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International Archives of Occupational and Environmental Health
Published in: International Archives of Occupational and Environmental Health 8/2015

Open Access 01-11-2015 | Original Article

Risk reclassification analysis investigating the added value of fatigue to sickness absence predictions

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

Published in: International Archives of Occupational and Environmental Health | Issue 8/2015

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Abstract

Background

Prognostic 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.

Methods

This 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.

Results

In 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.

Conclusion

In the present study, fatigue increased false-positive rates which may reduce the cost-effectiveness of interventions for preventing SA.
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Metadata
Title
Risk reclassification analysis investigating the added value of fatigue to sickness absence predictions
Authors
Corné A. M. Roelen
Ute Bültmann
Johan W. Groothoff
Jos W. R. Twisk
Martijn W. Heymans
Publication date
01-11-2015
Publisher
Springer Berlin Heidelberg
Published in
International Archives of Occupational and Environmental Health / Issue 8/2015
Print ISSN: 0340-0131
Electronic ISSN: 1432-1246
DOI
https://doi.org/10.1007/s00420-015-1032-3

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