In the field of insurance medicine and occupational health ‘work participation’ is frequently used as an umbrella term. Several outcomes are linked to ‘work participation’ as a concept and the instruments to measure these outcomes differ. Lack of standardization in outcome measurement and reporting greatly hinders the synthesis of research and, consequently, hampers decision making at the cost of the best possible treatment and social medical guidance for workers.
In a pilot review we found great variability among work participation outcomes reported in RCTs identified in seven Cochrane Reviews in the field of occupational health. The outcomes in these reviews include return to work (RTW), sick leave, absenteeism, work status, functional status, productivity, or work functioning. Further, outcomes were measured at different follow up times; definitions or cut-off points for RTW or sick leave varied; diverse statistics were included; and different sources to measure work participation were used. The authors of these Cochrane reviews recommend a uniform assessment of work participation outcomes and outcome measurement instruments, the use of explicit definitions and cut-off points, definition of minimal clinical important differences, and better validation of measurements instruments.
The variation in outcomes and measurements highlights the need for a Core Outcome Set for Work Participation (COS-WP) which is relevant within the field of occupational health and insurance medicine. A set of consistent definitions on key constructs and outcomes may improve the understanding of the outcomes that matter to the stakeholders, address the complexity of outcomes such as return to work, and help to understand the dynamic process in measuring these outcomes.
Starting mid-2018, the Coronel Institute of Occupational Health of the Amsterdam UMC, Academic Medical Center in Amsterdam will start a 4-year international collaborative project to develop a COS for work participation. Part of this 4-year project will be a PhD project. During the development of a COS we will use the methods advocated by COMET (www.comet-initiative.org) and COSMIN (www.cosmin.nl). By means of three systematic reviews on the topic of work participation, a survey among international experts / stakeholders in the field of occupational health/insurance medicine, a focus group study and a Delphi study to reach consensus among experts / stakeholders we aim to seek consensus on the core outcomes and the most suitable outcome measurement instruments. We also plan to perform two projects on dissemination/ implementation and knowledge transfer and evaluate these.
We call on the international community of practitioners, clients and researchers in occupational health and insurance medicine to help us join forces for the development of such a COS. To date, several partners support this initiative including the Amsterdam Public Health (APH) COS focus group, Cochrane Insurance Medicine (CIM) and Cochrane Work. The project will result in a universally applicable and broadly agreed COS for work participation that should be used when conducting RCTs and systematic reviews so that we can achieve the best possible treatment and social medical guidance for our clients.
Project leader and contact:
Dr. Jan L. Hoving; Amsterdam UMC, Academic Medical Center, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Amsterdam, NL. J.l.Hoving@amc.uva.nl; +31-(0)20-5665339
Project team:
1. Margarita Ravinskaya (PhD candidate on COS-WP project); Amsterdam UMC, Academic Medical Center, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Amsterdam, NL
2. Dr. Jos H. Verbeek; Cochrane Work, Kuopio, FIN
3. Dr. Miranda Langendam, Amsterdam UMC, Academic Medical Center, University of Amsterdam, Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam Public Health research institute, NL
4. Prof. Dr. Regina Kunz; Research Unit EbIM, Evidence Based Insurance Medicine, Department of Clinical Research, University of Basel, SZ
5. Dr. Suzanne Verstappen, Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, University of Manchester, UK
6. Dr. Ira Madan, Guy’s and St Thomas’ NHS Trust, UK and King’s College London, UK
7. Prof. Carel Hulshof, Amsterdam UMC, Academic Medical Center, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Amsterdam, NL
Disease Category: Other
Disease Name: N/A
Age Range: 18 - 65
Sex: Either
Nature of Intervention: Other
- Clinical experts
- Epidemiologists
- Journal editors
- Methodologists
- Patient/ support group representatives
- Policy makers
- Researchers
- COS (Other)
- Consensus meeting
- Delphi process
- Focus group(s)
- Interview
- Literature review
- Survey
- Systematic review
During the development of a COS we will use the methods advocated by COMET (www.comet-initiative.org) and COSMIN (www.cosmin.nl). By means of three systematic reviews on the topic of work participation, a survey among international experts / stakeholders in the field of occupational health/insurance medicine, a focus group study and a Delphi study to reach consensus among experts / stakeholders we aim to seek consensus on the core outcomes and the most suitable outcome measurement instruments. We also plan to perform two projects on dissemination/ implementation and knowledge transfer and evaluate these.