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Trusted evidence. Informed decisions. Better health.
February 2017
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Low agreement between medical experts in work disability assessment – a systematic review published in the BMJ 

A group of European and Canadian researchers explored agreement among healthcare professionals when assessing claimants with ill health for work disability benefits. They carried out a systematic review of 23 studies, conducted between 1992-2016, from 12 countries in Europe, North America, Australia, the Middle East, and northeast Asia.

In 63% (10/16) of studies, medical experts reached only low to moderate agreement in their judgement of capacity to work. The results also show that higher agreement was strongly associated with the use of a standardised approach to guide judgment.
Read the article…

Return to work after cancer - EU-OSHA review
A year ago EU OSHA started a large project to collect available evidence from the literature, from experts, and practice on politically important topics. One of these topics is ‘how to get cancer patients back to work’. Each project will first produce a review of the literature.
The first one titled ‘Rehabilitation and return to work after cancer: Literature review’ has been published recently.
Practice guideline for management of lower back pain
Just published: The new practice guideline of the management of acute, sub-acute, and chronic low back pain (American College of Physicians) reports on reduction in work disability and return to work as outcomes. The committee based its recommendations on systematic reviews of randomized, controlled trials and systematic reviews on non-invasive pharmacologic and non-pharmacologic treatments for low back pain.
Risk assessment - new section with reviews on Evidence on the Web 
Risk assessment is a core task of insurance physicians in the private sector when dealing with life, health, disability insurance. Using long-term adverse treatment effects of breast and testicular cancer’ as topic, we developed a concept on how to find systematic reviews about risk assessment. After identifying appropriate search terms and screening 120 search results we found four reviews which met the inclusion criteria. We will advance our concept to cover reviews about risk assessment from other topics
No Cochrane Colloquium in 2017
The Global Evidence Summit (13-17 September 2017) will be the first time that Cochrane, The Campbell Collaboration, Guidelines-International Network, International Society for Evidence-based Health Care, and Joanna Briggs Institute have joined forces to create the premiere event in evidence-based policy. 
The event aims to advance the use of reliable research evidence in addressing some of the world’s most serious health and social challenges.
Cochrane Insurance Medicine Research
Outcomes relevant for insurance medicine - an evaluation of the literature 
Several research institutes affiliated with Cochrane Insurance Medicine recently evaluated the literature for outcomes relevant to the field of insurance medicine to identify research gaps and recommend actions on a national or international level. Three recently completed initiatives will inform a new project to develop an international core outcome set on work participation.
Training and knowledge needs in Dutch insurance physicians 
Insurance physicians in the Netherlands are familiar with Cochrane Insurance Medicine and believe that it will contribute to a sound evidence base in insurance medicine. Many would like to underpin their disability assessments with more evidence. However, they reported a need for more knowledge and skills to better understand and apply the results of systematic reviews in individual assessments. In a recently published article, researchers explored awareness of, interest in and willingness to contribute to Cochrane Insurance Medicine among 85 Dutch insurance physicians and medical advisors. For more reading: english abstract or original Dutch article.
Evidence on the Web
More reviews about prognosis on Evidence on the Web

On our website ‘Evidence on the Web’ we are continuously gathering evidence that can support the work of professionals working in insurance medicine. Recently we have been looking for reviews about prognosis and risk assessment and have added nine systematic reviews – five on prognosis and four on risk assessment.
If you would like to suggest articles that match our inclusion criteria, please contact Rebecca Weida.
  • Detaille, S. I., et al. (2009). "Common prognostic factors of work disability among employees with a chronic somatic disease: a systematic review of cohort studies." Scand J Work Environ Health 35(4): 261-281.
  • Donker-Cools, B. H., et al. (2015). "Prognostic factors of return to work after traumatic or non-traumatic acquired brain injury." Disabil Rehabil: 1-9. 
  • Shi, Q., et al. (2014). "A systematic review of prognostic factors for return to work following work-related traumatic hand injury." J Hand Ther 27(1): 55-62; quiz 62.
  • Steenstra, I. A., et al. (2016). "Systematic Review of Prognostic Factors for Return to Work in Workers with Sub Acute and Chronic Low Back Pain." J Occup Rehabil.1-13.
  • van Velzen, J. M., et al. (2009). "How many people return to work after acquired brain injury?: a systematic review." Brain Inj 23(6): 473-488. 
Risk Assessment
  • Abouassaly, R., et al. (2011). "Sequelae of treatment in long-term survivors of testis cancer." Eur Urol 60(3): 516-526.
  • Goodwin, A., et al. (2009). "Post-operative radiotherapy for ductal carcinoma in situ of the breast--a systematic review of the randomised trials." Breast 18(3): 143-149.
  • Rutqvist, L. E., et al. (2003). "A systematic overview of radiation therapy effects in breast cancer." Acta Oncol 42(5-6): 532-545.
  • Zhang, X., et al. (2014). "Effect and safety of dual anti-human epidermal growth factor receptor 2 therapy compared to monotherapy in patients with human epidermal growth factor receptor 2-positive breast cancer: a systematic review." BMC Cancer 14: 625
On a final note...
CIM contributor Bert Cornelius captured one of the needs in insurance medicine in a comic...
Please circulate this newsletter to your colleagues and friends.
Our next newsletter will be published in May 2017.

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Cochrane Insurance Medicine · EbIM Research & Education / University Hospital Basel · Spitalstr. 8+12 · Basel 4031 · Switzerland

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