Abstract
BackgroundTwo models including age, self-rated health (SRH) and prior sickness absence (SA) were found to predict high SA in health care workers. The present study externally validated these prediction models in a population of office workers and investigated the effect of adding gender as a predictor.MethodsSRH was assessed at baseline in a convenience sample of office workers. Age, gender and prior SA were retrieved from an occupational health service register. Two pre-defined prediction models were externally validated: a model identifying employees with high (i.e. ≥30) SA days and a model identifying employees with high (i.e. ≥3) SA episodes during 1-year follow-up. Calibration was investigated by plotting the predicted and observed probabilities and calculating the calibration slope. Discrimination was examined by receiver operating characteristic (ROC) analysis and the area under the ROC-curve (AUC).ResultsA total of 593 office workers had complete data and were eligible for analysis. Although the SA days model showed acceptable calibration (slope = 0.89), it poorly discriminated office workers with high SA days from those without high SA days (AUC = 0.65; 95% CI 0.58–0.71). The SA episodes model showed acceptable discrimination (AUC = 0.76, 95% CI 0.70–0.82) and calibration (slope = 0.96). The prognostic performance of the prediction models did not improve in the population of office workers after adding gender.ConclusionThe SA episodes model accurately predicted the risk of high SA episodes in office workers, but needs further multisite validation and requires a simpler presentation format before it can be used to select high-risk employees for interventions to prevent or reduce SA.
Highlights
Two models including age, self-rated health (SRH) and prior sickness absence (SA) were found to predict high Sickness absence (SA) in health care workers
We evaluated the effect of excluding SRH from the prediction models, since SRH is not usually recorded in SA registers
The response on SRH was missing in 5 cases and SA data were missing in the occupational health service register in another 35 cases
Summary
Self-rated health (SRH) and prior sickness absence (SA) were found to predict high SA in health care workers. Sickness absence (SA) is an indicator of the health status of working populations [1,2,3,4]. Questionnaire surveys often have moderate response rates and healthy employees are more likely to participate in surveys than employees with health problems, known as the ‘healthy volunteer effect’ [14,15,16]. A prediction model or rule that includes readily available factors, would be practical for physicians to identify employees at risk of high SA. Not all employees visit physicians or other health care providers, they will be more likely to be at risk of high SA than the ‘healthy volunteers’ participating in questionnaire surveys
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