Abstract
BackgroundAssessing prognosis is challenging for many physicians in various medical fields. Research shows that physicians who perform disability assessments consider six areas when evaluating a prognosis: disease, treatment, course of the disease, external information, patient-related and physician-related aspects. We administered a questionnaire to evaluate how physicians rate the importance of these six prognosis areas during work disability evaluation and to explore what kind of support they would like during prognosis assessment.MethodsSeventy-six physicians scored the importance of 23 prognostic aspects distributed over six prognosis areas. Participants scored the importance of each aspect both “in general” and from the perspective of a case vignette of a worker with a severe degenerative disease. The questionnaire also covered needs and suggestions for support during the evaluation of prognoses.ResultsMedical areas that are related to the disease, or the treatment or course of the disease, appeared important (scores of 7.0–9.0), with less differing opinions among participants (IQR 1.0–3.0). Corresponding verbatim remarks supported the importance of disease and treatment as prognostic aspects. In comparison, patient- and physician-related aspects scored somewhat lower, with more variability (range 4.0–8.0, with IQR 2.0–5.0 for patient- and physician-related considerations). Participants indicated a need for a tool or online database that includes prognostic aspects and prognostic evidence.ConclusionsDespite some variation in scores, the physicians rated all six prognosis areas as important for work disability evaluations. This study provides suggested aids to prognosis assessment, including an online support tool based on evidence-based medicine features.
Highlights
Assessing prognosis is challenging for many physicians in various medical fields
The purpose of this study was to evaluate how physicians rate the importance of six prognosis areas considered during work disability evaluation and to explore what kind of support they would like during prognosis assessment
A slight majority of the physicians were over 55 years old (n = 31, versus n = 23 less than 55 years), Fig. 1 Case vignette and examples of evidence provided to physicians most had been in the profession for over 15 years (n = 42, versus n = 12 less than 15 years), and most worked 32 h or more per week (n = 40, versus n = 13 less than 32 h)
Summary
Research shows that physicians who perform disability assessments consider six areas when evaluating a prognosis: disease, treatment, course of the disease, external information, patient-related and physician-related aspects. A Dutch study identified 23 aspects for consideration in the prognosis evaluation during disability assessment [8] These aspects fell into six areas: the specific disease or disorder, any treatment or potential treatment, the course of the disease, external information from other specialists or scientific evidence, patient-related aspects (e.g., coping), and physician-related considerations (e.g., role, empathy). It is not known how these aspects are valued and dealt with in practice. More insight into the importance of the aspects considered during prognosis assessment will guide the development of a prognostic tool in the future
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