Prognostic Factors and Models for Predicting Work Absence in Adults with Musculoskeletal Conditions Consulting a Healthcare Practitioner: A Systematic Review.
Gwenllian Wynne-Jones, Elaine Wainwright, Nicola Goodson and 5 others
PMID 38753046WHAT IT FOUND
Older age and positive recovery expectations were the most consistent predictors of shorter sickness absence in adults with musculoskeletal pain.
However, evidence was weak for all factors and prediction models due to inconsistent measurement and reporting.
Key findings
01Increasing age was associated with a lower risk of work absence, demonstrating a protective effect across nine studies.
02Better recovery expectations were associated with better work outcomes, though the direction of effect was mixed across the four studies reporting this factor.
03The strength of evidence for all prognostic factors and models was graded as low to very low due to heterogeneity in study design and outcome measurement.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The studies included used widely different definitions of work absence (e.g., days lost, weeks on benefits, binary return to work) and followed patients up for different lengths of time, preventing direct comparison. Many studies had high risk of bias, particularly regarding attrition and failure to report potential confounders. Prognostic models rarely reported on calibration, meaning it is unknown how well the predicted risks matched the actual outcomes. The review only included adults already absent from work and seeking healthcare, so findings may not apply to those who are not absent or do not seek care.
Declared interests
Funding was provided by the Versus Arthritis/MRC Centre for Musculoskeletal Health and Work and the Economic and Social Research Council.
The easy way to misread this
Do not assume that a specific prognostic model or factor can reliably predict long-term absence for an individual patient. The evidence is weak, and the models included in the review had poor reporting of their accuracy and calibration.