Current research projects
Basel Fairness Questionnaire
There are some anecdotic reports that claimants for disability benefits sometimes consider themselves unfairly treated during work disability evaluations. In such cases, claimants might miss an atmosphere of trust and respect or the medical expert might not let them finish talking. Perceived fairness has yet not been systematically studied in Swiss work disability evaluations. For this purpose, we developed the Basel Fairness Questionnaire (BFQ). In a first study on 305 claimants, we found that only few of them perceived the work disability evaluation as unfair. However, this initial finding needs to be interpreted with some caution, as only 4 out of 29 Swiss assessment centers participated in the study. For future studies, we plan to compare mono-, bi-, and polydisciplinary work disability evaluations, as well as different medical disciplines.
Research group: Regina Kunz, Wout de Boer, Brigitte Walter Meyer, Regine Lohss, Timm Rosburg, Katrin Fischer
References:
Lohss R, Bachmann MS, B WM, de Boer W, K F, Kunz R. What are the concerns of claimants who underwent a disability assessment? – A case study. TBV–Tijdschrift voor Bedrijfs-en Verzekeringsgeneeskunde. 2018 26(7):358-63. https://doi.org/10.1007/s12498-018-0246-1
Lohss R, Rosburg T, Bachmann M, Meyer BW, de Boer W, Fischer K, et al. Perceived fairness of claimants undergoing a work disability evaluation: Development and validation of the Basel Fairness Questionnaire. PloS One. 2020 15(9):e0238930. https://doi.org/10.1371/journal.pone.0238930
Rosburg T, Lohss R, Bachmann MS, Walter Meyer B, de Boer W, Fischer K, et al. Basler Fairness Fragebogen (BFF): Erlebte Fairness der Begutachtung. Suva Medical 2021. (3). https://www.suva.ch/de-ch/unfall/fuer-leistungserbringer/suva-medical/publikationen/2021/maerz/2021-suva-medical-artikel-03-basler-fairness-fragebogen
Content analysis RELY: Implementation of the function-oriented interview in psychiatric assessment
Functional interviewing is a structured dialogue between the independent medical expert and the claimant where the claimant reports on his work which he cannot perform any longer and where he explains what kind of health impairments prevent him from working. Since each psychiatrist has developed a personal style to explore a patient or claimant, psychiatrists need to find their own way of integrating this interviewing technique into this style. In the RELY studies, we trained psychiatric evaluators to conduct the function-oriented interview and videotaped conversations. In two follow-up studies for RELY1 and 2, we use the audio recordings to examine how the psychiatrists implemented the specifications for the function-oriented interview in their conversations. Using a coding system, two raters independently rate the implementation of the specifications from the training.
Research group: Wout de Boer, David von Allmen, Regina Kunz, Timm Rosburg
Publications: von Allmen DY, Kedzia S, Dettwiler R, Vogel N, Kunz R, de Boer WEL. Functional interviewing was associated with improved agreement among expert psychiatrists in estimating claimant work capacity: A secondary data analysis of real-life work disability evaluations. Frontiers in Psychiatry. 2020;11(621). https://doi.org/10.3389/fpsyt.2020.00621
Mini-ICF APP in medical work disability evaluations
The Mini-ICF-APP is a rating instrument that allows standardised classification of functioning and disability in adults with mental health disorders (Linden et al., 2009). It encompasses ratings of thirteen functional domains, such as endurance or group integration. Since 2010, MEDAS Zentralschweiz (Lucerne) has been using the Mini-ICF-APP in polydisciplinary work disability evaluations for claimants with mental health disorders. In the current study, we investigated the association between the estimated residual work capacity and the Mini-ICF-APP ratings. In this context, we also analysed differences in the Mini-ICF-APP ratings between different mental health disorders.
Research group: Timm Rosburg, Regina Kunz, Urban Schwegler, Bruno Trezzini, Jörg Jeger
References: Rosburg T, Kunz R, Trezzini B, Schwegler U, Jeger J. The assessment of capacity limitations in psychiatric work disability evaluations by the social functioning scale Mini-ICF-APP. BMC Psychiatry. 2021;21(1):480. https://rdcu.be/c5AAt
Patient centeredness in psychiatric work disability evaluations
In patient centred approaches, the relationship between clinician and patient is considered as partnership, characterized by trust and caring. The concept of patient centeredness has gained considerable importance in clinical medicine also because of favourable effects on patient outcomes, like adherence to therapy. In contrast, the concept is yet poorly considered in the field of medical work disability evaluations. We analysed (a) to what extent interviews conducted in psychiatric work disability evaluations showed characteristics of patient centeredness and (b) whether higher levels of patient centeredness were associated with a better interrater agreement of work capacity (WC) estimates as favourable outcome. For this purpose, interviews conducted in psychiatric work disability evaluations were video-taped and their contents were categorized according to the Roter Interaction Analysis System (RIAS).
Research group: Timm Rosburg, Regina Kunz, Wolfgang Langewitz, David von Allmen, Wout de Boer, Sabina Hunziker, Ed Bunker
Publications: Rosburg T, von Allmen DY, Langewitz H, Weber H, Bunker EB, Langewitz W. Patient centeredness in psychiatric work disability evaluations and reproducibility of work capacity estimates. Patient Educ Couns. 2024; 119:108093. doi: 10.1016/j.pec.2023.108093.
Development of a Core Outcome Set for Work Participation (COS-WP)
In the field of insurance medicine and occupational health ‘work participation’ is frequently used as an umbrella term. Several outcomes are linked to ‘work participation’ as a concept and the instruments to measure these outcomes differ. Lack of standardization in outcome measurement and reporting greatly hinders the synthesis of research and, consequently, hampers decision making at the cost of the best possible treatment and social medical guidance for workers. The project aims to develop a universally applicable and broadly agreed COS for work participation that should be used when conducting RCTs and systematic reviews so that we can achieve the best possible treatment and social medical guidance for our clients. PI of this project is Jan Hoving (Amsterdam UMC).
Research group: Jan Hoving (PI), Margarita Ravinskaya, Jos H. Verbeek, Miranda Langendam, Regina Kunz, Suzanne Verstappen, Ira Madan, Carel Hulshof
References: Ravinskaya M, Verbeek JH, Langendam M, Daams JG, Hulshof CTJ, Madan I, et al. Extensive variability of work participation outcomes measured in randomized controlled trials: a systematic review. Journal of Clinical Epidemiology. 2022 142:60-99.
More: Core Outcome Set for Work Participation
Digitally-assisted Standard Diagnostics in Insurance Medicine (DASDIM): Psychometric data in work disability evaluations
Digitally-assisted Standard Diagnostics in Insurance Medicine (DASDIM, in German: Versicherungsmedizinische Standarddiagnostik, VSD) incorporates a number of well-established instruments for quantifying various fundamental aspects that are relevant for the work disability evaluation, including mental health, cognition, personality, resilience, and work-related behaviour. The DASDIM is accessible via a user-friendly computer interface and allows for an automated analysis of conducted tests. We propagate that the DASDIM can fundamentally increase the transparency and objectivity of work disability evaluations. Moreover, the DASDIM allows for conducting systematic studies in insurance medicine, namely by collecting quantitative, objective, and standardized data. PI of this project is Ralph Mager (University Basel).
Research group: Ralph Mager (PI), Timm Rosburg, Gunnar Deuring, Gerhard Ebner, Valerie Hauch, Rolf Stieglitz, Pasquale Calabrese, Hennric Jokeit, Yvonne Bollag
Publications: Rosburg T, Deuring G, Ebner G, Hauch V, Pflueger MO, Stieglitz RD, Calabrese P, Schaub B, Cotar T, Jabat M, Jokeit H, Bollag Y, Mager R. Digitally Assisted Standard Diagnostics in Insurance Medicine (DASDIM): psychometric data in psychiatric work disability evaluations. Disabil Rehabil. 2022; 15:1-14. https://doi.org/10.1080/09638288.2022.2151655
Early prediction of disease course in injured patients with neuropathic pain based on analgesia usage and other claims data: a retrospective analysis
Identifying contextual factors that influence Return-to Work (RTW) outcomes in intervention trials: the development of a country reporting card
Background: The effect of intervention studies in the field of insurance medicine and occupational health are highly influenced by contextual factors such as legal and compensation system, health care and social security system, employer-related factors that are frequently not reported e.g. in the control group or the settings section. For example, the return-to-work (RTW) rate in distinct geographical regions may be highly influenced by differences in job opportunities or rates of unemployment. It therefore requires full reporting of such contextual factors in the study reports to allow appropriate interpretation of the study results and appropriate judgments on transferability and implementation.
Purpose: To improve transferability of study results of interventions in the field of insurance medicine and occupational health across distinct contexts.
Aim the study: Developing a Country reporting card to identify potentially relevant factors that may impact on the effectiveness of RTW interventions and develop a reporting sheet for authors to describe in sufficient details in methods and context.
Research group: Maurizio Trippolini, Regina Kunz, Jan Hoving
Publications: Planned