The Work Instability Scale for rheumatoid arthritis predicts arthritis-related work transitions within 12 months.
OBJECTIVE
Among people with arthritis, the need for work transitions may signal a risk for more adverse work outcomes in the future, such as permanent work loss. Our aim was to evaluate the ability of the Work Instability Scale for Rheumatoid Arthritis (RA-WIS) to predict arthritis-related work transitions within a 12-month period.


METHODS
Workers with osteoarthritis or rheumatoid arthritis (n = 250) from 3 clinical sites participated in self-administered surveys that assessed the impact of health on employment at multiple time points over 12 months. Multivariable logistic regressions were conducted to assess the ability of the RA-WIS (range 0-23, where 23 = highest work instability) to predict 4 types of work transition: reductions in work hours, disability leaves of absence, changes in job/occupation, or temporary unemployment, assembled as a composite outcome. Covariates assessed include age, sex, education, marital status, income, pain intensity, disease duration, and the Health Assessment Questionnaire. Areas under the receiver operating characteristic curves (AUROCCs) were also assessed to further examine the predictive ability of the RA-WIS and to determine optimal cut points for predicting specific work transitions.


RESULTS
After 12 months, 21.7% (n = 50 of 230) of the participants had indicated at least one arthritis-related work transition. Higher baseline RA-WIS was predictive of such an outcome (relative risk [RR] 1.05 [95% confidence interval (95% CI) 1.00-1.11]), particularly at >17 (RR 2.30 [95% CI 1.11-4.77]). The RA-WIS cut point of >13 was found to be most accurate for prediction (AUROCC 0.68 [95% CI 0.58-0.78]).


CONCLUSIONS
The RA-WIS demonstrated the ability to predict arthritis-related work transitions within a short timeframe, and could be a promising measurement candidate for risk prognostication where work disability outcomes are of concern.
St. Michael's Hospital, University of Toronto, Institute for Work & Health, Ontario, Canada.
Kenneth
K
Tang
Dorcas E
DE
Beaton
Monique A M
MA
Gignac
Diane
D
Lacaille
Wei
W
Zhang
Claire
C
Bombardier
D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000175:diagnosis* / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys / Q000379:methods; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods*; D011237:Predictive Value of Tests; D013997:Time Factors; D016526:Workload / Q000523:psychology*