title: Predicting return to work among sickness-certified patients in general practice: properties of two assessment tools.
abstract: OBJECTIVE
  The purpose was to analyse the properties of two models for the assessment of return to work after sickness certification, a manual one based on clinical judgement including non-measurable information ('gut feeling'), and a computer-based one.
  
  
  METHODS
  All subjects aged 18 to 63 years, sickness-certified at a primary health care centre in Sweden during 8 months (n = 943), and followed up for 3 years.
  
  
  METHODS
  Baseline information included age, sex, occupational status, sickness certification diagnosis, full-time or part-time current sick-leave, and sick-leave days during the past year. Follow-up information included first and last day of each occurring sick spell. In the manual model all subjects were classified, based on baseline information and gut feeling, into a high-risk (n = 447) or a low-risk group (n = 496) regarding not returning to work when the present certificate expired. It was evaluated with a Cox's analysis, including time and return to work as dependent variables and risk group assignment as the independent variable, while in the computer-based model the baseline variables were entered as independent variables.
  
  
  RESULTS
  Concordance between actual return to work and return to work predicted by the analysis model was 73%-76% during the first 28-180 days in the manual model, and approximately 10% units higher in the computer-based model. Based on the latter, three nomograms were constructed providing detailed information on the probability of return to work.
  
  
  CONCLUSIONS
  The computer-based model had a higher precision and gave more detailed information than the manual model.
authors.affiliation: Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine Section, Uppsala University , Uppsala , Sweden.
authors.forename: Anna-Sophia
authors.initials: AS
authors.lastname: von Celsing
authors.forename: Kurt
authors.initials: K
authors.lastname: Svärdsudd
authors.forename: Thorne
authors.initials: T
authors.lastname: Wallman
mesh_terms: D000293:Adolescent; D000328:Adult; D058006:General Practice; D006801:Humans; D008875:Middle Aged; D062707:Return to Work; D018582:Sick Leave; D013548:Sweden; D055815:Young Adult
keywords: Gut feeling; long-term sick-leave; nomogram; return to work; risk assessment; sickness certification