Matthias Bethge1, Christoph Gutenbrunner, Silke Neuderth. 1. Department for Rehabilitation Medicine, Coordination Centre for Applied Rehabilitation Research, Hannover Medical School, Hannover. Electronic address: bethge.matthias@mh-hannover.de.
Abstract
OBJECTIVE: To determine whether the Work Ability Index (WAI), a short 7-item self-report questionnaire addressing issues of perceived disability, impairment, and expectations for resuming work, predicts application for disability pension, recommendations for further treatment, and other adverse work-related criteria in patients with chronic back pain after rehabilitation. DESIGN: Cohort study with 3-month follow-up. SETTING: Seven inpatient rehabilitation centers. PARTICIPANTS: Patients (N=294; 168 women; mean age, 49.9y) with chronic back pain. INTERVENTION: The WAI was completed at the beginning of rehabilitation. All patients were treated according to the German rehabilitation guidelines for chronic back pain and work-related medical rehabilitation. MAIN OUTCOME MEASURE: Application for disability pension, as assessed by a postal questionnaire 3 months after discharge. RESULTS: Receiver operating characteristic curve analysis of the association between the WAI at baseline and subsequent application for disability pension revealed an area under the curve of .80 (95% confidence interval [CI], .62-.97). Youden index was highest when the WAI cutoff value was ≤20 points (sensitivity, 72.7%; specificity, 82.2%; total correct classification, 81.7%). After adjusting for age and sex, persons with a baseline WAI score of ≤20 points had 15.6 times (95% CI, 3.6-68.2) higher odds of subsequent application for disability pension, 4.9 times (95% CI, 1.5-16.8) higher odds of unemployment, and 6 times (95% CI, 2.4-15.2) higher odds of long-term sick leave at follow-up. CONCLUSIONS: The WAI could help rehabilitation professionals identify patients with back pain with a high risk of a subsequent application for disability pension.
OBJECTIVE: To determine whether the Work Ability Index (WAI), a short 7-item self-report questionnaire addressing issues of perceived disability, impairment, and expectations for resuming work, predicts application for disability pension, recommendations for further treatment, and other adverse work-related criteria in patients with chronic back pain after rehabilitation. DESIGN: Cohort study with 3-month follow-up. SETTING: Seven inpatient rehabilitation centers. PARTICIPANTS: Patients (N=294; 168 women; mean age, 49.9y) with chronic back pain. INTERVENTION: The WAI was completed at the beginning of rehabilitation. All patients were treated according to the German rehabilitation guidelines for chronic back pain and work-related medical rehabilitation. MAIN OUTCOME MEASURE: Application for disability pension, as assessed by a postal questionnaire 3 months after discharge. RESULTS: Receiver operating characteristic curve analysis of the association between the WAI at baseline and subsequent application for disability pension revealed an area under the curve of .80 (95% confidence interval [CI], .62-.97). Youden index was highest when the WAI cutoff value was ≤20 points (sensitivity, 72.7%; specificity, 82.2%; total correct classification, 81.7%). After adjusting for age and sex, persons with a baseline WAI score of ≤20 points had 15.6 times (95% CI, 3.6-68.2) higher odds of subsequent application for disability pension, 4.9 times (95% CI, 1.5-16.8) higher odds of unemployment, and 6 times (95% CI, 2.4-15.2) higher odds of long-term sick leave at follow-up. CONCLUSIONS: The WAI could help rehabilitation professionals identify patients with back pain with a high risk of a subsequent application for disability pension.
Keywords:
AUC; Back pain; HRQOL; ICD-10; International Classification of Diseases–10th Revision; Medical Outcomes Study 36-Item Short-Form Health Survey; Needs assessment; Pensions; Questionnaires; ROC; Rehabilitation; SES; SF-36; WAI; WMR; Work Ability Index; area under the curve; health-related quality of life; receiver operating characteristic; standardized effect size; work-related medical rehabilitation
Authors: Kerstin G Reeuwijk; Suzan J W Robroek; Maurice A J Niessen; Roderik A Kraaijenhagen; Yvonne Vergouwe; Alex Burdorf Journal: PLoS One Date: 2015-05-27 Impact factor: 3.240
Authors: Pernille Frederiksen; Aage Indahl; Lars L Andersen; Kim Burton; Rasmus Hertzum-Larsen; Tom Bendix Journal: PLoS One Date: 2017-03-27 Impact factor: 3.240