The perceived importance of prognostic aspects considered by physicians during work disability evaluation: a survey

Abstract

Background: Assessing prognosis is challenging for many physicians in various medical fields. Research shows that physicians who perform disability assessments consider six areas when evaluating a prognosis: disease, treatment, course of the disease, external information, patient-related and physician-related aspects. We administered a questionnaire to evaluate how physicians rate the importance of these six prognosis areas during work disability evaluation and to explore what kind of support they would like during prognosis assessment. Methods: Seventy-six physicians scored the importance of 23 prognostic aspects distributed over six prognosis areas. Participants scored the importance of each aspect both “in general” and from the perspective of a case vignette of a worker with a severe degenerative disease. The questionnaire also covered needs and suggestions for support during the evaluation of prognoses. Results: Medical areas that are related to the disease, or the treatment or course of the disease, appeared important (scores of 7.0–9.0), with less differing opinions among participants (IQR 1.0–3.0). Corresponding verbatim remarks supported the importance of disease and treatment as prognostic aspects. In comparison, patient- and physician-related aspects scored somewhat lower, with more variability (range 4.0–8.0, with IQR 2.0–5.0 for patient- and physician-related considerations). Participants indicated a need for a tool or online database that includes prognostic aspects and prognostic evidence. Conclusions: Despite some variation in scores, the physicians rated all six prognosis areas as important for work disability evaluations. This study provides suggested aids to prognosis assessment, including an online support tool based on evidence-based medicine features.