Marco Streibelt1, Matthias Bethge2, Thomas Gross3, Klaus Herrmann4, Ferman Ustaoglu5, Christoph Reichel6. 1. Department of Rehabilitation, German Federal Pension Insurance, Berlin, Germany. Electronic address: dr.marco.streibelt@drv-bund.de. 2. Institute of Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany. 3. Rehabilitation Center Schömberg, Schömberg, Germany. 4. Rehabilitation Center Bad Kissingen, Bad Kissingen, Germany. 5. Rehabilitation Center Bad Homburg, Bad Homburg, Germany. 6. Rehabilitation Center Bad Brückenau, Bad Brückenau, Germany; Institute of Hygiene and Public Health, University of Bonn, Bonn, Germany.
Abstract
OBJECTIVE: To test the predictive validity of the SIMBO (Screening-Instrument zur Feststellung des Bedarfs an medizinisch-beruflich orientierten Maßnahmen in der medizinischen Rehabilitation [Screening Instrument for the Access to Work-Related Multimodal Rehabilitation]; total score ranges from 0 to 100 points) in patients with internal diseases in a rehabilitation setting. DESIGN: Prospective multicenter study. SETTING: Inpatient rehabilitation centers. PARTICIPANTS: Patients (N=1366) aged 18 to 65 years with internal diseases. INTERVENTIONS: Multimodal rehabilitation programs. MAIN OUTCOME MEASURES: The primary outcome was occurrence of a critical return-to-work (RTW) event during the follow-up period. Receiver operating characteristic analyses were performed. Sensitivity, specificity, and positive predictive values were calculated for each disease group using the cutoff score of 27 points. RESULTS: A total of 1366 patients with neoplasms (n=203); endocrine, nutritional, and metabolic diseases (n=355); and diseases of the circulatory (n=470), respiratory (n=255), and digestive (n=83) systems were included. Between 9.9% and 40.6% of the patients reported critical RTW events during the 3-month follow-up period. The area under the curve was between .849 (.754-.923) and .903 (.846-.959). Sensitivity and specificity ranged from 65.6% to 92.9% and from 80.4% to 89.9%, respectively. The positive predictive values were between 40.4% and 77.8%. CONCLUSIONS: The risk score SIMBO predicts short-term RTW problems after rehabilitation in patients with internal diseases. The cutoff of 27 points was confirmed as a reasonable threshold.
OBJECTIVE: To test the predictive validity of the SIMBO (Screening-Instrument zur Feststellung des Bedarfs an medizinisch-beruflich orientierten Maßnahmen in der medizinischen Rehabilitation [Screening Instrument for the Access to Work-Related Multimodal Rehabilitation]; total score ranges from 0 to 100 points) in patients with internal diseases in a rehabilitation setting. DESIGN: Prospective multicenter study. SETTING: Inpatient rehabilitation centers. PARTICIPANTS: Patients (N=1366) aged 18 to 65 years with internal diseases. INTERVENTIONS: Multimodal rehabilitation programs. MAIN OUTCOME MEASURES: The primary outcome was occurrence of a critical return-to-work (RTW) event during the follow-up period. Receiver operating characteristic analyses were performed. Sensitivity, specificity, and positive predictive values were calculated for each disease group using the cutoff score of 27 points. RESULTS: A total of 1366 patients with neoplasms (n=203); endocrine, nutritional, and metabolic diseases (n=355); and diseases of the circulatory (n=470), respiratory (n=255), and digestive (n=83) systems were included. Between 9.9% and 40.6% of the patients reported critical RTW events during the 3-month follow-up period. The area under the curve was between .849 (.754-.923) and .903 (.846-.959). Sensitivity and specificity ranged from 65.6% to 92.9% and from 80.4% to 89.9%, respectively. The positive predictive values were between 40.4% and 77.8%. CONCLUSIONS: The risk score SIMBO predicts short-term RTW problems after rehabilitation in patients with internal diseases. The cutoff of 27 points was confirmed as a reasonable threshold.
Authors: Michael Schuler; Kathrin Murauer; Stefanie Stangl; Anna Grau; Katharina Gabriel; Lauren Podger; Peter U Heuschmann; Hermann Faller Journal: BMJ Open Date: 2019-06-01 Impact factor: 2.692