• Anna-Sophia von Celsing, Kurt Svärdsudd, and Thorne Wallman.
• Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine Section, Uppsala University , Uppsala , Sweden.
• Ups. J. Med. Sci. 2014 Aug 1; 119 (3): 268277268-77.

AimThe purpose was to analyse the properties of two models for the assessment of return to work after sickness certification, a manual one based on clinical judgement including non-measurable information ('gut feeling'), and a computer-based one.Study PopulationAll subjects aged 18 to 63 years, sickness-certified at a primary health care centre in Sweden during 8 months (n = 943), and followed up for 3 years.MethodsBaseline information included age, sex, occupational status, sickness certification diagnosis, full-time or part-time current sick-leave, and sick-leave days during the past year. Follow-up information included first and last day of each occurring sick spell. In the manual model all subjects were classified, based on baseline information and gut feeling, into a high-risk (n = 447) or a low-risk group (n = 496) regarding not returning to work when the present certificate expired. It was evaluated with a Cox's analysis, including time and return to work as dependent variables and risk group assignment as the independent variable, while in the computer-based model the baseline variables were entered as independent variables.ResultsConcordance between actual return to work and return to work predicted by the analysis model was 73%-76% during the first 28-180 days in the manual model, and approximately 10% units higher in the computer-based model. Based on the latter, three nomograms were constructed providing detailed information on the probability of return to work.ConclusionThe computer-based model had a higher precision and gave more detailed information than the manual model.

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