Work ability assessment in prolonged depressive illness

Abstract

Major depressive disorder (MDD) is a complex disease and therefore the assessment of work ability in patients with MDD is complicated. A checklist has been developed to support such assessment. To assess the mean score and variation of work ability assessments undertaken by Dutch insurance physicians (IPs) in five real case history vignettes of MDD patients on long-term sick leave, with and without the aid of a checklist. In a post-test-only randomized experiment, 25 IPs assessed work ability for five cases on a scale of 0-100 without the use of the checklist, while 21 IPs used the checklist. Differences between groups in mean and absolute variation of work ability were tested with independent t-tests. Intraclass correlation (ICC) analysis was used to determine inter-rater reliability. When using the checklist, the mean work ability score of all vignettes was 3-12 points higher than without its use. There was no difference in the variation in work ability scores per vignette and between groups. ICC was 0.64 for both groups. The use of the checklist increased the mean score of work ability but had no effect on the variation in scores between assessors. The inter-rater reliability was moderate, independent of the use of the checklist.