Evidence map›Paper›PMID 41491901›Full record

ArticleJournal of occupational rehabilitation2026

Machine Learning to Predict Return to Work After Medical Rehabilitation for Musculoskeletal Disorders: A Retrospective Cohort Study.

Mathis Elling, Christian Hetzel, Marco Streibelt, Nadine Sänger, Betje Schwarz, Nico Seifert

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Article in Journal of occupational rehabilitation, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–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.

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

1 citing paper in PubMed.

  1. Article
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.

Mathis EllingInstitute for Quality Assurance in Prevention and Rehabilitation (IQPR), German Sport University Cologne, Eupener Str. 70, 50933, Cologne, Germany. publication@iqpr.de.ORCID http://orcid.org/0000-0002-1402-1860
Christian HetzelInstitute for Quality Assurance in Prevention and Rehabilitation (IQPR), German Sport University Cologne, Eupener Str. 70, 50933, Cologne, Germany.ORCID http://orcid.org/0000-0002-4767-8244
Marco StreibeltDepartment of Rehabilitation Sciences, German Federal Pension Insurance, Berlin, Germany.
Nadine SängerInstitute for Quality Assurance in Prevention and Rehabilitation (IQPR), German Sport University Cologne, Eupener Str. 70, 50933, Cologne, Germany.ORCID http://orcid.org/0009-0000-2529-1543
Betje SchwarzInstitute for Quality Assurance in Prevention and Rehabilitation (IQPR), German Sport University Cologne, Eupener Str. 70, 50933, Cologne, Germany.ORCID http://orcid.org/0000-0001-8467-0164
Nico SeifertDepartment of Rehabilitation Sciences, German Federal Pension Insurance, Berlin, Germany.ORCID http://orcid.org/0000-0002-2348-3485

Funding

German Federal Pension Insurance 0421/40-64-50-91
6 · The paper itself

Abstract

purposeThis study aimed to identify and quantify the contribution of various features and their interactions to the prediction of return to work (RTW) following medical rehabilitation due to musculoskeletal disorders, using a machine learning approach.

methodsThis retrospective cohort study used data from the Rehabilitation Statistics Database (RSD) of the German Pension Insurance. A total of 685,890 individuals who received multimodal medical rehabilitation for musculoskeletal disorders between January 2018 and December 2021 were included. A Light Gradient Boosting Machine (LightGBM) model was trained on 75% of the sample and tested on the remaining 25%. Model predictions were explained using Shapley values to determine the contributions of individual features and their interactions.

resultsOverall, 65.0% of individuals achieved stable RTW. On the test dataset (threshold 0.5), the model achieved an accuracy of 0.815, precision of 0.830, recall of 0.901, and an AUC-ROC of 0.867. The most important predictors of RTW were days in employment, income, incapacity for work at admission, occupational status, duration of incapacity for work, and age. The model also identified interaction effects, including an interaction between postacute rehabilitation and incapacity for work at admission, and an interaction between age and income.

conclusionThe machine learning model demonstrated good predictive performance for RTW after medical rehabilitation for musculoskeletal disorders and confirmed the relevance of established predictors, such as prior employment and incapacity for work. In addition, the analysis identified interactions that are difficult to detect with traditional regression approaches.

Indexed as

Explainable AIMachine learningMedical rehabilitationReturn to work

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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.