Creation of a core outcome set measures for use in occupational health research

This project aims to develop an internationally agreed core outcome set (outcome measures) for work participation that can be adopted for use in all intervention studies where work participation is an outcome.

Internationally, there is a lack of consensus as to how to best measure various work impacts, such as absenteeism, presenteeism or sustained return to work, in health and work research. Building on consensus from health researchers, the CMHW is now taking the lead in developing an international consensus about which measures should be used in research and clinical practice. This work is being undertaken in partnership with our international collaborators at the Coronel Institute of Occupational Health at Amsterdam UMC, and with colleagues in the OMERACT worker productivity group with an overlapping interest.

Aims

This work comprises of two core aims:

  1. Decide upon an agreed set of core work outcome measures for health and work research

  2. Develop an international consensus as how best to measure these outcomes

What will this research involve?

This research will take a mixed methods approach, with two key stages:

  1. A systematic review of the available literature, in order to identify which key work outcomes are currently being measured

  2. A survey targeting trialists and systematic reviewers, in order to gather feedback on how they currently select outcome measures for their studies, as well as other information regarding the feasibility and suitability of a core outcome measure set

This will be followed up by a consensus building exercise, including voting on the proposed outcome set.

What has the study found so far?

Systematic reviews

From 10,022 database hits, we selected 269 trials reporting on 435 work participation outcomes. The study identified:

  • 70 outcomes that reported on "employment status"

  • 196 that reported "absence from work" and “return-to-work”

  • 132 reported "at-work productivity loss"

  • 7 reported other "employability" outcomes

Variability in measurement methods existed across all categories. Employment status and absenteeism measures consisted mostly of unvalidated tools. "At-work productivity loss" and "employability" were measured by at least 41 different questionnaires.

Survey results

The majority of respondents (86%) selected work participation outcome measures from previous similar studies, and the majority to respondents did not seek feedback from patients in this regard. Feasibility was considered an important factor when selecting a suitable measurement instrument and measurement instruments should be available, easy and quick to administer. Over half (72%) of respondents experienced difficulties when pooling data due to wide variation in follow-up times and cut off points and definitions of work outcomes. The majority (92%) support the use of a Core Outcome Set for Work.

As of July 2022, the consensus exercise has consisted of two international workshops and two rounds of voting. The results are currently being analysed.

Publications

Papers

Conference presentations

  • Ravinskaya, M, Verbeek, JH, Langendam, M,  Madan, I, Verstappen, SMM, Kunz, R, Hoving, JL. Preferred methods of measuring work participation. An international survey among trialists and Cochrane systematic reviewers.  Faculty/Society of Occupational Medicine annual conference (Edinburgh, UK) June 2022.

Study team

Chief investigator
Dr Jan Hoving (Amsterdam UMC)

Co-investigators
Professor Ira Madan (Guy’s and St Thomas’ NHS Trust / King’s College London)
Dr Suzanne Verstappen (University of Manchester)
Margarita Ravinskaya (Amsterdam UMC)
Dr Jos Verbeek (Amsterdam UMC)
Dr Miranda Langendam (Amsterdam UMC)
Professor Regina Kunz (University of Basel)
Professor Carel Hulshof (Amsterdam UMC

Associated research staff
Dr Vaughan Parsons (King’s College London)

Centre institutions

Research partners

Further information

For any queries related to this work, please contact ira.madan@kcl.ac.uk