Work ability assessment in prolonged depressive illness

Abstract

Background: Major depressive disorder (MDD) is a complex disease and therefore the assessment of work ability in patients with MDD is complicated. A checklist has been developed to support such assessment.

Aims: To assess the mean score and variation of work ability assessments undertaken by Dutch insurance physicians (IPs) in five real case history vignettes of MDD patients on long-term sick leave, with and without the aid of a checklist.

Methods: In a post-test-only randomized experiment, 25 IPs assessed work ability for five cases on a scale of 0-100 without the use of the checklist, while 21 IPs used the checklist. Differences between groups in mean and absolute variation of work ability were tested with independent t-tests. Intraclass correlation (ICC) analysis was used to determine inter-rater reliability.

Results: When using the checklist, the mean work ability score of all vignettes was 3-12 points higher than without its use. There was no difference in the variation in work ability scores per vignette and between groups. ICC was 0.64 for both groups.

Conclusions: The use of the checklist increased the mean score of work ability but had no effect on the variation in scores between assessors. The inter-rater reliability was moderate, independent of the use of the checklist.