Musculoskeletal Health and Work: Development and Internal–External Cross-Validation of a Model to Predict Risk of Work Absence and Presenteeism in People Seeking Primary Healthcare

Archer, Lucinda; Peat, George; Snell, Kym I. E.; Hill, Jonathan C.; Dunn, Kate M; Foster, Nadine E.; Bishop, Annette; van der Windt, Danielle; Wynne-Jones, Gwenllian

Abstract

Purpose
To develop and validate prediction models for the risk of future work absence and level of presenteeism, in adults seeking primary healthcare with musculoskeletal disorders (MSD).

Methods
Six studies from the West-Midlands/Northwest regions of England, recruiting adults consulting primary care with MSD were included for model development and internal–external cross-validation (IECV). The primary outcome was any work absence within 6 months of their consultation. Secondary outcomes included 6-month presenteeism and 12-month work absence. Ten candidate predictors were included: age; sex; multisite pain; baseline pain score; pain duration; job type; anxiety/depression; comorbidities; absence in the previous 6 months; and baseline presenteeism.

Results
For the 6-month absence model, 2179 participants (215 absences) were available across five studies. Calibration was promising, although varied across studies, with a pooled calibration slope of 0.93 (95% CI: 0.41–1.46) on IECV. On average, the model discriminated well between those with work absence within 6 months, and those without (IECV-pooled C-statistic 0.76, 95% CI: 0.66–0.86). The 6-month presenteeism model, while well calibrated on average, showed some individual-level variation in predictive accuracy, and the 12-month absence model was poorly calibrated due to the small available size for model development.

Conclusions
The developed models predict 6-month work absence and presenteeism with reasonable accuracy, on average, in adults consulting with MSD. The model to predict 12-month absence was poorly calibrated and is not yet ready for use in practice. This information may support shared decision-making and targeting occupational health interventions at those with a higher risk of absence or presenteeism in the 6 months following consultation. Further external validation is needed before the models’ use can be recommended or their impact on patients can be fully assessed.

Citation

Archer, L., Peat, G., Snell, K. I. E., Hill, J. C., Dunn, K. M., Foster, N. E., …Wynne-Jones, G. (2024). Musculoskeletal Health and Work: Development and Internal–External Cross-Validation of a Model to Predict Risk of Work Absence and Presenteeism in People Seeking Primary Healthcare. Journal of Occupational Rehabilitation, https://doi.org/10.1007/s10926-024-10223-w

• Journal Article Type: Article
• Acceptance Date: Jun 22, 2024
• Online Publication Date: Jul 4, 2024
• Publication Date: Jul 4, 2024
• Deposit Date: Jul 16, 2024
• Journal: Journal of Occupational Rehabilitation
• Print ISSN: 1053-0487
• Electronic ISSN: 1573-3688
• Publisher: Springer Verlag
• Peer Reviewed: Peer Reviewed
• DOI: https://doi.org/10.1007/s10926-024-10223-w
• Keywords: Work absence, Musculoskeletal pain, Primary care, Prognosis, Prognostic model
• Public URL: https://keele-repository.worktribe.com/output/872295