Abstract
Purpose: Assessment of work-related disability has been a focus of a research program of the Center for Rehabilitation of the University Medical Center Groningen, the Netherlands. The main aim of the program was to study and compare 3 types of instruments that are commonly used to assess components of work-related disability of patients with chronic non-specific low back pain. These 3 instruments are: patients self reports (questionnaires), expert opinion (clinical examination by a physician), and a performance based assessment (Functional Capacity Evaluation).
Methods: Not applicable.
Results: This program has currently produced over 20 papers in peer reviewed journals. The main results of the studies of the program will be presented during the meeting:
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Psychometric properties. A summary of the reliability and validity of the 3 instruments separately as well as a comparison of the outcomes will be presented. The reliability of both self reports and performance based instruments are moderate to good, while the reliability of expert based assessments of work-related disability appears poor. Comparisons of the instruments demonstrate that substantial differences exist between the instruments. On the basis of self reports patients appear more disabled than based on expert opinion. On the basis of expert opinion patients appear more disabled than based on performances.
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Determinants of test performances. A summary of studies on determinants of test performances will be presented. It appears that test performances are weakly related to pain intensity, most often unrelated to pain related fears and to other psychological variables. Quite a large proportion of variance in test performances remains unexplained at the moment. Hypotheses for current and future research will be presented.
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The research has provided knowledge about the strengths, weaknesses, and applicability of the instruments. These will be presented, as well as hiatus in the current knowledge.
Conclusions: Main lessons learned for the research program, both with regards to clinical application and with regards to future research. How should we assess ‘fitness for work’?
Correspondence should be addressed to: Mr John O’ Dowd, SBPR, c/o BOA, The Royal College of Surgeons, 35–43 Lincoln’s Inn Fields, London WC2A 3PE.
