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  • Which outcomes should always be measured in intervention studies for improving work participation for people with a health problem? An international multistakeholder Delphi study to develop a core outcome set for Work participation (COS for Work)

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Occupational and environmental medicine
Original research
Which outcomes should always be measured in intervention studies for improving work participation for people with a health problem? An international multistakeholder Delphi study to develop a core outcome set for Work participation (COS for Work)
  1. Margarita Ravinskaya1,
  2. Jos H Verbeek1,
  3. Miranda Langendam2,
  4. Ira Madan3,4,
  5. Suzanne M.M. Verstappen5,6,7,
  6. Regina Kunz8,
  7. Carel T.J. Hulshof9,
  8. Jan L. Hoving1
  9. Delphi participants
    1. 1Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam Public Health Research Institute, Cochrane Work, Amsterdam UMC Location AMC, University of Amsterdam, Amsterdam, The Netherlands
    2. 2Department Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC Location AMC, University of Amsterdam, Amsterdam, The Netherlands
    3. 3Guy's and St Thomas' NHS Foundation Trust, London, UK
    4. 4King's College London Faculty of Life Sciences and Medicine, London, UK
    5. 5Centre for Epidemiology Versus Arthritis, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
    6. 6Manchester University NHS Foundation Trust, NIHR Manchester Biomedical Research Centre, Manchester, UK
    7. 7MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton, Southampton, UK
    8. 8Research Unit EbIM, Evidence Based Insurance Medicine, Division of Clinical Epidemiology, University Hospital Basel, Basel, Switzerland
    9. 9Department of Public and Occupational Health, Coronel Institute of Occupational Health, Amsterdam UMC Location AMC, University of Amsterdam, Amsterdam, The Netherlands
    1. Correspondence to Margarita Ravinskaya; m.ravinskaya{at}amsterdamumc.nl

    Abstract

    Objective Synthesising evidence of the effects of interventions to improve work participation among people with health problems is currently difficult due to heterogeneity in outcome measurements. A core outcome set for work participation is needed.

    Study design and setting Following the Core Outcome Measures in Effectiveness Trials methodology, we used a five-step approach to reach international multistakeholder consensus on a core outcome set for work participation. Five subgroups of stakeholders took part in two rounds of discussions and completed two Delphi voting rounds on 26 outcomes. A consensus of ≥80% determined core outcomes and 50%–80% consensus was required for candidate outcomes.

    Results Fifty-eight stakeholders took part in the Delphi rounds. Core outcomes were: ‘any type of employment including self-employment’, ‘proportion of workers that return to work after being absent because of illness’ and ‘time to return to work’. Ten candidate outcomes were proposed, among others: ‘sustainable employment’, ‘work productivity’ and ‘workers’ perception of return to work’.

    Conclusion As a minimum, all studies evaluating the impact of interventions on work participation should include one employment outcome and two return to work outcomes if workers are on sick leave prior to the intervention.

    • occupational & industrial medicine
    • public health
    • rehabilitation medicine
    • statistics & research methods

    Data availability statement

    All data relevant to the study are included in the article or uploaded as online supplemental information.

    https://creativecommons.org/licenses/by/4.0/

    This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.

    http://dx.doi.org/10.1136/bmjopen-2022-069174

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      Data availability statement

      All data relevant to the study are included in the article or uploaded as online supplemental information.

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      Footnotes

      • Collaborators Delphi participants: Aasdahl, Lene (NO); Anema, Johannes (NL); Berkowitz, Debbie (US); Bethge, Matthias (DE); Bühler, Jonas (CTJH); Bültmann, Ute (NL); Böckerman, Petri (FI); Coons, Trevor (US); Curti, Stefania (IT); Crosse, Caroline (AU); de Boer, Angela (NL); Dorstyn, Diana (AU); Foster, Nadine (AU); Friberg, Emilie (SE); Gehanno, Jean Francois (FR); Godderis, Lode (BE); Goodson, Nicola (UK); Graveline, Christine (CA); Gross, Douglas (CA); Hara, Karen Walseth (NO); Hannu, Timo (FI); Hoff, Andreas (DK); Hensing, Gunnel (SE); Hegewald, Janice (DE); Hoorntje, Alexander (NL); Janssen, Svenja (NL); Lacaille, Diane (CA); Lam, Raymond (CA); Landsbergis, Paul (US); Luiza Comper, Maria (BR); Lytsy, Per (SE); Macfarlane, Gary (UK); Mantis, Steve (CA); Merry, Kohle (CA); Meyers, Alysha (US); Neupane, Subas (FI); Nygård, Clas-Hakan (FI); Oyeflaten, Irene Larsen (NO); Pingle, Shyam (IN); Prior, Yeliz (UK); Schaafsma, Frederieke (NL); Samant, Yogindra (NO); Shaw, William (US); Snyder, Alexis (US); Steenstra, Ivan (CA); Sturkenboom, Ingrid (NL); Suijkerbuijk, Yvonne (NL); Tsutsumi, Akizumi (JP); Urquhart, Donna (AU); van Ee, Ilse (NL); van Zaanen, Yvonne (NL); Yamaguchi, Sosei (JP); Zhang, Wei (CA); Walker Bone, Karen (UK).

      • Contributors MR, JH, JHV, RK, CTJH, ML, IM and SV contributed to the conception, the study design and the execution of the Delphi. MR and JH tested the DelphiManager software prior to the first Delphi round. MR and JHV analysed the data. MR and JH assessed data quality. MR drafted the first version of the manuscript and the minor revisions, and JH, JHV, RK, CTJH, ML, IM and SV contributed to the review and the editing process. JH is the guarantor of the publication.

      • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors. SV is supported by Versus Arthritis (grant numbers 20385, 20380) and the NIHR Manchester Biomedical Research Centre.

      • Competing interests None declared.

      • Patient and public involvement Patients and/or the public were involved in the design, or conduct, or reporting, or dissemination plans of this research. Refer to the Methods section for further details.

      • Provenance and peer review Not commissioned; externally peer reviewed.

      • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.