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Aim: To present a model that estimates when predictors most accurately predict the remaining duration of certified sickness absence. Methods: A questionnaire was given to 549 patients who were certified sick, and to their doctors. The questionnaires were completed at consultations that occurred from one to 20 weeks after the start of absence. The duration of the episodes of certified sickness absence was provided by the National Sickness Benefit Register. Four separate analyses were performed for self-assessed work ability, diagnoses, age and gender of the patients. The difference between observed remaining duration of the episodes of absence and their estimated expected duration, in percent, served as a measure of predictive accuracy. The improvement of predictive accuracy, compared with a variable that had no association with the outcome (a constructed comparison variable), was estimated for each of the variables of interest, by weeks of consultations. Results: Self-assessed work ability had no improved predictive accuracy in consultations at one week. It was 10% better at eight weeks, reached a maximum of 12% at 13 weeks, and was 10% better at 20 weeks. The predictive accuracy of diagnoses was at its best of 22% in consultations at one week, and at a minimum of 9% better at 11 weeks. The predictive accuracy of age was 7% better at one week, and 10% at 20 weeks. Gender showed no improved predictive accuracy. Conclusions: Self-assessed work ability is most accurate as a predictor in the interval between eight and twenty weeks from the start of absence, diagnoses are most accurate in the first weeks.

norsk epidemiologi

To ask the right question at the right time: When is the patient's self-assessed work ability most accurate as a predictor of the remaining duration of certified sickness absence?