Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Cochrane Work, Amsterdam UMC Location AMC, University of Amsterdam, Amsterdam, The Netherlands
Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Cochrane Work, Amsterdam UMC Location AMC, University of Amsterdam, Amsterdam, The Netherlands.
BMJ Open. 2023 Feb 15;13(2):e069174. doi: 10.1136/bmjopen-2022-069174.
Synthesising evidence of the effects of interventions to improve work participation among people with health problems is currently difficult due to heterogeneity in outcome measurements. A core outcome set for work participation is needed.
Following the Core Outcome Measures in Effectiveness Trials methodology, we used a five-step approach to reach international multistakeholder consensus on a core outcome set for work participation. Five subgroups of stakeholders took part in two rounds of discussions and completed two Delphi voting rounds on 26 outcomes. A consensus of ≥80% determined core outcomes and 50%-80% consensus was required for candidate outcomes.
Fifty-eight stakeholders took part in the Delphi rounds. Core outcomes were: 'any type of employment including self-employment', 'proportion of workers that return to work after being absent because of illness' and 'time to return to work'. Ten candidate outcomes were proposed, among others: 'sustainable employment', 'work productivity' and 'workers' perception of return to work'.
As a minimum, all studies evaluating the impact of interventions on work participation should include one employment outcome and two return to work outcomes if workers are on sick leave prior to the intervention.
由于干预措施对改善健康问题人群工作参与效果的测量结果存在异质性,目前难以综合相关证据。因此,需要制定一个工作参与的核心结局集。
本研究采用核心结局测量在疗效试验方法学的指导,通过五个步骤达成国际多利益相关者对工作参与核心结局集的共识。五个利益相关者小组参与了两轮讨论,并对 26 项结局指标进行了两轮 Delphi 投票。共识≥80% 确定核心结局,而候选结局则需要 50%-80%的共识。
58 名利益相关者参与了 Delphi 投票。核心结局包括:“任何类型的就业,包括自营职业”、“因疾病缺勤后重返工作岗位的工人比例”和“重返工作岗位的时间”。还提出了其他 10 项候选结局,包括“可持续就业”、“工作生产力”和“工人对重返工作岗位的看法”。
如果工人在干预前因病缺勤,评估干预措施对工作参与影响的所有研究,至少应包含一项就业结局和两项重返工作结局。