Do patient characteristics affect the predictive validity of Functional Capacity Evaluations?

Content Provider	Europe PMC
Author	Bühne, David Alles, Torsten Hetzel, Christian Streibelt, Marco Froböse, Ingo
Abstract	PurposeThe aim of this study was to identify patient-related characteristics that affect the predictive validity of the FCE assessment ELA.MethodsA prospective multicenter study was conducted on 303 patients with musculoskeletal disorders (MSD) recruited from eleven rehabilitation centers. The ELA-based estimation of the participants' ability to cope with physical work demands was considered valid if RTW was paired with a positive ELA outcome (≥ moderate) as well as if non-RTW was accompanied by a negative ELA outcome (rather or very poor). In the remaining cases, the ELA result was judged as non-valid. To reduce the risk of false conclusions, the rating was performed inversely in participants that (1) reported severe limitations regarding their productivity at work, (2) attributed RTW to a change in job resp. a reduction of their physical work demands and in those that (3) attributed non-RTW to non-physical reintegration barriers only. Using questionnaires, 28 patient-related characteristics were collected. Logistic regression models were calculated to identify characteristics that affected the predictive validity of ELA.ResultsELA was considered valid in 208 of 303 (69%) participants. A moderate and strong pain-related disability at work were associated with a 0.15-fold (95% confidence interval (95% CI) 0.05–0.46), respectively, 0.19-fold (95% CI 0.05–0.72) chance for a valid outcome. In addition, a negative influence was found in participants that reported psychosocial distress (odds ratio (OR) 0.35; 95% CI 0.15–0.82), a native language different from the national language (OR 0.16; 95% CI 0.05–0.56) as well as in those that expected to return to work, but not within one month (OR 0.17; 95% CI 0.06–0.46). Further variables—including age, employment status, fear-avoidance beliefs and the level of physical work demands—did not affect the predictive validity of ELA.ConclusionsThe results suggest that the predictive validity of ELA is primarily limited by patients that report a moderate or strong pain-related disability at work, psychosocial distress as well as the expectation to return to work, but not within one month. Furthermore, a negative influence can be assumed for language barriers.Supplementary InformationThe online version contains supplementary material available at 10.1007/s00420-021-01807-7.
Related Links	https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC8551349&blobtype=pdf
ISSN	03400131
Journal	International Archives of Occupational and Environmental Health [Int Arch Occup Environ Health]
Volume Number	95
DOI	10.1007/s00420-021-01807-7
PubMed Central reference number	PMC8551349
Issue Number	4
PubMed reference number	34709439
e-ISSN	14321246
Language	English
Publisher	Springer Berlin Heidelberg
Publisher Date	2021-10-28
Publisher Place	Berlin/Heidelberg
Access Restriction	Open
Rights License	This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic. © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2021
Subject Keyword	FCE Work assessment Return to work Physical work capacity Rehabilitation
Content Type	Text
Resource Type	Article
Subject	Public Health, Environmental and Occupational Health