title: Predictive Validity of a Screening Instrument for the Risk of Non-Return to Work in Patients With Internal Diseases.
abstract: 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.
authors.affiliation: Department of Rehabilitation, German Federal Pension Insurance, Berlin, Germany. Electronic address: dr.marco.streibelt@drv-bund.de.
authors.forename: Marco
authors.initials: M
authors.lastname: Streibelt
authors.affiliation: Institute of Social Medicine and Epidemiology, University of Lübeck, Lübeck, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Bethge
authors.affiliation: Rehabilitation Center Schömberg, Schömberg, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Gross
authors.affiliation: Rehabilitation Center Bad Kissingen, Bad Kissingen, Germany.
authors.forename: Klaus
authors.initials: K
authors.lastname: Herrmann
authors.affiliation: Rehabilitation Center Bad Homburg, Bad Homburg, Germany.
authors.forename: Ferman
authors.initials: F
authors.lastname: Ustaoglu
authors.affiliation: Rehabilitation Center Bad Brückenau, Bad Brückenau, Germany; Institute of Hygiene and Public Health, University of Bonn, Bonn, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Reichel
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D011446:Prospective Studies; D012372:ROC Curve; D012047:Rehabilitation Centers / Q000706:statistics & numerical data*; D062707:Return to Work; D012680:Sensitivity and Specificity; D018582:Sick Leave / Q000706:statistics & numerical data; D014938:Work Capacity Evaluation; D055815:Young Adult
keywords: Rehabilitation; Return to work