Evidence map›Paper›PMID 35216560›Full record

Trial reportBMC public health2022

What is the effect of independent medical evaluation on days on sickness benefits for long-term sick listed employees in Norway? A pragmatic randomised controlled trial, the NIME-trial.

Silje Mæland, Tor Helge Holmås, Irene Øyeflaten, Elisabeth Husabø, Erik L Werner, Karin Monstad

Registry-linked trialAbstract readPragmatic Clinical TrialRandomized Controlled Trial
In one paragraph

Trial report in BMC public health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02524392 (Effect Evaluation of Independent Medical Evaluation), which is not on this map. Cited by 1 paper, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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.

NCT02524392 nacompletednot on this map

Effect Evaluation of Independent Medical Evaluation (IME) After Six Months Sick Leave: A Randomized Controlled Trial of Independent Medical Evaluation (IME) Versus Treatment as Usual in Norway

TypeinterventionalSponsorNORCE Norwegian Research Centre ASRan2015 to 2018Enrolled7,642ConditionsAll International Classification of Primary Care 2 DiagnosesArmsIndependent medical evaluation
3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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

6 authors.

Silje MælandResearch Unit for General Practice, NORCE Norwegian Research Centre, Bergen, Norway. silje.maeland@uib.no.
Tor Helge HolmåsNORCE Norwegian Research Centre, Health and Social Sciences, Bergen, Norway.
Irene ØyeflatenNORCE Norwegian Research Centre, Health and Social Sciences, Bergen, Norway.
Elisabeth HusabøRKBU West, NORCE Norwegian Research Centre, Bergen, Norway.
Erik L WernerDepartment of General Practice, Institute of Health and Society, Faculty of medicine, University of Oslo, Oslo, Norway.
Karin MonstadNORCE Norwegian Research Centre, Health and Social Sciences, Bergen, Norway.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIndependent medical evaluations are used to evaluate degree and reason for work disability, uncertainty around the functional status, and/or the employee's rehabilitation potential in several jurisdictions, but not in Norway. The main aim of this trial was to test the return to work effect of independent medical evaluation (IME) (summoning and consultation) compared to treatment as usual (TAU) in Norway, for workers who have been on continuous sick leave for 6 months.

methodsThis was a pragmatic randomised controlled trial including all employees aged 18-65 years, sick-listed by their general practitioner and on full or partial sick leave for the past 26 weeks in Hordaland County, Norway in 2015/16. Trial candidates were drawn from a central register at the Norwegian Labour and Welfare Administration at 22 weeks of sick leave. Pregnant women, individuals with cancer or dementia diagnoses, those with secret address, employed by NAV or sick listed by the specialist health services were excluded. Separate regression analyses were conducted to investigate the "intention-to-treat" and "treatment on the treated" effects, using the ordinary least squares and instrumental variable methods, respectively.

resultsAfter exemption based on predefined exclusion criteria, 5888 individuals were randomised to either IME (n = 2616) or TAU (n = 2599). The final intervention group constitutes 1698 individuals, of which 937 attended the IME consultation. No baseline differences were found between the IME and TAU group regarding gender, age, and previous sick leave. Individuals attending the IME were older than those who cancelled the appointment ((47/45), p = 0.006) and those who did not show up without cancelling ((47/42), p < 0.001). Mainly the IME physician agreed with the regular GP upon level of sick leave. In cases with different assessments, the difference tended to be towards a lower sick leave level. There were no intention to treat or treatment on the treated effect on days of sick leave after randomisation during follow up.

conclusionsOverall, the analyses showed no effect of IME on changes in sick leave for sick listed employees. This result was consistent for those who were offered an IME consultation (intention to treat) and those who undertook an IME consultation (treatment on the treated).

trial registrationClinicalTirals.gov trial number NCT02524392 first registration 14.08.2015.

Indexed as

General PractitionersIndependent Medical EvaluationPersons with DisabilitiesAdolescentAdultAgedFemaleHumansMiddle AgedNorwayPregnancySick LeaveYoung AdultIndependent medical examinationInjured workersInsurance medicineReturn to workSick leave

Identifiers

PMID35216560
PMCPMC8881877

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

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.