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Comparing current definitions of return to work: a measurement approach
I A Steenstra1, H Lee, E M M de Vroome
1Institute for Work and Health, 481 University Avenue, Suite 800, Toronto, ON, M5G 2E9, Canada. isteenstra@iwh.on.ca
Journal of Occupational Rehabilitation
|March 15, 2012
Summary
Return-to-work (RTW) definitions are highly correlated and predict outcomes similarly. However, their construct validity compared to functional status varies by societal context, suggesting caution when comparing studies with different RTW definitions.
Area of Science:
- Occupational health
- Health services research
- Pain management
Background:
- Return-to-work (RTW) is a key outcome in work and health research, particularly for low back pain (LBP).
- Inconsistent RTW definitions across studies and jurisdictions complicate comparisons and systematic reviews.
- This study examines the measurement properties of various RTW outcomes.
Purpose of the Study:
- To evaluate the measurement properties of different return-to-work (RTW) outcome definitions.
- To assess the correlations, predictive validity, and construct validity of these RTW definitions.
- To compare RTW outcome measurement across two distinct study populations and countries.
Main Methods:
- Analysis of RTW data from the Canadian Early Claimant Cohort (ECC) and the Dutch Amsterdam Sherbrooke Evaluation (ASE) studies.
- Examination of correlations between different RTW outcome definitions.
- Assessment of predictive validity and construct validity against functional status outcomes.
Main Results:
- In the ECC, all RTW definitions showed high correlations and similar predictive validity, performing fairly to good against functional status.
- In the ASE, RTW definitions were highly correlated and similar in predictive validity but poorly compared to functional status.
- Differences in construct validity suggest that societal context may influence RTW outcome interpretation.
Conclusions:
- While differently defined RTW outcomes correlate highly and predict similarly, their construct validity relative to functional status can vary.
- Societal context or birth cohort may influence the relationship between RTW definitions and functional status.
- Comparing studies with varying RTW definitions is feasible if RTW is not treated as a proxy for functional status.
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