Predictive validity of a screening instrument for the risk of non-return-to-work in patients with internal diseases

Publication date: Available online 27 January 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Marco Streibelt, Matthias Bethge, Thomas Gross, Klaus Herrmann, Ferman Ustaoglu, Christoph Reichel
ObjectivesA screening instrument (SIMBO, 0-100 points) to predict return-to-work (RTW) problems was developed in a pilot study. We tested the predictive validity of the SIMBO in patients with internal diseases.DesignA prospective multicenter study was conducted. Data were obtained from questionnaires at admission and 3 months after rehabilitation.Setting12 inpatient rehabilitation centers.ParticipantsPatients aged 18 to 65 years with internal diagnoses were included.InterventionsMultimodal rehabilitation programs.Main Outcome MeasureThe primary outcome was occurrence of a critical RTW event during the follow-up. Receiver operating characteristic (ROC) analyses were performed. Sensitivity, specificity and positive predictive values were calculated for each disease group using the cut-off score of 27 points.Results1,366 patients with neoplasms (n=203), endocrine, nutritional and metabolic diseases (n=355), diseases of the circulatory (n=470), respiratory (n=255) and digestive systems (n=83) were included. Between 9.9% and 40.6% of the patients reported critical RTW events during the 3-month follow-up. The AUC was between .849 (.754-.923) and .903 (.846-.959). Sensitivity and specificity ranged from 65.6% to 92.9% and 80.4% to 89.9%, respectively. The positive predictive values were between 40.4% and 77.8%.ConclusionThe risk score SIMBO predicts short-term RTW problems after rehabilitation in patients with internal diseases. The cut-off of 27 points was confirmed as a reasonable threshold.



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