title: Prospective Cohort Analysis of the Predictive Validity of a Screening Instrument for Severe Restrictions of Work Ability in Patients with Musculoskeletal Disorders.
abstract: OBJECTIVE
  The aim of this study was to determine whether the Screening-Instrument zur Feststellung des Bedarfs an medizinisch-beruflich orientierter Rehabilitation (SIMBO) screening instrument can identify persons with a high work disability risk.
  
  
  METHODS
  Patients with chronic musculoskeletal disorders and participation in a rehabilitation program were included in the analysis. Data were collected by questionnaires at admission and at the 6-mo follow-up. Failed return to work (RTW; i.e., unemployment or active employment with sick leave of >12 wks in the follow-up) was the primary outcome. Additional outcome data were obtained from the physician's discharge form (e.g., assessment of work ability). Receiver operating characteristic analyses and logistic regression models were used to analyze the data.
  
  
  RESULTS
  Valid data were available for 1755 participants. Of these, 25% reported failed RTW. The area under the curve of the SIMBO score predicting failed RTW was 0.81 (0.79-0.83). The optimal cutoff to identify failed RTW was 23 points (of 100). The odds of failed RTW, unemployment, and sick leave of more than 12 wks were increased 12, 11, and 10 times for the persons with a SIMBO score of 23 points or greater compared with the persons with lower SIMBO scores. The odds of reduced work time capacity were increased 21 times.
  
  
  CONCLUSIONS
  The SIMBO predicts work disability in patients with chronic musculoskeletal disorders. Further research should focus on its predictive validity in patients with other disorders and within other rehabilitation systems.
authors.affiliation: From the Department of Rehabilitation, German Federal Pension Insurance, Berlin (MS); and Institute of Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany (MB).
authors.forename: Marco
authors.initials: M
authors.lastname: Streibelt
authors.forename: Matthias
authors.initials: M
authors.lastname: Bethge
mesh_terms: D004185:Disability Evaluation; D005260:Female; D005858:Germany; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000534:rehabilitation*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D062707:Return to Work; D018582:Sick Leave / Q000706:statistics & numerical data; D014478:Unemployment / Q000706:statistics & numerical data; D014938:Work Capacity Evaluation