Soer Remko, Reneman Michiel F, Frings-Dresen Monique H W, Kuijer P Paul
Center for Rehabilitation, University of Groningen, University Medical Center Groningen, 30.002, 9750 RA, Haren, The Netherlands,
J Occup Rehabil. 2014 Dec;24(4):806-11. doi: 10.1007/s10926-014-9507-8.
Application of normative values for functional capacity evaluation (FCE) is controversial for the assessment of clients for work ability. The objective of this study was to study when clinicians and researchers consider normative values of FCE useful or of no use for their purposes.
A focus group meeting was organized among 43 FCE experts working in insurance, occupational and/or rehabilitation medicine from eight countries during the first international FCE research meeting on October 25th, 2012 in the Netherlands. Participants were asked to rate to which degree they agree or disagree with a statement concerning their position toward normative values for FCE on a 10 cm VAS ranging from 0 (completely disagree) to 100 (completely agree) at T0 and T1. Arguments for aspects that are useful and of no use for normative values were systematically collected during the meeting and afterwards independently clustered by two researchers in higher order topics.
Baseline opinion of participants on their position toward normative values was 49 ± 29 points. After the meeting, mean VAS was 55 ± 23 (p = 0.07), indicating that participants did not significantly change their opinion toward normative values. Based on arguments provided by the experts, seven higher order topics were constructed namely 'Comparison with job demands or treatment goals'; 'Comparison with co-workers physical ability'; 'Sincerity of effort'; 'Validity for work ability and return to work'; 'Experience of referrer with assessment method'; 'Clinimetrics compared to alternative assessment methods or reference values'; and 'Ease of use for clinician and stakeholders'.
Although experts state useful aspects for the use of normative values of FCE for these assessments, it may also lead to over-interpretation of results, leading to dualistic statements concerning work ability, with potential harmful consequences for work ability of patients.
在评估客户的工作能力时，应用功能能力评估（FCE）的规范值存在争议。本研究的目的是探讨临床医生和研究人员何时认为FCE的规范值对其目的有用或无用。
2012年10月25日在荷兰举行的首届国际FCE研究会议期间，组织了一次焦点小组会议，与会者为来自八个国家从事保险、职业和/或康复医学工作的43位FCE专家。要求参与者在0（完全不同意）至100（完全同意）的10厘米视觉模拟量表（VAS）上，对关于他们对FCE规范值立场的陈述在T0和T1时表示同意或不同意的程度进行评分。在会议期间系统收集了支持规范值有用和无用方面的论据，之后由两名研究人员独立将其归为更高层次的主题。
参与者对规范值立场的基线意见为49±29分。会议结束后，平均VAS为55±23（p = 0.07），表明参与者对规范值的意见没有显著改变。根据专家提供的论据，构建了七个更高层次的主题，即“与工作要求或治疗目标的比较”；“与同事身体能力的比较”；“努力的真诚度”；“对工作能力和重返工作的有效性”；“转诊者对评估方法的经验”；“与替代评估方法或参考值相比的临床测量学”；以及“对临床医生和利益相关者的易用性”。
尽管专家指出了在这些评估中使用FCE规范值的有用方面，但这也可能导致对结果的过度解读，从而产生关于工作能力的二元化陈述，对患者的工作能力可能产生有害后果。
