skills are high risk. Four subgroups emerged, with those holding negative expectations needing the most return-to-work support.
Key findings
01A prediction model using only educational level, expected sickness absence duration, and help-seeking ability fairly discriminated between workers with and without long-term sickness absence.
02Workers expecting sickness absence to last more than three months had higher odds of long-term sickness absence, while those with help-seeking ability had lower odds.
03Latent class analysis identified four subgroups, with the 'negative expectations' cluster showing the highest predicted risk of long-term sickness absence and poor coping skills.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study population was restricted to workers without permanent employment contracts in the Netherlands, limiting generalizability to employed workers or other countries. Self-reported questionnaires were developed for practical purposes rather than being fully validated research instruments, and may have missed other relevant predictors. The prediction model was developed and validated internally within the same cohort, so external validity is unknown. Latent class analysis clusters are statistically derived and may not always align with clinically recognizable patient groups without professional consensus.
Declared interests
The study was conducted by researchers at Amsterdam UMC and the Dutch Social Security Institute. The text does not list specific funding sources or declare conflicts of interest, but notes that data collection was part of the mandatory SSI process.
The easy way to misread this
Do not assume this model is ready for clinical use without external validation. The discrimination was fair but not strong, and the model was derived from a specific Dutch population of workers without permanent contracts. It does not account for the actual interventions received, so a high predicted risk does not guarantee a poor outcome if appropriate support is provided.