return to work coordination programmes for work disability a meta-analysis of randomised controlled trials返回工作协调项目工作残疾随机对照试验的荟萃分析.pdfVIP

Return to Work Coordination Programmes for Work Disability: A Meta-Analysis of Randomised Controlled Trials 1 2 1 1 Stefan Schandelmaier *, Shanil Ebrahim , Susan C. A. Burkhardt , Wout E. L. de Boer , 3 2 2,4 1 Thomas Zumbrunn , Gordon H. Guyatt , Jason W. Busse , Regina Kunz 1 Academy of Swiss Insurance Medicine, University Hospital Basel, Basel, Switzerland, 2 Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada, 3 Clinical Trial Unit, University Hospital Basel, Basel, Switzerland, 4 Department of Anesthesia, McMaster University, Hamilton, Ontario, Canada Abstract Background: The dramatic rise in chronically ill patients on permanent disability benefits threatens the sustainability of social security in high-income countries. Social insurance organizations have started to invest in promising, but costly return to work (RTW) coordination programmes. The benefit, however, remains uncertain. We conducted a systematic review to determine the long-term effectiveness of RTW coordination compared to usual practice in patients at risk for long-term disability. Methods and Findings: Eligible trials enrolled employees on work absence for at least 4 weeks and randomly assigned them to RTW coordination or to usual practice. We searched 5 databases (to April 2, 2012). Two investigators performed standardised eligibility assessment, study appraisal and data extraction independently and in duplicate. The GRADE framework guided our assessment of confidence in the meta-analytic estimates. We identifi