Risk reclassification analysis investigating the added value of fatigue to sickness absence predictionsReport as inadecuate




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International Archives of Occupational and Environmental Health

, Volume 88, Issue 8, pp 1069–1075

First Online: 22 February 2015Received: 04 October 2014Accepted: 04 February 2015

Abstract

BackgroundPrognostic models including age, self-rated health and prior sickness absence SA have been found to predict high ≥30 SA days and high ≥3 SA episodes during 1-year follow-up. More predictors of high SA are needed to improve these SA prognostic models. The purpose of this study was to investigate fatigue as new predictor in SA prognostic models by using risk reclassification methods and measures.

MethodsThis was a prospective cohort study with 1-year follow-up of 1,137 office workers. Fatigue was measured at baseline with the 20-item checklist individual strength and added to the existing SA prognostic models. SA days and episodes during 1-year follow-up were retrieved from an occupational health service register. The added value of fatigue was investigated with Net Reclassification Index NRI and integrated discrimination improvement IDI measures.

ResultsIn total, 579 51 % office workers had complete data for analysis. Fatigue was prospectively associated with both high SA days and episodes. The NRI revealed that adding fatigue to the SA days model correctly reclassified workers with high SA days, but incorrectly reclassified workers without high SA days. The IDI indicated no improvement in risk discrimination by the SA days model. Both NRI and IDI showed that the prognostic model predicting high SA episodes did not improve when fatigue was added as predictor variable.

ConclusionIn the present study, fatigue increased false-positive rates which may reduce the cost-effectiveness of interventions for preventing SA.

KeywordsAbsenteeism Prediction models Reclassification table Risk distribution Risk stratification Sick leave  Download fulltext PDF



Author: Corné A. M. Roelen - Ute Bültmann - Johan W. Groothoff - Jos W. R. Twisk - Martijn W. Heymans

Source: https://link.springer.com/



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