Abstract
ObjectiveTo investigate how work participation outcomes in randomized controlled trials are measured internationally and across disciplines. Study Design and SettingWe identified trials that reported on work participation in Medline, Embase, PsycINFO and Cochrane Central published between 2014 and 2019. Screening, selection, and data extraction were done by two authors independently. We grouped outcomes into four categories (“employment status”, “absence from work”, “at-work productivity loss,” and “employability”) and created subcategories according to how the outcome was measured. ResultsFrom 10,022 database hits we selected 269 trials reporting on 435 work participation outcomes. Authors used inconsistent outcome terminology to describe the measured constructs. Grouped in four main categories we identified 70 outcomes that reported on “employment status”, 196 on “absence from work” and return-to-work, 132 on “at-work productivity loss,” and 37 on “employability” outcomes. Variability in measurement methods existed across all categories. Employment status and absenteeism measures consisted mostly of clinimetrically unvalidated tools. “At-work productivity loss” and “employability” were measured by at least 41 different questionnaires. ConclusionExtensive variability exists among trials in the measurement of outcomes, measurement methods and measurement instruments that focus on work participation. This study is a first step towards the development of a Core Outcome Set for work participation.
Highlights
10% of the world’s population experiences some form of disability [1, 2], the majority of whom experience problems with participation in the workforce [3, 4] resulting in major negative socio-economic consequences and impacts on society at large [5]
Extensive variability exists among trials in the measurement of outcomes, measurement methods and measurement instruments that focus on work participation
This study is a first step towards the development of a Core Outcome Set for work participation
Summary
10% of the world’s population experiences some form of disability [1, 2], the majority of whom experience problems with participation in the workforce [3, 4] resulting in major negative socio-economic consequences and impacts on society at large [5]. Activity limitations due to a health problem can restrict work participation and, in the worst case, lead to work loss [6]. Work- participation improves quality of life and helps the recovery process of people with health problems [10,11,12,13]. Outcome measurements need to account for the various work-life stages, long-term health effects and the perspectives of workers, employers, society and the economy. Sickness and disability policies vary in individual countries [15] which may influence the measurement and level of work participation
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