Introduction
Methods
Study Sample
Sources of Data
Candidate Predictors
Construct | Source | Level of evidence | Direction of effect |
---|---|---|---|
Worker-related factors | |||
Age | Electronic claim file | Inconsistent findings in multiple studies (due to non report) | Less likely to RTW if older |
Sex | Electronic claim file | Insufficient evidence | No effect |
Presence of language barriers | Electronic claim file | Insufficient evidence (not enough studies) | Less likely to RTW |
Prior work absence | Electronic claim file and imaged files | Moderate evidence | Less likely to RTW |
Recovery expectations of worker | Form 8 | Strong evidence | Less likely to RTW if low |
Physical functioning, functional ability | Form 8 | Strong evidence | Less likely to RTW if more disabled |
Work-related factors | |||
Physical demands | Electronic claim file | Strong evidence | Less likely to RTW when high |
Job tenure | Electronic claim file | Moderate evidence | Less likely to RTW if shorter |
Modified duties | Form 7 | Strong evidence | More likely if modified |
Union member | Form 6 | Insufficient evidence (not enough studies) | More likely to RTW if member |
Health-care-related factors | |||
Treating health-care provider | Health-care billings | Strong evidence | More likely to RTW when treated by some HCPs |
WSIB work rehabilitation program | Health-care billings | Stakeholder input | More likely to RTW |
Early and prolonged prescription of opioids | Health-care billings | Insufficient evidence (not enough studies) | Less likely to RTW |
Insurer-related factors | |||
Benefits paid: height of compensation, employer continues pay | Form 7 | Moderate evidence | Less likely to RTW if higher compensation |
Process of RTW | |||
Worker signature | Form 7 | Moderate evidence | More likely to RTW |
HCP discussed RTW | Form 8 | ||
Communication of functional ability to RTW | Health-care billings | ||
Doubt of work-relatedness | Form 7 | Insufficient evidence (not enough studies) | Less likely to RTW |
Worker-Related Factors
Work-Related Factors
Health-Care-Related Factors
Insurer-Related Factors
The Return-to-Work Process
Outcome Measures
Statistical Analyses
Derivation of the Model
Internal Validation
Model Fit
Results
Variable | uHRR |
P value | Proportion of bootstraps remaining in the model | aHRR |
---|---|---|---|---|
Age in categories | ||||
15 to <25 (n = 97) | 1.14 (.90, 1.44) | .001 | 1 | 1.27 (1.00, 1.60) |
25 to <35 (n = 291) | 1 | 1 | ||
35 to <45 (n = 486) | .89 (.77, 1.04) | .90 (.78, 1.05) | ||
45 to <55 (n = 411) | .87 (.74, 1.01) | .84 (.72, 99) | ||
55–65 (n = 157) | .64 (.52, .79) | .65 (.52, .80) | ||
Men (n = 890) | 1 | .116 | 1 | 1 |
Women (n = 552) | 1.09 (.98, 1.22) | .97 (.87, 1.09) | ||
Previous lost-time claim | .114 | .110 | – | |
Yes (n = 657) | 1.08 (.97, 1.21) | |||
No (n = 785) | 1 | |||
Previous no-lost-time claim | 1.11 | .066 | .095 | – |
Yes (n = 750) | (.99, 1.23) | |||
No (n = 692) | 1 | |||
Physical demands | .007 | .785 | ||
Non-manual (n = 139) | 1 | 1 | ||
Mixed manual (n = 465) | 1.00 (.82, 1.21) | 1.05 (.86, 1.28) | ||
Manual (n = 798) | .83 (.69, .99) | .84 (.69, .1.01) | ||
Missing (n = 40) | .94 (.65, 1.02) | .95 (.65, 1.02) | ||
Language | ||||
French/English (n = 1,396) | 1 | .06 | .165 | – |
Other (n = 46) | .74 (.54, 1.01) | |||
Union member | ||||
Yes (n = 610) | 1.29 (1.15, 1.45) | .001 | .790 | 1.14 (1.01, 1.29) |
No (n = 656) | 1 | 1 | ||
Missing (n = 176) | 1.34 (1.13, 1.59) | 1.34 (1.12, 1.60) | ||
Early RTW program | .001 | 1 | ||
Yes (n = 1,042) | 1 | 1 | ||
No (n = 278) | .58 (.50, .67) | .59 (.516, .69) | ||
Missing (n = 122) | .68 (.56, .83) | .70 (.56, .87) | ||
Employer continued pay salary | .001 | .305 | – | |
No (n = 1,234) | 1 | |||
Yes (n = 181) | 1.31 (1.11, 1.53) | |||
Doubt work relatedness | 1 | .062 | .575 | 1 |
No (n = 1,051) | .94 (.80, 1.10) | .929 (.78, 1.08) | ||
Yes (n = 195) | 1.19 (1.01, 1.40) | 1.18 (.99, 1.40) | ||
Missing value (n = 180) | .71 (.42, 1.20) | .76 (.43, 1.35) | ||
Missing form 7 (n = 16) | – | – | ||
Worker signed | ||||
Yes (n = 327) | .88 (.77, 1.00) | .080 | .025 | – |
No (n = 1,085) | 1 | |||
Missing (n = 30) | .82 (.56, 1.19) | |||
Recovery expected | ||||
Yes (n = 224) | 1 | .02 | .795 | 1 |
No (n = 11) | .36 (.17, .76) | .43 (.20, .92) | ||
Missing value (n = 38) | .68 (.47, .97) | .66 (.46, .94) | ||
HCP report form ‘03a (n = 1,169) | .83 (.72, .96) | .86 (.74, .99) | ||
Use public transport | .167 | .030 | – | |
No (n = 13) | .65 (.35, 1.19) | |||
Yes (n = 209) | 1 | |||
Missing (n = 1,209) | .89 (.77, 1.04) | |||
Functional abilities form | .0001 | .990 | 1 | |
0 (n = 754) | 1 | |||
1 (n = 426) | 1.24 (1.10, 1.41) | 1.12 (.996, 1.27) | ||
2 (n = 181) | 1.40 (1.19, 1.66) | 1.21 (1.02, 1.44) | ||
3 (n = 57) | 1.60 (1.22, 2.10) | 1.43 (1.07, 1.89) | ||
≥4 (n = 24) | 2.44 (1.62, 3.67) | 2.32 (1.53, 3.52) | ||
Medical doctor | ||||
No (n = 204) | 1 | .832 | .185 | – |
Yes (n = 1,238) | 1.02 (.87, 1.19) | |||
Chiropractor | ||||
No (n = 1,209) | 1 | .117 | .260 | – |
Yes (n = 233) | .89 (.77, 1.03) | |||
Physiotherapist | ||||
No (n = 1,006) | 1 | .816 | .220 | – |
Yes (n = 436) | 1.01 (.90, 1.14) | |||
POC | ||||
No (n = 1,171) | 1 | .102 | .530 | 1 |
Yes (n = 271) | 1.12 (.98, 1.29) | 1.15 (1.00, 1.33) | ||
Opioid prescription | ||||
No (n = 1,306) | 1 | .001 | .955 | 1 |
Yes (n = 136) | .63 (.52, .76) | .71 (.58, .86) |
First block risk factors | uHRR |
P value | Proportion of bootstraps remaining in the model | mHRR |
---|---|---|---|---|
First episode length beyond 4 weeks | 1.00 (1.00, 1.00) | 1.000 | 1.00 (1.00, 1.00) | |
Age in categories | ||||
15 to <25 (n = 96) | .70 (.41, 1.19) | .572 | 1.000 | .70 (.41, 1.19) |
25 to <35 (n = 275) | 1 | 1 | ||
35 to <45 (n = 461) | 1.04 (.77, 1.40) | .97 (.72, 1.31) | ||
45 to <55 (n = 382) | .99 (.73, 1.36) | .98 (.72, 1.34) | ||
55 to <65 (n = 133) | .90 (.59, 1.38) | .86 (.57, 1.32) | ||
Men (n = 821) | 1 | .031 | 1.000 | 1 |
Women (n = 526) | 1.27 (1.02, 1.58) | 1.36 (1.09, 1.70) | ||
Previous claim | ||||
Yes (n = 1,018) | 1.24 (.96, 1.62) | .098 | .355 | |
No (n = 329) | 1 | |||
Physical demands | .085 | .725 | ||
Non-manual (n = 132) | 1 | 1 | ||
Mixed (n = 448) | 1.11 (.73, 1.71) | 1.12 (.73, 1.72) | ||
Manual (n = 730) | 1.45 (.97, 2.16) | 1.55 (1.02, 2.34) | ||
Missing (n = 37) | 1.29 (.62, 2.75) | 1.43 (.66, 3.08) | ||
Opioid prescription | ||||
No (1,231) | 1 | .030 | .675 | 1 |
Yes (116) | 1.47 (1.06, 2.06) | 1.52 (1.09, 2.13) | ||
Early RTW program | ||||
Yes (n = 1,002) | 1 | .022 | .395 | |
No (n = 237) | .65 (.47, .90) | |||
Missing (n = 94) | .83 (.53, 1.30) | |||
Functional ability forms | ||||
0 (n = 687) | 1 | .021 | .630 | 1 |
1 (n = 404) | 1.33 (1.04, 1.70) | 1.31 (1.02, 1.68) | ||
2 (n = 176) | 1.60 (1.18, 2.19) | 1.58 (1.15, 2.15) | ||
3 (n = 56) | 1.35 (.79, 2.30) | 1.26 (.74, 2.15) | ||
4+ (n = 24) | 1.71 (.84, 3.49) | 1.45 (.71, 2.99) | ||
Medical doctor | ||||
No (n = 189) | 1 | .084 | .080 | |
Yes (n = 1,158) | 1.33 (.95, 1.87) | |||
Physiotherapist | ||||
No (n = 806) | 1 | .299 | .310 | |
Yes (n = 541) | 1.12 (.90, 1.39) | |||
Chiropractor | ||||
No (n = 1,038) | 1 | .041 | 475 | |
Yes (n = 309) | .76 (.58, .99) |