Streibelt Marco, Bethge Matthias, Gross Thomas, Herrmann Klaus, Ustaoglu Ferman, Reichel Christoph
Department of Rehabilitation, German Federal Pension Insurance, Berlin, Germany.
Institute of Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany.
Arch Phys Med Rehabil. 2017 May;98(5):989-996.e1. doi: 10.1016/j.apmr.2016.12.022. Epub 2017 Jan 27.
To test the predictive validity of the SIMBO (Screening-Instrument zur Feststellung des Bedarfs an medizinisch-beruflich orientierten Maßnahmen in der medizinischen Rehabilitation [Screening Instrument for the Access to Work-Related Multimodal Rehabilitation]; total score ranges from 0 to 100 points) in patients with internal diseases in a rehabilitation setting.
Prospective multicenter study.
Inpatient rehabilitation centers.
Patients (N=1366) aged 18 to 65 years with internal diseases.
Multimodal rehabilitation programs.
The primary outcome was occurrence of a critical return-to-work (RTW) event during the follow-up period. Receiver operating characteristic analyses were performed. Sensitivity, specificity, and positive predictive values were calculated for each disease group using the cutoff score of 27 points.
A total of 1366 patients with neoplasms (n=203); endocrine, nutritional, and metabolic diseases (n=355); and diseases of the circulatory (n=470), respiratory (n=255), and digestive (n=83) systems were included. Between 9.9% and 40.6% of the patients reported critical RTW events during the 3-month follow-up period. The area under the curve was between .849 (.754-.923) and .903 (.846-.959). Sensitivity and specificity ranged from 65.6% to 92.9% and from 80.4% to 89.9%, respectively. The positive predictive values were between 40.4% and 77.8%.
The risk score SIMBO predicts short-term RTW problems after rehabilitation in patients with internal diseases. The cutoff of 27 points was confirmed as a reasonable threshold.
在康复环境中测试SIMBO（医学康复中确定职业医学导向措施需求的筛查工具[工作相关多模式康复准入筛查工具]；总分范围为0至100分）对内科疾病患者的预测效度。
前瞻性多中心研究。
住院康复中心。
18至65岁患有内科疾病的患者（N = 1366）。
多模式康复计划。
主要结局为随访期间发生的关键重返工作岗位（RTW）事件。进行了受试者工作特征分析。使用27分的临界值计算每个疾病组的敏感性、特异性和阳性预测值。
共纳入1366例患有肿瘤（n = 203）、内分泌、营养和代谢疾病（n = 355）以及循环系统（n = 470）、呼吸系统（n = 255）和消化系统（n = 83）疾病的患者。在3个月的随访期内，9.9%至40.6%的患者报告了关键RTW事件。曲线下面积在0.849（0.754 - 0.923）至0.903（0.846 - 0.959）之间。敏感性和特异性分别在65.6%至92.9%和80.4%至89.9%之间。阳性预测值在40.4%至77.8%之间。
风险评分SIMBO可预测内科疾病患者康复后的短期RTW问题。27分的临界值被确认为合理阈值。
