Evidence map›Paper›PMID 34999999›Full record

ArticleInternational archives of occupational and environmental health2022

Reforming the workers' compensation process for occupational lung disease among miners in South Africa: an efficiency study of claims assessment.

S Barker, R Ehrlich, J M Spiegel, B Kistnasamy, F Riera, A Fourie, N Mtshali, M Rabada, K Lockhart, A Yassi

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Article in International archives of occupational and environmental health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.6field-weighted citation impact, top 34% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 4 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 5 institutions in 3 countries.

S BarkerSchool of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.
R EhrlichSchool of Public Health and Family Medicine, University of Cape Town, Cape Town, South Africa. rodney.ehrlich@uct.ac.za.ORCID 0000-0001-5736-9237
J M SpiegelSchool of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.
B KistnasamyOffice of the Compensation Commissioner for Occupational Diseases, Johannesburg, South Africa.
F RieraIMC Worldwide Inc., London, UK.
A FourieIP Capital, Centurion, South Africa.
N MtshaliMedical Bureau for Occupational Diseases, Johannesburg, South Africa.
M RabadaMedical Bureau for Occupational Diseases, Johannesburg, South Africa.
K LockhartSchool of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.
A YassiSchool of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.
University of British Columbia · CASouth African Institute for Medical Research · ZAAIR Worldwide (United Kingdom) · GBEducation Labour Relations Council · ZAUniversity of Cape Town · ZA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe large burden of silicosis and tuberculosis (TB) in the South African mining industry, coupled with an under-resourcing of the compensation agencies responsible for certifying occupational lung disease, have resulted in serious backlogs. This work aimed to measure the efficiency gains from triaging occupational lung disease claims using claim type, years of mining exposure and computer aided detection (CAD) to save on scarce medical adjudicators.

methodsDuring 2020, the compensation authority started to triage claims for TB and those of miners with < 10 years of service to two-person panels instead of the four-person panel plus radiologist used previously. Efficiency gain was calculated in medical person-units saved and reduction in delays. Different service thresholds predictive of silicosis were simulated, as well as the impact of pre-classification of chest X-rays with CAD using different combinations of sensitivity and specificity.

resultsThe new triage system saved 20.3% in person-time units and reduced delays by 10-20 days. Without CAD the greatest efficiency gain (28%) was projected from dispensing with a mining service threshold and routing all non-TB claims to the small panels at the outset. Simulation of four different CAD sensitivity/specificity combinations yielded efficiency gains of 18.2-36.1%, with 31.1% judged the most realistic. Use of sensitivity of close to 100% would not be feasible because of the very low resulting specificity.

conclusionPre-adjudication triage of claims at the compensation agency is capable of saving a substantial proportion of adjudicator time and reducing certification delays. Additional efficiency gains are achievable by referring all claims to small panels to begin with and improvement of CAD performance for this ex-miner population.

Indexed as

Lung DiseasesMinersOccupational DiseasesSilicosisTuberculosisHumansSouth AfricaWorkers' CompensationCompensationComputer aided detectionProcess efficiencySilicosisTriageTuberculosis

Identifiers

PMID34999999
OpenAlexW4205205138

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.