Patrick Duong1, Katrine Sauvé-Schenk2, Mary Y Egan3, Matthew J Meyer4, Tricia Morrison5. 1. School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada. Electronic address: Pduong@uottawa.ca. 2. School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada; Institut du Savoir Montfort, Ottawa, Ontario, Canada. 3. School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada; Bruyère Research Institute, Ottawa, Ontario, Canada. 4. School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada; London Health Sciences Centre, Schulich School of Medicine and Dentistry, Ivey School of Business, Western University, London, Ontario, Canada. 5. School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada.
Abstract
OBJECTIVE: To examine operational definitions of return to work (RTW) poststroke and provide more precise estimates of RTW through meta-analysis. DATA SOURCES: A systematic search was conducted using MEDLINE, CINAHL, PsycINFO, and SCOPUS (2005 to March 26, 2018). The search strategy involved expansion of medical subjective headings using terms related to stroke and work. The reference lists of review articles and included studies were checked for additional relevant studies. STUDY SELECTION: Studies were included if they (1) quantitatively analyzed RTW outcomes or factors associated with RTW; (2) reported RTW outcomes for participants employed prior to stroke; and (3) were written in English or French. Two reviewers independently screened titles and abstracts. Of 7265 articles initially identified, 55 studies were included. DATA EXTRACTION: Data were extracted and study quality was assessed by 1 reviewer and verified by a second reviewer. DATA SYNTHESIS: Explicit and implicit operational definitions of RTW were determined and categorized. Ranges of RTW estimates were presented for study and participant characteristics. Pooled summary estimates were calculated for comparable studies by follow-up time poststroke: 55.7% at 1 year (95% confidence interval [95% CI], 51.3%-60.0%) and 67.4% at 2 years (95% CI, 60.4%-74.4%). Similar summary estimates were noted when only population-based studies were considered: 56.7% at 1 year (95% CI, 48.3%-65.1%) and 66.7% at 2 years (95% CI, 60.2%-73.2%). CONCLUSIONS: Operational definitions varied across studies and were often not explicitly reported. To promote comparability of RTW outcomes in future studies, we recommend working toward a universal operational definition and consistent follow-up times. The more precise estimates calculated in this review could be used as benchmarks for health care and social service providers.
OBJECTIVE: To examine operational definitions of return to work (RTW) poststroke and provide more precise estimates of RTW through meta-analysis. DATA SOURCES: A systematic search was conducted using MEDLINE, CINAHL, PsycINFO, and SCOPUS (2005 to March 26, 2018). The search strategy involved expansion of medical subjective headings using terms related to stroke and work. The reference lists of review articles and included studies were checked for additional relevant studies. STUDY SELECTION: Studies were included if they (1) quantitatively analyzed RTW outcomes or factors associated with RTW; (2) reported RTW outcomes for participants employed prior to stroke; and (3) were written in English or French. Two reviewers independently screened titles and abstracts. Of 7265 articles initially identified, 55 studies were included. DATA EXTRACTION: Data were extracted and study quality was assessed by 1 reviewer and verified by a second reviewer. DATA SYNTHESIS: Explicit and implicit operational definitions of RTW were determined and categorized. Ranges of RTW estimates were presented for study and participant characteristics. Pooled summary estimates were calculated for comparable studies by follow-up time poststroke: 55.7% at 1 year (95% confidence interval [95% CI], 51.3%-60.0%) and 67.4% at 2 years (95% CI, 60.4%-74.4%). Similar summary estimates were noted when only population-based studies were considered: 56.7% at 1 year (95% CI, 48.3%-65.1%) and 66.7% at 2 years (95% CI, 60.2%-73.2%). CONCLUSIONS: Operational definitions varied across studies and were often not explicitly reported. To promote comparability of RTW outcomes in future studies, we recommend working toward a universal operational definition and consistent follow-up times. The more precise estimates calculated in this review could be used as benchmarks for health care and social service providers.