Abstract
BackgroundPrevious validation studies of sick leave measures have focused on self-reports. Register-based sick leave data are considered to be valid; however methodological problems may be associated with such data. A Danish national register on sickness benefit (DREAM) has been widely used in sick leave research. On the basis of sick leave records from 3,554 and 2,311 eldercare workers in 14 different workplaces, the aim of this study was to: 1) validate registered sickness benefit data from DREAM against workplace-registered sick leave spells of at least 15 days; 2) validate self-reported sick leave days during one year against workplace-registered sick leave.MethodsAgreement between workplace-registered sick leave and DREAM-registered sickness benefit was reported as sensitivities, specificities and positive predictive values. A receiver-operating characteristic curve and a Bland-Altman plot were used to study the concordance with sick leave duration of the first spell. By means of an analysis of agreement between self-reported and workplace-registered sick leave sensitivity and specificity was calculated. Ninety-five percent confidence intervals (95% CI) were used.ResultsThe probability that registered DREAM data on sickness benefit agrees with workplace-registered sick leave of at least 15 days was 96.7% (95% CI: 95.6-97.6). Specificity was close to 100% (95% CI: 98.3-100). The registered DREAM data on sickness benefit overestimated the duration of sick leave spells by an average of 1.4 (SD: 3.9) weeks. Separate analysis on pregnancy-related sick leave revealed a maximum sensitivity of 20% (95% CI: 4.3-48.1).The sensitivity of self-reporting at least one or at least 56 sick leave day/s was 94.5 (95% CI: 93.4 – 95.5) % and 58.5 (95% CI: 51.1 – 65.6) % respectively. The corresponding specificities were 85.3 (95% CI: 81.4 – 88.6) % and 98.9 (95% CI: 98.3 – 99.3) %.ConclusionsThe DREAM register offered valid measures of sick leave spells of at least 15 days among eldercare employees. Pregnancy-related sick leave should be excluded in studies planning to use DREAM data on sickness benefit. Self-reported sick leave became more imprecise when number of absence days increased, but the sensitivity and specificity were acceptable for lengths not exceeding one week.
Highlights
Previous validation studies of sick leave measures have focused on self-reports
The lowest sensitivity was 79%, the highest sensitivity 92%
The lowest positive predictive value (PPV) (75%; 95% CI: 68–81) was found in week 1
Summary
Previous validation studies of sick leave measures have focused on self-reports. Register-based sick leave data are considered to be valid; methodological problems may be associated with such data. A Danish national register on sickness benefit (DREAM) has been widely used in sick leave research. Among the four traditional sources (employer’s personnel files, insurance-based data, national social security registers and self-reported data) from which sick leave data are traditionally retrieved, register-based sick leave data is an option available only in few countries. Even where registers are available, self-reported sick leave data are usually more acquired than data from other sources. Company-based data retrieved from employers’ personnel files is considered a golden standard, mainly because these data are used for calculating earnings [5,6,7,8]
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